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Volume:1 Issue:5 Number:112 ISSN#:2563-5476
RCT
ACE Report #4949

ISAKOS: Free or Restricted Rehabilitation After Meniscus Repair


Study Type:Randomized Trial
OE Level Evidence:N/A
Journal Level of Evidence:N/A

The Impact of Free or Restricted Rehabilitation After Meniscus Repair. A Prospective Randomized Clinical Trial

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CONFERENCE ACE REPORTS

This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.

Synopsis

60 patients who had undergone arthroscopic repair of vertical meniscus lesions were randomized to either a free or a strict rehabilitation program after to compare the functional, healing, and patient related outcomes of the two protocols. Follow-up at one year follow demonstrated a slightly better healing rate for the free rehabilitation group, with no differences between the groups in Knee Osteoarthritis Outcome Score (KOOS), Tegner score, pain and patient satisfaction.

Why was this study needed now?

Meniscal tear occurs in the cartilage during a number of physical activities. Currently no randomized controlled trials exist to investigate the best rehabilitation program for meniscal repair. The purpose of this trial was to compare the outcomes of free and restricted rehabilitation program on meniscal healing.

What was the principal research question?

How does free rehabilitation compare to strict rehabilitation in terms healing rates, functional, and patient-related outcomes, 1 year after meniscal repair surgery?

Study Characteristics -
Population:
60 patients who underwent vertical meniscus lesion repair during an arthroscopy procedure (n=54 at final follow up)
Intervention:
Free group: 2 weeks in brace 0-90 degrees and touch weight bearing with free rehabilitation after (n=33)
Comparison:
Restricted Group: 6 weeks in brace with gradual range of motion increase to 90 degrees with only touch weight bearing during the 6 weeks (n=27)
Outcomes:
MRI for healing evaluation, Knee Osteoarthritis Outcome Score (KOOS), Tegner Score, pain assessment and patient satisfaction
Methods:
RCT: Prospective
Time:
1 year (follow-up at 3 and 12 months)

What were the important findings?

  • 33% of restricted and 24% of free rehabilitation patients had partial or lack of healing with re-arthroscopy.
  • Both groups had similar KOOS scores
  • No differences in Tegner score were found between two groups
  • Patients reported similar satisfaction with either rehabilitation

What should I remember most?

Free rehabilitation demonstrated a slightly better healing rate for meniscal repair, but no differences were found in functional outcomes and patient satisfaction at a one year follow up.

How will this affect the care of my patients?

Free rehabilitation seams to show a trend towards better healing rates, despite similar functional outcomes between two rehabilitation protocols. Future follow up of 2 years for this study is currently being awaited, while the lack of healing remains a concern.

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