Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries

Abstract The relationship between ramp lesion (RL), tibial slope (TS), and meniscal slope (MS) remains inadequately explored. This study aims to investigate whether TS and MS are predictive factors for anterior cruciate ligament (ACL) injuries associated with RL, and to evaluate the performance of T...

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Main Authors: Xiaotan Wang, Kun Liu, Le Yu, Jiushan Yang, Lizhong Jing, Steven Duhig
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-99592-7
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author Xiaotan Wang
Kun Liu
Le Yu
Jiushan Yang
Lizhong Jing
Steven Duhig
author_facet Xiaotan Wang
Kun Liu
Le Yu
Jiushan Yang
Lizhong Jing
Steven Duhig
author_sort Xiaotan Wang
collection DOAJ
description Abstract The relationship between ramp lesion (RL), tibial slope (TS), and meniscal slope (MS) remains inadequately explored. This study aims to investigate whether TS and MS are predictive factors for anterior cruciate ligament (ACL) injuries associated with RL, and to evaluate the performance of TS and MS in predicting RL, including determining optimal cut-off values. A retrospective cohort study was conducted on 253 patients who underwent ACL reconstruction. Magnetic resonance imaging was used to measure TS and MS on tibial plateaus. Logistic regression analyses determined associations between TS, MS, and RL. Receiver operating characteristic (ROC) curves evaluated predictive performance and cut-off values. A total of 65 cases (25.7%) were found to have RL. Significant differences in causes of injury, medial TS (MTS), medial MS (MMS), and bone bruises were observed between groups. In the unadjusted model and adjusted models, they showed significant (P < 0.001) associations for MTS (1.73–1.75) and MMS (OR range = 2.14–2.24). The AUC for MTS was 0.72 (95% CI 0.65–0.79, P < 0.001) with a cut-off value of 6.73°, for MMS was 0.80 (95% CI 0.74–0.86, P < 0.001) with a cut-off value of 4.03°, indicating good predictive performance. Larger MTS and MMS are significant predictive factors for RL in patients with ACL injury. Clinicians should closely monitor ACL injury patients with elevated MTS or MMS. Utilizing MTS or MMS as a predictive parameter shows promise for the identification of RL.
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spelling doaj-art-e02f97d427d84de9a4a8aec5aa53ebf62025-08-20T03:52:24ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-99592-7Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuriesXiaotan Wang0Kun Liu1Le Yu2Jiushan Yang3Lizhong Jing4Steven Duhig5Department of Sports Medicine, Affiliated Hospital of Shandong University of Traditional Chinese MedicineThe Second Affiliated Hospital of Shandong University of Traditional Chinese MedicineDepartment of Sports Medicine, Affiliated Hospital of Shandong University of Traditional Chinese MedicineDepartment of Sports Medicine, Affiliated Hospital of Shandong University of Traditional Chinese MedicineDepartment of Sports Medicine, Affiliated Hospital of Shandong University of Traditional Chinese MedicineSchool of Health Sciences and Social Work, Griffith UniversityAbstract The relationship between ramp lesion (RL), tibial slope (TS), and meniscal slope (MS) remains inadequately explored. This study aims to investigate whether TS and MS are predictive factors for anterior cruciate ligament (ACL) injuries associated with RL, and to evaluate the performance of TS and MS in predicting RL, including determining optimal cut-off values. A retrospective cohort study was conducted on 253 patients who underwent ACL reconstruction. Magnetic resonance imaging was used to measure TS and MS on tibial plateaus. Logistic regression analyses determined associations between TS, MS, and RL. Receiver operating characteristic (ROC) curves evaluated predictive performance and cut-off values. A total of 65 cases (25.7%) were found to have RL. Significant differences in causes of injury, medial TS (MTS), medial MS (MMS), and bone bruises were observed between groups. In the unadjusted model and adjusted models, they showed significant (P < 0.001) associations for MTS (1.73–1.75) and MMS (OR range = 2.14–2.24). The AUC for MTS was 0.72 (95% CI 0.65–0.79, P < 0.001) with a cut-off value of 6.73°, for MMS was 0.80 (95% CI 0.74–0.86, P < 0.001) with a cut-off value of 4.03°, indicating good predictive performance. Larger MTS and MMS are significant predictive factors for RL in patients with ACL injury. Clinicians should closely monitor ACL injury patients with elevated MTS or MMS. Utilizing MTS or MMS as a predictive parameter shows promise for the identification of RL.https://doi.org/10.1038/s41598-025-99592-7Magnetic resonance imagingKnee jointCohort studiesDiagnostic techniques and procedures
spellingShingle Xiaotan Wang
Kun Liu
Le Yu
Jiushan Yang
Lizhong Jing
Steven Duhig
Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
Scientific Reports
Magnetic resonance imaging
Knee joint
Cohort studies
Diagnostic techniques and procedures
title Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
title_full Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
title_fullStr Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
title_full_unstemmed Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
title_short Steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
title_sort steeper tibial and meniscal slopes as predictive factors for ramp lesions in anterior cruciate ligament injuries
topic Magnetic resonance imaging
Knee joint
Cohort studies
Diagnostic techniques and procedures
url https://doi.org/10.1038/s41598-025-99592-7
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