Lim Y, Bonner T, Wood L, Moss V, Van Niekerk L, Volpin A. Meniscocapsular ramp lesions in the paediatric knee: A review of diagnosis and surgical management. World J Clin Pediatr 2026; 15(4): 120301 [DOI: 10.5409/wjcp.120301]
Corresponding Author of This Article
Andrea Volpin, MD, Consultant, Department of Trauma and Orthopedics, James Cook Hospital, Marton Road, Middlesbrough TS4 3BW, Redcar and Cleveland, United Kingdom. andrea.volpin1@nhs.net
Research Domain of This Article
Orthopedics
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review-article
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Lim Y, Bonner T, Wood L, Moss V, Van Niekerk L, Volpin A. Meniscocapsular ramp lesions in the paediatric knee: A review of diagnosis and surgical management. World J Clin Pediatr 2026; 15(4): 120301 [DOI: 10.5409/wjcp.120301]
World J Clin Pediatr. Dec 9, 2026; 15(4): 120301 Published online Dec 9, 2026. doi: 10.5409/wjcp.120301
Meniscocapsular ramp lesions in the paediatric knee: A review of diagnosis and surgical management
Yizhe Lim, Timothy Bonner, Lisa Wood, Victoria Moss, Louw Van Niekerk, Andrea Volpin
Yizhe Lim, Timothy Bonner, Lisa Wood, Victoria Moss, Louw Van Niekerk, Andrea Volpin, Department of Trauma and Orthopedics, James Cook Hospital, Middlesbrough TS4 3BW, Redcar and Cleveland, United Kingdom
Author contributions: Lim Y led the conception and design of the study, conducted the literature review and data synthesis, and prepared the original draft of the manuscript; Bonner T, Wood L, Moss V, and Van Niekerk L contributed to manuscript development, provided critical revisions for important intellectual content, and approved the final version for publication; Volpin A is the senior author; supervised the study and approved the final manuscript; and all authors approved the final manuscript and agree to be accountable for all aspects of the work.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Andrea Volpin, MD, Consultant, Department of Trauma and Orthopedics, James Cook Hospital, Marton Road, Middlesbrough TS4 3BW, Redcar and Cleveland, United Kingdom. andrea.volpin1@nhs.net
Received: February 24, 2026 Revised: March 8, 2026 Accepted: March 26, 2026 Published online: December 9, 2026 Processing time: 208 Days and 14.2 Hours
Abstract
Meniscocapsular ramp lesions, which are tears of the posterior horn of the medial meniscus at the meniscocapsular junction, are increasingly recognised as associated injuries, particularly in the setting of anterior cruciate ligament injuries. While extensively studied in adults, their prevalence, diagnostic challenges, and management in the paediatric and adolescent populations remain areas of active investigation. This review synthesises current evidence regarding the epidemiology, biomechanical significance, diagnostic and treatment modalities for paediatric ramp lesions. We further evaluate surgical repair techniques, including all-inside and inside-out approaches, and discuss clinical outcomes. Despite the high prevalence of these lesions in children, significant gaps exist in long-term follow-up data and standardised treatment algorithms, underscoring the need for further research to optimise care for this vulnerable patient group.
Core Tip: Ramp lesions are commonly encountered when systematically sought, with reported prevalence of 20%-27% in paediatric anterior cruciate ligament (ACL) injuries. This is lower than many adult series. It is highly dependent on surgeon vigilance and exploration technique; therefore, prevalence is likely detection-dependent and not reflective of true incidence. Systematic exploration should therefore be strongly considered in high-risk cases, such as patients undergoing delayed ACL reconstruction, high-grade instability, or suggestive magnetic resonance imaging features. Biomechanical evidence suggests that repair may contribute to improved stability and graft protection, although paediatric clinical confirmation is lacking.
