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Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions
The intra-articular injury most often associated with a chronic anterior cruciate ligament tear involves the posterior horn of the medial meniscus. A specific type of medial meniscal injury, called a ramp lesion, has received greater attention for identification and treatment because of its consider...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323914/ https://www.ncbi.nlm.nih.gov/pubmed/37424638 http://dx.doi.org/10.1016/j.eats.2023.02.033 |
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author | Pires, Diego Monteiro, Leonardo Rocha de Faria, José Leonardo Albuquerque, Rodrigo Sattamini Pires e Astur, Diego Pádua, Vitor Barion Castro de Salim, Rodrigo LaPrade, Robert F. |
author_facet | Pires, Diego Monteiro, Leonardo Rocha de Faria, José Leonardo Albuquerque, Rodrigo Sattamini Pires e Astur, Diego Pádua, Vitor Barion Castro de Salim, Rodrigo LaPrade, Robert F. |
author_sort | Pires, Diego |
collection | PubMed |
description | The intra-articular injury most often associated with a chronic anterior cruciate ligament tear involves the posterior horn of the medial meniscus. A specific type of medial meniscal injury, called a ramp lesion, has received greater attention for identification and treatment because of its considerable incidence and diagnostic difficulty. Based on their location, these lesions may be arthroscopically “hidden” during traditional anterior visualization. The purpose of the present Technical Note is to describe the Recife maneuver. This maneuver diagnoses injuries to the posterior horn of the medial meniscus using additional arthroscopic management through a standard portal. The Recife maneuver is performed with the patient in the supine position. A 30° arthroscope is inserted through the anterolateral portal, and the posteromedial compartment is accessed according to the transnotch view (modified Gillquist view). In the proposed maneuver, with the knee in 30° of flexion, a valgus stress with internal rotation is performed, followed by palpation of the popliteal region and digital pressure on the joint interline. This maneuver allows a greater visualization of the posterior compartment, allowing the diagnostic evaluation of the integrity between the meniscus and the capsule, in a safer way, being able to identify ramp tears without the need to create a posteromedial portal. We recommend that the addition of the diagnostic visualization step of the posteromedial compartment as described by the Recife maneuver be performed to assess the meniscal status in routine anterior cruciate ligament reconstruction. |
format | Online Article Text |
id | pubmed-10323914 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-103239142023-07-07 Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions Pires, Diego Monteiro, Leonardo Rocha de Faria, José Leonardo Albuquerque, Rodrigo Sattamini Pires e Astur, Diego Pádua, Vitor Barion Castro de Salim, Rodrigo LaPrade, Robert F. Arthrosc Tech Technical Note The intra-articular injury most often associated with a chronic anterior cruciate ligament tear involves the posterior horn of the medial meniscus. A specific type of medial meniscal injury, called a ramp lesion, has received greater attention for identification and treatment because of its considerable incidence and diagnostic difficulty. Based on their location, these lesions may be arthroscopically “hidden” during traditional anterior visualization. The purpose of the present Technical Note is to describe the Recife maneuver. This maneuver diagnoses injuries to the posterior horn of the medial meniscus using additional arthroscopic management through a standard portal. The Recife maneuver is performed with the patient in the supine position. A 30° arthroscope is inserted through the anterolateral portal, and the posteromedial compartment is accessed according to the transnotch view (modified Gillquist view). In the proposed maneuver, with the knee in 30° of flexion, a valgus stress with internal rotation is performed, followed by palpation of the popliteal region and digital pressure on the joint interline. This maneuver allows a greater visualization of the posterior compartment, allowing the diagnostic evaluation of the integrity between the meniscus and the capsule, in a safer way, being able to identify ramp tears without the need to create a posteromedial portal. We recommend that the addition of the diagnostic visualization step of the posteromedial compartment as described by the Recife maneuver be performed to assess the meniscal status in routine anterior cruciate ligament reconstruction. Elsevier 2023-05-15 /pmc/articles/PMC10323914/ /pubmed/37424638 http://dx.doi.org/10.1016/j.eats.2023.02.033 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Technical Note Pires, Diego Monteiro, Leonardo Rocha de Faria, José Leonardo Albuquerque, Rodrigo Sattamini Pires e Astur, Diego Pádua, Vitor Barion Castro de Salim, Rodrigo LaPrade, Robert F. Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions |
title | Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions |
title_full | Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions |
title_fullStr | Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions |
title_full_unstemmed | Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions |
title_short | Diagnosis by Manual Maneuver of Medial Meniscus Ramp Lesions |
title_sort | diagnosis by manual maneuver of medial meniscus ramp lesions |
topic | Technical Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323914/ https://www.ncbi.nlm.nih.gov/pubmed/37424638 http://dx.doi.org/10.1016/j.eats.2023.02.033 |
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