Excessive anterior tibial translation in the contralateral uninjured limb is significantly associated with ramp lesion in anterior cruciate ligament injury

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>This study aimed to evaluate the excessive anterior tibial translation (ATT) and muscle strength of patients with ramp lesions. We hypothesised that the higher ATT, lower hamstring-to-quadriceps (HQ) ratio, and higher flexion peak torque influenced by semimembranosus would be associated with ramp lesions.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>One hundred and twenty-one patients who underwent anterior cruciate ligament (ACL) reconstruction were retrospectively evaluated. Clinical evaluation included ATT of the contralateral uninjured limb measured using a KT-1000 arthrometer, the knee flexor and extensor muscle strength of the contralateral uninjured limb at 60°/s and 180°/s of an angular velocity measured using an isokinetic dynamometer, and HQ ratio at 60°/s and 180°/s during the preoperative state. Binary stepwise logistic regression analysis was performed to evaluate the risk factors of ramp lesions.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Ramp lesions were found in 27 cases of ACL injuries (27/121, 22.3%). Male sex (odds ratio [OR], 2.913; 95% confidence interval [CI], 1.090–7.787; P = 0.033), longer time between injury to surgery (OR, 2.225; 95% CI, 1.074–4.608; P = 0.031), and higher ATT in the contralateral uninjured limb (OR, 1.502; 95% CI, 1.046–2.159; P = 0.028) were indicated as the independent risk factors of the presence of ramp lesion associated with an ACL injury.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Male sex, longer period from injury to surgery, and higher ATT in the contralateral uninjured limb were significantly associated with ramp lesion. These findings are advantageous for identifying patients with a greater risk of developing a ramp lesion with an ACL injury in the clinical setting.</jats:p> </jats:sec><jats:sec> <jats:title>Level of evidence</jats:title> <jats:p>Level IV</jats:p> </jats:sec>