Return-to-Play and Rehabilitation Protocols Following Isolated Meniscal Repair—A Systematic Review

Abstract

Purpose To systematically review the literature and assess the reported rehabilitation protocols, return-to-play guidelines, and reported rates of return-to-play after meniscal repair. Methods MEDLINE, EMBASE, and the Cochrane Library were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies on meniscal repair. Studies were included if return-to-play data and/or rehabilitation protocols were reported. The rate and timing of return-to-play was assessed. The rehabilitation protocols were documented, in addition to when to start range of motion (ROM), full ROM, partial weight-bearing (WB), and full WB. Results Overall, 88 studies met our inclusion criteria. Thirteen studies, including 507 patients, cited a range of 71.2% to 100% of return-to-play, with 53.9% to 92.6% returning to the same/greater level, ranging between 3.3 and 10 months. There was considerable variability in the reported rehabilitation protocols, but the most frequently reported time to begin ROM exercises was within the first week (78.9%) and full ROM at 6 weeks (33.3%). Partial WB was typically begun during the first week (61.0%), and full WB between the fourth and sixth week (65.6%) postoperatively. Following surgery, time elapsed was the most commonly cited criteria for return-to-play (97.0%), with 6 months being the most common time point applied (46.9%). No study advised against returning to competitive or contact sports after meniscal repair. Conclusions In conclusion, there was a high rate of return-to-play following meniscal repair, with 60% of patients returning to the same level of play. However, there was considerable diversity in the reported rehabilitation protocols and insufficient reporting on return-to-play criteria in the literature. This demonstrates the need for further research and formulation of an evidence-based consensus statement for this patient population. Level of Evidence Level IV, systematic review of Level I to IV studies.

Rehabilitation and return to sports after isolated meniscal repairs: a new evidence-based protocol

“…Meniscal repair is largely performed in young and active patients including elite and professional athletes, but only a few studies looked at the RTS after meniscal repairs using a sport-specific approach [33][34][35]. Only six studies specifically evaluated RTS in either mixed-level or professional athletes after isolated meniscal suture [31,[36][37][38][39][40].…”

Outside‐in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review

“…Pogorelic et al [50] did not specify their rehabilitation protocol. A recent systematic review analysed the rehabilitation protocol in 88 studies after meniscal repair [17]. In two‐thirds of the included studies, partial weight bearing was allowed within the first week.…”

Meniscus tears in professional soccer athletes: resect or repair?

“…26 , 27 Eberbach et al 26 in their systematic review reporting sport-specific outcomes after isolated meniscal repair, also reported that similarly successful outcomes were observed in both recreational and professional level athletes. Fried et al 28 in their systematic study on RTP and rehabilitation after isolated meniscal repairs, found a RTP rate ranging from 71.2% to 100%, while 53.9% to 92.6% returned to the preinjury level. Additionally, they found that 44% had returned to play within 4 months after surgery and up to 97% RTP within 6 months postoperatively.…”