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Yusuf Omar Qalib Department of Orthopaedics, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
These authors contributed equally to this work

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Yicun Tang Department of Orthopaedics, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
These authors contributed equally to this work

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Dawei Wang Department of Orthopaedics, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China

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Baizhou Xing Department of Orthopaedics, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China

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Xingming Xu Department of Orthopaedics, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China

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Huading Lu Department of Orthopaedics, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China

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Overview of ramp lesion of the medial meniscus The medial meniscus is attached to the posterior tibial plateau and articular capsule, serving as the fundamental structure in knee joint kinematics. 1 It has a multitude of functions such as

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Vicente Carlos da Silva Campos Hospital Curry Cabral, Lisboa, Portugal

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Francisco Guerra Pinto Hospital Ortopédico de Sant’Ana, Hospital Cruz Vermelha Portuguesa, Universidad de Barcelona, Nova Medical School, Lisboa, Portugal

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Diogo Constantino Hospital Curry Cabral, Lisboa, Portugal

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Renato Andrade Clínica Do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal
Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal

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João Espregueira-Mendes Clínica Do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal
Dom Henrique Research Centre, Porto, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
School of Medicine, Minho University, Braga, Portugal

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posteromedial compartment may represent a technical challenge during arthroscopy in patients with a tight tibiofemoral joint space ( Fig. 1 ). In fact, the posterior horn of the medial meniscus is one of the most difficult areas for knee arthroscopy to access

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Alfonso Vaquero-Picado Department of Orthopaedic Surgery, ‘La Paz’ University Hospital, Spain

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, ‘La Paz’ University Hospital, Spain

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structures of the meniscus are determined by its functions. Alteration of its morphology could lead to early degenerative osteoarthritis. 11 The medial meniscus is C-shaped and slightly smaller than the lateral meniscus. 12 The lateral meniscus is

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Mahmut Nedim Doral Hacettepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Department of Sports Medicine, Ankara, Turkey

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Onur Bilge Konya N.E. University, Meram Faculty of Medicine, Department of Orthopaedics and Traumatology, Department of Sports Medicine, Konya, Turkey

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Gazi Huri Hacettepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey

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Egemen Turhan Hacettepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey

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René Verdonk Ghent University, Faculty of Medicine, Department of Orthopaedics and Traumatology, De Pintelaan, Ghent, Belgium

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. 22 The most common meniscal tears in active young people and in the elderly are traumatic longitudinal-vertical and degenerative tears respectively. The most common side and site for tears are the medial meniscus and the posterior horn of the

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Sebastian Kopf Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Germany

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Manuel-Paul Sava Orthopedics and Traumatology 2nd Department, Colentina Clinical Hospital, Bucharest, Romania

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Christian Stärke Department of Orthopaedic Surgery, Otto-von-Guericke University Magdeburg, Germany

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Roland Becker Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Germany

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ligament including the ‘meniscus ramp’. The meniscus ramp is the part of the coronary ligament which connects the posterior horn of the medial meniscus to the tibial head. Fig. 1 Top-down view onto the tibial plateau showing the medial and lateral

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Sohrab Keyhani Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Mohammad Movahedinia Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Arash Sherafat Vaziri Center of Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran

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Mehran Soleymanha Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran

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Fardis Vosoughi Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

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Mohammad Tahami Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

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Robert F LaPrade Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA

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posteromedial portal, one can reach the medial aspect of the PCL attached to the posterior septum and the posterior third of the medial meniscus (the entire ramp area from the corner point to the posterior root) ( 7 ) ( Fig. 1A ). Entering the posterolateral

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Philippe Beaufils Department of Orthopaedics and Traumatology, Centre Hospitalier de Versailles, 78150 Le Chesnay, France

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Roland Becker Department of Orthopaedics and Traumatology, Hospital Brandenburg, Medical School Theodor Fontane, Hochstrasse 26, 14770 Brandburg/Havel, Germany

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Sebastian Kopf Center for Musculoskeletal Surgery, Charité University Medicine, Berlin, Charitéplatz 1, 10117 Berlin, Germany

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Ollivier Matthieu Department of Orthopaedics and Traumatology, Centre Hospitalier de Versailles, 78150 Le Chesnay, and Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13000 Marseille, France

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Nicolas Pujol Department of Orthopaedics and Traumatology, Centre Hospitalier de Versailles, 78150 Le Chesnay, France

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. In stable knees (intact ACL), about 6% of acutely injured knees sustain a meniscus tear. 10 In chronic ACL-ruptured knees, the rate of meniscal tears is very high, 11 and increases with time with the medial meniscus while it remains the same

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Jonathan G. Robin Box Hill Hospital, Eastern Health Network, Australia

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Philippe Neyret Lyon 1 University, France

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displacement of the instantaneous centre of rotation of the knee toward the medial compartment. Medial meniscus injury: the role of the medial meniscus in preventing OA is well documented. Medial meniscectomy alone or in combination with ACL deficiency

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Hélder Pereira Orthopedic Department of Póvoa de Varzim - Vila do Conde Hospital Centre, Vila do Conde, Portugal
Ripoll y De Prado Sports Clinic, Murcia-Madrid, FIFA Medical Centre of Excellence, Madrid, Spain
International Centre of Sports Traumatology of the Ave, Vila do Conde, Portugal
3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Ibrahim Fatih Cengiz 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Sérgio Gomes International Centre of Sports Traumatology of the Ave, Vila do Conde, Portugal

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João Espregueira-Mendes 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal
Orthopedic Department, University of Minho, Braga, Portugal

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Pedro L. Ripoll Ripoll y De Prado Sports Clinic, Murcia-Madrid, FIFA Medical Centre of Excellence, Madrid, Spain

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Joan C. Monllau Orthopaedic Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain

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Rui L. Reis 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, Guimarães, Portugal

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J. Miguel Oliveira 3Bs Research Group, I3Bs, Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Barco, Guimarães, Portugal
ICVS/3Bs, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Orthopaedic Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, Guimarães, Portugal

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lateral meniscus is accountable for most of the load transfer within the lateral compartment (around 70%), 14 while the transmission of loading is more equally dispersed through the cartilage surfaces and the medial meniscus (50%) in the medial

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N. Reha Tandogan Çankaya Orthopedics, Ankara, Turkey

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Asim Kayaalp Çankaya Orthopedics, Ankara, Turkey

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collateral ligament (dMCL) originates 1 cm distally from the insertion of the sMCL on the medial epicondyle and courses deep to the sMCL. It has strong attachments to the medial meniscus and attaches a few millimetres distal to the joint line on the tibia. It

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