Article Text

Download PDFPDF

Rehabilitation following meniscal repair: a systematic review
  1. Robert C Spang III1,
  2. Michael C Nasr2,
  3. Amin Mohamadi2,
  4. Joseph P DeAngelis1,
  5. Ara Nazarian2,3,
  6. Arun J Ramappa1
  1. 1 Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Center for Advanced Orthopaedic Studies, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia
  1. Correspondence to Dr Arun J Ramappa; aramappa{at}bidmc.harvard.edu

Abstract

Objective To review existing biomechanical and clinical evidence regarding postoperative weight-bearing and range of motion restrictions for patients following meniscal repair surgery.

Methods and data sources Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we searched MEDLINE using following search strategy: ((((“Weight-Bearing/physiology”[Mesh]) OR “Range of Motion, Articular”[Mesh]) OR “Rehabilitation”[Mesh])) AND (“Menisci, Tibial”[Mesh]). Additional articles were derived from previous reviews. Eligible studies were published in English and reported a rehabilitation protocol following meniscal repair on human. We summarised rehabilitation protocols and patients’ outcome among original studies.

Results Seventeen clinical studies were included in this systematic review. There was wide variation in rehabilitation protocols among clinical studies. Biomechanical evidence from small cadaveric studies suggests that higher degrees of knee flexion and weight-bearing may be safe following meniscal repair and may not compromise the repair. An accelerated protocol with immediate weight-bearing at tolerance and early motion to non-weight-bearing with immobilising up to 6 weeks postoperatively is reported. Accelerated rehabilitation protocols are not associated with higher failure rates following meniscal repair.

Conclusions There is a lack of consensus regarding the optimal postoperative protocol following meniscal repair. Small clinical studies support rehabilitation protocols that allow early motion. Additional studies are needed to better clarify the interplay between tear type, repair method and optimal rehabilitation protocol.

  • arthroscopy
  • knee surgery
  • knee injuries
  • sporting injuries
  • rehabilitation

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Footnotes

  • JPD, AN and AJR are joint senior authors.

  • JPD, AN and AJR contributed equally.

  • Contributors RCS, MCN, AM, JPD, AN and AJR developed the idea of the study. RCS, MCN and AM collected the data. JPD, AN and AJR approved the accuracy of the collected data. RCS, MCN and AM prepared first draft of the manuscript. JPD, AN and AJR provided clinical and biomechanical insight to the study. All authors approved final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Not required.

  • Data sharing statement This is a systematic review of previously published studies. All studies are available to the public.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.