Combined Posteromedial Loop Stitch and All-Inside Anterior Suture Technique for Medial Meniscus Ramp Lesion Repair

Medial meniscus ramp lesions have historically been underdiagnosed and often overlooked during arthroscopic procedures. Increasing recognition of their prevalence and biomechanical importance, especially with anterior cruciate ligament injuries, has recently made these lesions a key focus in knee surgery and research. Despite this awareness, management of medial meniscus ramp lesions remains challenging due to their complex anatomy and essential contribution to knee stability. Although various repair techniques are available, the optimal approach remains unknown. We describe a technique using a posteromedial loop stitch complemented by an anterior all-inside suture, aiming to integrate the advantages of direct visualization with enhanced fixation strength. This hybrid method offers a reproducible option to optimize healing and biomechanical stability in ramp lesion repair.