{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:42:27Z","timestamp":1790192547015,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T00:00:00Z","timestamp":1517529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T00:00:00Z","timestamp":1517529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T00:00:00Z","timestamp":1517529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T00:00:00Z","timestamp":1517529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","arthroscopyjournal.org","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To document the diagnostic accuracy and steps for sequential arthroscopic exploration of ramp lesions\u2014peripheral tear within 4\u00a0mm of meniscocapsular junction of medial meniscus\u2014associated with anterior cruciate ligament (ACL) injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective consecutive study of 195 primary ACL reconstructions with arthroscopic exploration for ramp lesion in 4 steps: (1) standard exploration through the anterolateral portal, (2) through the intercondylar space using a 30\u00b0 arthroscope, (3) through the intercondylar space using a 70\u00b0 arthroscope, and (4) after creation of a posteromedial portal. Acute (&lt;3\u00a0months) and chronic case (&gt;3\u00a0months) groups were compared, and the sensitivity and specificity of magnetic resonance imaging (MRI) were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 50 patients (26.6%) were confirmed as having a ramp lesion. After step 1, only 19 cases (38%) were identified as a ramp lesion. After step 2, 24 cases (48%) were found, and the sensitivity of step 2 was estimated at 48%. After step 3, an additional 26 cases (52%) were identified. No more additional cases of ramp lesion were found after step 4. There were statistically significant differences between steps 2 and 3 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .001), but no differences between steps 1 and 2, or steps 3 and 4. Although there were no statistical differences in overall prevalence for acute (28\/128, 21.8%) and chronic (22\/67, 32.8%) groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.136), the incidence of ramp lesion confirmed through the standard portal approach was found to be significantly correlated with chronic group (odds ratio: 2.95,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .023). The sensitivity and specificity of preoperative MRI were 84% and 95.17%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many ramp lesions could not be diagnosed through the standard portal and intercondylar space using a 30\u00b0 arthroscope. Posteromedial inspection using a 70\u00b0 arthroscope has improved the diagnostic accuracy for ramp lesion without direct exploration through the posteromedial portal. Care should be taken to identify ramp lesions when ACL reconstruction is performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, diagnostic study of consecutive patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2017.12.008","type":"journal-article","created":{"date-parts":[[2018,5,2]],"date-time":"2018-05-02T04:08:31Z","timestamp":1525234111000},"page":"1582-1589","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":58,"title":["Diagnostic Accuracy of Sequential Arthroscopic Approach for Ramp Lesions of the Posterior Horn of the Medial Meniscus in Anterior Cruciate Ligament\u2013Deficient Knee"],"prefix":"10.1002","volume":"34","author":[{"given":"Seong Hwan","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Hanmaeum Changwon Hospital 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