Accelerated rehabilitation for meniscus repairs

Abstract

Although meniscus tears suitable for repair are infrequent, meniscal repair is preferable to meniscectomy. Unfortunately, the postoperative restrictions commonly recommended preclude the athlete's rapid return to sports and can lead to the selection of meniscectomy over meniscus repair. Wide variations presently exist in the published postmeniscus repair rehabilitation programs. No objective assessment of these variables has been made to date. To assess the value of postoperative limits to motion, weight bearing, and agility activities, a comparison was made of our previously published "standard" rehabilitation program with an "accelerated" program permitting unlimited weight bearing, full motion, and no restrictions on pivoting sports. Group 1 (58 repairs), treated conventionally, had 11 failures (19%) at an average of 38 months postsurgery. The average age in group 1 was 23 years (range 14-45). Group 2, which included 40 repairs treated with the "accelerated" program, had four failures (10%) at an average follow-up of 20 months. The average age in group 2 was 26 years (range 15-40). Arthroscopic second looks were performed in 35% of group 1 and 25% of group 2. These data fail to show any statistical difference and do not support the need for activity restrictions after a meniscus repair.