Early Functional Rehabilitation after Meniscus Surgery: Are Currently Used Orthopedic Rehabilitation Standards Up to Date?

Abstract

Meniscus therapy is a challenging process. Besides the respective surgical procedure such as partial meniscectomy, meniscus repair, or meniscus replacement, early postoperative rehabilitation is important for meniscus regeneration and return to sport and work as well as long-term outcome. Various recommendations are available. However, the current literature lacks information concerning the actual early rehabilitation in daily routine recommended by orthopedic surgeons. Thus, the purpose of this study was to investigate currently used standard early rehabilitation protocols in the daily routine of orthopedic surgeons. This study investigated the recommendations and concepts for early rehabilitation after meniscus therapy given by German, Austrian, and Swiss orthopedic institutions. Standardized criteria such as weight bearing, range of motion, use of an orthosis, and rehabilitation training were analyzed according to the conducted surgical procedure: partial meniscectomy, meniscus repair, or meniscus replacement. The analysis of standard rehabilitation concepts for partial meniscectomy (n=15), meniscus repair (n=54), and meniscus replacement (n=7) showed significantly earlier functional rehabilitation in all criteria after partial meniscectomy in contrast to meniscus repair techniques (p<0.001). In addition, significant restrictions were found in full weight bearing, full range of motion, and the use of braces. In summary, a wide range of recommendations for weight bearing, ROM, brace therapy, and mobilization is available, particularly after meniscus repair and meniscus replacement. Most concepts are in accordance with those described in the current literature. Further research is necessary to enhance the scientific evidence on currently used early rehabilitation concepts after meniscus therapy.

The efficacy of intraarticular viscosupplementation after arthroscopic partial meniscectomy: a randomized controlled trial

“…Early functional rehabilitation and a nearly unrestricted start of weight-bearing and full range of motion are the current trends of rehabilitation after partial meniscectomy [20,21]. After partial meniscectomy, pain is a major limiting factor for patients before returning to full activity [14,22].…”

Effects of Aquatic Training and Bicycling Training on Leg Function and Range of Motion in Amateur Athletes with Meniscal Allograft Transplantation during Intermediate-Stage Rehabilitation

“…After absolute immobilization, it is important to restore the ROM [ 32 ]. In a non-weight-bearing state, passive ROM has limitations in promoting active muscle contraction and mechanoreceptor activation; therefore, it is difficult to restore the functional movement patterns required in sports [ 33 ].…”

Lateral Meniscus Tears in Acl Injured Knee

“…In fact, the rehabilitation is dependent of several factors like the tear type location, type, repair strength and patient profile. An earlier functional rehabilitation without any restrictions can be instituted after a partial meniscectomy 74 . Similarly, small stable LM repairs do not need limitations of weight bearing or ROM and they can rehabilitate in a similar manner as for an isolated ACLR.…”