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Erschienen in: Pediatric Radiology 12/2023

14.09.2023 | Pictorial Essay

Medial meniscal posterior horn tears and ramp lesions in pediatric patients: lessons learned

verfasst von: Rida Salman, Matthew G. Ditzler, Siddharth P. Jadhav, Erica K. Schallert, Scott D. McKay, J. Herman Kan

Erschienen in: Pediatric Radiology | Ausgabe 12/2023

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Abstract

Meniscal injuries are increasingly reported in pediatric patients due to early sports participation and are commonly encountered during anterior cruciate ligament reconstruction. Preoperative identification of meniscal tears is crucial, particularly when involving the posteromedial meniscocapsular junction (ramp lesion). MRI plays an important role in detecting this particular type of meniscal injury. Consequently, pediatric radiologists should be aware of particular MRI findings related to ramp lesions including the presence of a medial meniscal tear, peripheral meniscal irregularity, meniscocapsular junctional fluid-like signal intensity, and capsular ligament tears. Thus, we illustrate the lessons we have learned from our institutional multidisciplinary arthroscopic-MR correlation conference for retrospectively identified posterior horn medial meniscal tears and ramp lesions.

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Literatur
1.
Zurück zum Zitat Vinagre G, Cruz F, Alkhelaifi K, D’Hooghe P (2022) Isolated meniscus injuries in skeletally immature children and adolescents: state of the art. J ISAKOS 7:19–26CrossRefPubMed Vinagre G, Cruz F, Alkhelaifi K, D’Hooghe P (2022) Isolated meniscus injuries in skeletally immature children and adolescents: state of the art. J ISAKOS 7:19–26CrossRefPubMed
2.
Zurück zum Zitat Jackson T, Fabricant PD, Beck N et al (2019) Epidemiology, injury patterns, and treatment of meniscal tears in pediatric patients: a 16-year experience of a single center. Orthop J Sports Med 7:2325967119890325PubMedPubMedCentral Jackson T, Fabricant PD, Beck N et al (2019) Epidemiology, injury patterns, and treatment of meniscal tears in pediatric patients: a 16-year experience of a single center. Orthop J Sports Med 7:2325967119890325PubMedPubMedCentral
3.
Zurück zum Zitat Bouju Y, Carpentier E, Bergerault F et al (2011) The concordance of MRI and arthroscopy in traumatic meniscal lesions in children. Orthop Traumatol Surg Res 97:712–718CrossRefPubMed Bouju Y, Carpentier E, Bergerault F et al (2011) The concordance of MRI and arthroscopy in traumatic meniscal lesions in children. Orthop Traumatol Surg Res 97:712–718CrossRefPubMed
4.
Zurück zum Zitat Samora WP 3rd, Palmer R, Klingele KE (2011) Meniscal pathology associated with acute anterior cruciate ligament tears in patients with open physes. J Pediatr Orthop 31:272–276CrossRefPubMed Samora WP 3rd, Palmer R, Klingele KE (2011) Meniscal pathology associated with acute anterior cruciate ligament tears in patients with open physes. J Pediatr Orthop 31:272–276CrossRefPubMed
5.
Zurück zum Zitat Laurens M, Cavaignac E, Fayolle H et al (2022) The accuracy of MRI for the diagnosis of ramp lesions. Skeletal Radiol 51:525–533CrossRefPubMed Laurens M, Cavaignac E, Fayolle H et al (2022) The accuracy of MRI for the diagnosis of ramp lesions. Skeletal Radiol 51:525–533CrossRefPubMed
6.
Zurück zum Zitat Nguyen JC, Bram JT, Lawrence JTR et al (2021) MRI criteria for meniscal ramp lesions of the knee in children with anterior cruciate ligament tears. AJR Am J Roentgenol 216:791–798CrossRefPubMed Nguyen JC, Bram JT, Lawrence JTR et al (2021) MRI criteria for meniscal ramp lesions of the knee in children with anterior cruciate ligament tears. AJR Am J Roentgenol 216:791–798CrossRefPubMed
7.
Zurück zum Zitat Stephen JM, Halewood C, Kittl C et al (2016) Posteromedial meniscocapsular lesions increase tibiofemoral joint laxity with anterior cruciate ligament deficiency, and their repair reduces laxity. Am J Sports Med 44:400–408CrossRefPubMed Stephen JM, Halewood C, Kittl C et al (2016) Posteromedial meniscocapsular lesions increase tibiofemoral joint laxity with anterior cruciate ligament deficiency, and their repair reduces laxity. Am J Sports Med 44:400–408CrossRefPubMed
8.
Zurück zum Zitat Gans I, Bedoya MA, Ho-Fung V, Ganley TJ (2015) Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges? Pediatr Radiol 45:194–202CrossRefPubMed Gans I, Bedoya MA, Ho-Fung V, Ganley TJ (2015) Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges? Pediatr Radiol 45:194–202CrossRefPubMed
9.
Zurück zum Zitat Yeo Y, Ahn JM, Kim H et al (2018) MR evaluation of the meniscal ramp lesion in patients with anterior cruciate ligament tear. Skeletal Radiol 47:1683–1689CrossRefPubMed Yeo Y, Ahn JM, Kim H et al (2018) MR evaluation of the meniscal ramp lesion in patients with anterior cruciate ligament tear. Skeletal Radiol 47:1683–1689CrossRefPubMed
10.
Zurück zum Zitat Bryceland JK, Powell AJ, Nunn T (2017) Knee menisci: structure, function, and management of pathology. Cartilage 8:99–104CrossRefPubMed Bryceland JK, Powell AJ, Nunn T (2017) Knee menisci: structure, function, and management of pathology. Cartilage 8:99–104CrossRefPubMed
13.
Zurück zum Zitat Strobel MJ (1998) Menisci. In: Fett HM, Flechtner P (eds) Manual of Arthroscopic Surgery. Springer, New York, NY, pp 171–178 Strobel MJ (1998) Menisci. In: Fett HM, Flechtner P (eds) Manual of Arthroscopic Surgery. Springer, New York, NY, pp 171–178
14.
Zurück zum Zitat Chahla J, Dean CS, Moatshe G et al (2016) Meniscal ramp lesions: anatomy, incidence, diagnosis, and treatment. Orthop J Sports Med 4:2325967116657815PubMedPubMedCentral Chahla J, Dean CS, Moatshe G et al (2016) Meniscal ramp lesions: anatomy, incidence, diagnosis, and treatment. Orthop J Sports Med 4:2325967116657815PubMedPubMedCentral
15.
Zurück zum Zitat Sonnery-Cottet B, Conteduca J, Thaunat M et al (2014) Hidden lesions of the posterior horn of the medial meniscus: a systematic arthroscopic exploration of the concealed portion of the knee. Am J Sports Med 42:921–926CrossRefPubMed Sonnery-Cottet B, Conteduca J, Thaunat M et al (2014) Hidden lesions of the posterior horn of the medial meniscus: a systematic arthroscopic exploration of the concealed portion of the knee. Am J Sports Med 42:921–926CrossRefPubMed
16.
Zurück zum Zitat DePhillipo NN, Moatshe G, Chahla J et al (2019) Quantitative and qualitative assessment of the posterior medial meniscus anatomy: defining meniscal ramp lesions. Am J Sports Med 47:372–378CrossRefPubMed DePhillipo NN, Moatshe G, Chahla J et al (2019) Quantitative and qualitative assessment of the posterior medial meniscus anatomy: defining meniscal ramp lesions. Am J Sports Med 47:372–378CrossRefPubMed
17.
Zurück zum Zitat Greif DN, Baraga MG, Rizzo MG et al (2020) MRI appearance of the different meniscal ramp lesion types, with clinical and arthroscopic correlation. Skeletal Radiol 49:677–689CrossRefPubMed Greif DN, Baraga MG, Rizzo MG et al (2020) MRI appearance of the different meniscal ramp lesion types, with clinical and arthroscopic correlation. Skeletal Radiol 49:677–689CrossRefPubMed
18.
Zurück zum Zitat Thaunat M, Fayard JM, Guimaraes TM et al (2016) Classification and surgical repair of ramp lesions of the medial meniscus. Arthrosc Tech 5:e871–e875CrossRefPubMedPubMedCentral Thaunat M, Fayard JM, Guimaraes TM et al (2016) Classification and surgical repair of ramp lesions of the medial meniscus. Arthrosc Tech 5:e871–e875CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Kumar NS, Spencer T, Cote MP et al (2018) Is edema at the posterior medial tibial plateau indicative of a ramp lesion? An examination of 307 patients with anterior cruciate ligament reconstruction and medial meniscal tears. Orthop J Sports Med 6:2325967118780089PubMedPubMedCentral Kumar NS, Spencer T, Cote MP et al (2018) Is edema at the posterior medial tibial plateau indicative of a ramp lesion? An examination of 307 patients with anterior cruciate ligament reconstruction and medial meniscal tears. Orthop J Sports Med 6:2325967118780089PubMedPubMedCentral
20.
Zurück zum Zitat Balazs GC, Greditzer HG 4th, Wang D et al (2019) Ramp lesions of the medial meniscus in patients undergoing primary and revision ACL reconstruction: prevalence and risk factors. Orthop J Sports Med 7:2325967119843509PubMedPubMedCentral Balazs GC, Greditzer HG 4th, Wang D et al (2019) Ramp lesions of the medial meniscus in patients undergoing primary and revision ACL reconstruction: prevalence and risk factors. Orthop J Sports Med 7:2325967119843509PubMedPubMedCentral
21.
Zurück zum Zitat DePhillipo NN, Cinque ME, Chahla J et al (2017) Incidence and detection of meniscal ramp lesions on magnetic resonance imaging in patients with anterior cruciate ligament reconstruction. Am J Sports Med 45:2233–2237CrossRefPubMed DePhillipo NN, Cinque ME, Chahla J et al (2017) Incidence and detection of meniscal ramp lesions on magnetic resonance imaging in patients with anterior cruciate ligament reconstruction. Am J Sports Med 45:2233–2237CrossRefPubMed
22.
Zurück zum Zitat Hatayama K, Terauchi M, Saito K et al (2018) Magnetic resonance imaging diagnosis of medial meniscal ramp lesions in patients with anterior cruciate ligament injuries. Arthroscopy 34:1631–1637CrossRefPubMed Hatayama K, Terauchi M, Saito K et al (2018) Magnetic resonance imaging diagnosis of medial meniscal ramp lesions in patients with anterior cruciate ligament injuries. Arthroscopy 34:1631–1637CrossRefPubMed
23.
Zurück zum Zitat Nguyen JC, De Smet AA, Graf BK, Rosas HG (2014) MR imaging-based diagnosis and classification of meniscal tears. Radiographics 34:981–999CrossRefPubMed Nguyen JC, De Smet AA, Graf BK, Rosas HG (2014) MR imaging-based diagnosis and classification of meniscal tears. Radiographics 34:981–999CrossRefPubMed
24.
Zurück zum Zitat Han JH, Song JG, Kwon JH et al (2015) Spontaneous healing of a displaced bucket-handle tear of the lateral meniscus in a child. Knee Surg Relat Res 27:65–67CrossRefPubMedPubMedCentral Han JH, Song JG, Kwon JH et al (2015) Spontaneous healing of a displaced bucket-handle tear of the lateral meniscus in a child. Knee Surg Relat Res 27:65–67CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat De Smet AA, Nathan DH, Graf BK et al (2008) Clinical and MRI findings associated with false-positive knee MR diagnoses of medial meniscal tears. AJR Am J Roentgenol 191:93–99CrossRefPubMed De Smet AA, Nathan DH, Graf BK et al (2008) Clinical and MRI findings associated with false-positive knee MR diagnoses of medial meniscal tears. AJR Am J Roentgenol 191:93–99CrossRefPubMed
26.
Zurück zum Zitat Lee JY, Chia ZY, Jiang L et al (2020) A review of the Gillquist maneuver: modifications for a safer and easily reproducible approach for knee transintercondylar notch posterior compartment arthroscopy. Arthrosc Tech 9:e435–e438CrossRefPubMedPubMedCentral Lee JY, Chia ZY, Jiang L et al (2020) A review of the Gillquist maneuver: modifications for a safer and easily reproducible approach for knee transintercondylar notch posterior compartment arthroscopy. Arthrosc Tech 9:e435–e438CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat de Alencar B, Neto J, de Gusmão M et al (2022) All-inside technique for ramp lesion repair: arthroscopic suture with knee scorpion suture passer. Arthrosc Tech 11:2091–2096CrossRef de Alencar B, Neto J, de Gusmão M et al (2022) All-inside technique for ramp lesion repair: arthroscopic suture with knee scorpion suture passer. Arthrosc Tech 11:2091–2096CrossRef
28.
Zurück zum Zitat Negrín R, Reyes NO, Iñiguez M (2018) Meniscal ramp lesion repair using an all-inside technique. Arthrosc Tech 7:265–270CrossRef Negrín R, Reyes NO, Iñiguez M (2018) Meniscal ramp lesion repair using an all-inside technique. Arthrosc Tech 7:265–270CrossRef
Metadaten
Titel
Medial meniscal posterior horn tears and ramp lesions in pediatric patients: lessons learned
verfasst von
Rida Salman
Matthew G. Ditzler
Siddharth P. Jadhav
Erica K. Schallert
Scott D. McKay
J. Herman Kan
Publikationsdatum
14.09.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 12/2023
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-023-05736-0

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