Editorial Commentary: Posterior Visualization in Ramp Repair: The Only Path to True Healing.

Abstract

In the past 2 decades, posteromedial ramp repair for meniscocapsular lesions has transitioned from a challenging surgical technique to a vital element of anterior cruciate ligament reconstruction. Emerging biomechanical and clinical evidence underscores the posterior approach as the sole method offering direct visualization and effective engagement of meniscotibial structures. This technique enables precise debridement, stable fixation, and enhanced biological healing. Comparative studies reveal nearly double the healing rates and significantly fewer secondary meniscectomies with posterior visualization compared with anterior all-inside techniques. Consequently, posterior visualization is now the gold standard for anatomic ramp repair and a cornerstone of contemporary anterior cruciate ligament surgery.