# Single-Stage Medial Meniscus Ramp Repair, Lateral Meniscus Root Repair, Revision Anterior Cruciate Ligament Reconstruction and Lateral Extra-Articular Tenodesis

## TL;DR

This paper describes a new surgical technique for addressing specific meniscus injuries during revision ACLR procedures.

## Contribution

The paper introduces a systematic approach for managing the 'new terrible triad' during revision ACLR.

## Key findings

- Combined medial meniscus ramp lesions and lateral meniscus posterior root tears are common in revision ACLR.
- Addressing these meniscus injuries during surgery may reduce the risk of ACL graft failure.
- A systematic approach is proposed for managing these injuries in revision ACLR.

## Abstract

Revision anterior cruciate ligament reconstruction (ACLR) is being performed increasingly as a result of the growing number of primary ACLR failures. The combined lesions of medial meniscus ramp lesions and lateral meniscus posterior root tears are being observed among many patients who undergo revision ACLR. This combination of meniscus injuries is referred to as "the new terrible triad." Various studies suggest that failing to address these meniscus injuries during primary ACLR can increase the risk of anterior cruciate ligament graft failure. In this technique report, we present our systematic approach to manage medial meniscus ramp lesions and lateral meniscus posterior root tears in revision ACLR.