A 2025 multicenter study found that articular cartilage damage is very common in children and adolescents. It includes those who suffer both an anterior cruciate ligament (ACL) tear and a medial meniscal ramp lesion, a specific injury affecting the meniscus of the knee. The research examined 189 patients under the age of 18 who underwent ACL reconstruction and ramp lesion repair at several major orthopedic centers in the United States. The findings of the study showed that 53% of these young athletes already had cartilage damage present at the time of surgery.
Furthermore, according to the study, the medial femoral condyle, located on the inner side of the thigh bone within the knee joint is the most common site of cartilage injury. In addition, researchers also found that nearly one-third of the cartilage injuries were classified as moderate to severe.
Several factors were associated with a higher likelihood of cartilage damage. For example, obesity, being 16 years of age or older, having a steeper lateral posterior tibial slope (a structural feature of the knee), and experiencing a delay of three months or more between injury and surgery.
These findings highlight the importance of early recognition and treatment of ACL tears and associated meniscal ramp lesions in pediatric athletes. Moreover, prompt diagnosis may help reduce the risk of ongoing joint damage and improve long-term outcomes. The results also suggest that clinicians should carefully assess young athletes with these injuries for possible cartilage damage and monitor them over time for signs of joint degeneration.
Although the study demonstrates a strong association between these injuries and cartilage damage, it does not establish a direct cause-and-effect relationship. Because the research was retrospective and focused on surgical patients, the findings may not apply to all pediatric ACL injuries.
