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Studies assessing MRI diagnostic accuracy for RLs or the clinical effect of RL repair in participants with ACL injuries were included. Diagnostic accuracy measures were pooled and plotted in forest plots. Preoperative and at last follow\u2010up treatment efficacy outcome measures were extracted and plotted in forest plots, for graphical comprehension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen studies met the criteria and were included. The diagnostic analysis showed a pooled sensitivity, specificity, positive and negative likelihood ratios of 65.1% (95% CI, 59.73 to 70.42), 91.6% (95% CI, 89.14 to 94.05), 2.91 (95% CI, 2.38\u20133.55) and 0.53 (95% CI, 0.44\u20130.64), respectively, with high heterogeneity (I<jats:sup>2<\/jats:sup> above 80%) for all measures. Treatment analysis showed improved Lysholm Knee Score, IKDC score and laxity difference between the knees in all studies after meniscal suture repair. A separate analysis showed no differences between repair of smaller, stable, RLs with meniscal sutures and repair with abrasion and trephination only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the results present considerable heterogeneity, MRI seems to demonstrate moderate accuracy in the diagnosis of RLs in patients with ACL tear and the surgical repair of RLs can be associated with improved overall outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40634-020-00287-x","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T15:02:36Z","timestamp":1601046156000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Ramp lesions: a systematic review of MRI diagnostic accuracy and treatment efficacy"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7445-285X","authenticated-orcid":false,"given":"Jos\u00e9","family":"Moreira","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Porto Alameda Hern\u00e2ni Monteiro 4200\u2010319 Porto Portugal"}]},{"given":"Margarida","family":"Almeida","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Porto Alameda Hern\u00e2ni Monteiro 4200\u2010319 Porto Portugal"}]},{"given":"Nuno","family":"Lunet","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica University of Porto Porto Portugal"},{"name":"Departamento de Ci\u00eancias da Sa\u00fade P\u00fablica e Forenses e Educa\u00e7\u00e3o M\u00e9dica Faculty of Medicine University of Porto Porto Portugal"}]},{"given":"Manuel","family":"Gutierres","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Porto Alameda Hern\u00e2ni Monteiro 4200\u2010319 Porto Portugal"},{"name":"Servi\u00e7o de Ortopedia e Traumatologia Centro Hospitalar de S. 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