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Separating the bones of the knee in a balanced way, two semicircular structures composed of collagen are found between the femur and tibia in the knee joint. The menisci provide knee stability, cushioning against stresses on the joint, and allow forces on the knee to be spread evenly through the joint. The menisci (medial meniscus and lateral meniscus in the respective side of the knee), serve as shock-absorbers of the body and are susceptible to injuries. Meniscus tears are common injuries amongst young or middle-aged athletes, and the result of age-related degenerative changes of the knee in older individuals.
The meniscus attaches to the tibia with the help of the meniscal roots, one on the anterior and one on the posterior side. Contemporary studies reveal that meniscal root tears–even if they are not the most common of injuries–, are associated with anterior cruciate ligament tears, especially in cases of sports injuries or falls. In older patients, these tears are correlated with osteoarthritis. 

Researchers call attention to the fact that in the past, ramp lesions were mostly misdiagnosed (cited as ramp lesions in international bibliography), predominantly as a result of their peripheral placement that frequently does not show up on MRI scans–as well as the position of the knee in full flexion during an MRI scan. Generally, ramp lesions are detected via knee arthroscopy. However, the same research points out that the anatomical structure loses functional capacity once the meniscal root is torn. 

The surgical procedure aims to restore the meniscal root to its normal anatomic position and is regarded as a very demanding and technically challenging operation. Sutures are arthroscopically placed around the meniscal root and subsequently are used to reattach the meniscus back to the tibia. In sports injuries, studies stipulate that surgical repair of the injured meniscus is necessary–depending on the study, the successful surgical outcomes vary, however it is generally admitted that success rates are intertwined with factors such as the appropriate and complete postoperative rehabilitation, the time of return to physical activities, as well as the surgeon’s experience and technical skills. Postoperatively, the same rehabilitation program as the one for a torn meniscus is required.

In cases of meniscal degeneration due to moderate or severe osteoarthritis, conservative treatment is usually chosen over surgery, since it is presumed that additional tears will occur in the same area, after a short period of time. For tears of the meniscal root associated with knee arthritis, rest, crutches for reducing pressure on the knee joint, as well as physiotherapy sessions are recommended.

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