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Rehabilitation and return to sports after isolated meniscal repairs: a new evidence-based protocol
Journal of Experimental Orthopaedics ( IF 2.0 ) Pub Date : 2022-08-17 , DOI: 10.1186/s40634-022-00521-8
Filippo Calanna 1, 2 , Victoria Duthon 1 , Jacques Menetrey 1, 3
Affiliation  

Despite many protocols that have been proposed, there’s no consensus in the literature regarding the optimal rehabilitation program and return to sports (RTS) protocol following isolated meniscal repair. The aim of this current concept review is to look at the evidence of rehabilitation and RTS program after isolated meniscal repair, focusing on general and specific protocols per type of injury trying to give some guidelines based on the current state of knowledge. A narrative literature review was performed searching PubMed database to identify relevant articles from January 1985 to October 2021 on rehabilitation and RTS after isolated meniscal repair. Randomized controlled trials (RCTs), prospective and retrospective cohort studies, case series, systematic reviews, meta-analyses, cadaveric studies and basic science studies were included. When the hoop tensile stress effect is preserved, an accelerated rehabilitation program may be suggested. Hence, partial weight bearing (20 kg) in association with ROM limited to 90° is allowed for the first four weeks, followed by weight bearing as tolerated. In contrast, when circumferential hoop fibers are disrupted, a restricted rehabilitation protocol may be recommended. In this scenario no weight bearing is allowed for the first six weeks after the surgery and range of motion (ROM) is limited to 90°. Biomechanical evidence suggests that tailoring an individualized protocol based upon the type of lesion and meniscus stability is reasonable. Level V.

中文翻译:

孤立的半月板修复后的康复和重返运动:一种新的循证方案

尽管已经提出了许多协议,但文献中没有关于孤立半月板修复后的最佳康复计划和恢复运动 (RTS) 协议的共识。本次概念审查的目的是查看孤立半月板修复后康复和 RTS 计划的证据,重点关注每种损伤类型的一般和特定方案,试图根据当前的知识状态给出一些指导。对 PubMed 数据库进行叙述性文献综述,以确定 1985 年 1 月至 2021 年 10 月关于孤立半月板修复后康复和 RTS 的相关文章。包括随机对照试验(RCT)、前瞻性和回顾性队列研究、病例系列、系统评价、荟萃分析、尸体研究和基础科学研究。当环向拉应力效应被保留时,可能会建议加速康复计划。因此,前 4 周允许部分负重(20 公斤)与 ROM 限制为 90°,然后在允许的情况下负重。相反,当环向纤维被破坏时,可能会推荐使用受限的康复方案。在这种情况下,手术后的前六周内不允许负重,并且运动范围 (ROM) 限制为 90°。生物力学证据表明,根据病变类型和半月板稳定性定制个性化方案是合理的。V 级。前 4 周允许部分负重(20 公斤)与 ROM 限制为 90°,然后在允许的情况下负重。相反,当环向纤维被破坏时,可能会推荐使用受限的康复方案。在这种情况下,手术后的前六周内不允许负重,并且运动范围 (ROM) 限制为 90°。生物力学证据表明,根据病变类型和半月板稳定性定制个性化方案是合理的。V 级。前 4 周允许部分负重(20 公斤)与 ROM 限制为 90°,然后在允许的情况下负重。相反,当环向纤维被破坏时,可能会推荐使用受限的康复方案。在这种情况下,手术后的前六周内不允许负重,并且运动范围 (ROM) 限制为 90°。生物力学证据表明,根据病变类型和半月板稳定性定制个性化方案是合理的。V 级。生物力学证据表明,根据病变类型和半月板稳定性定制个性化方案是合理的。V 级。生物力学证据表明,根据病变类型和半月板稳定性定制个性化方案是合理的。V 级。
更新日期:2022-08-17
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