Postoperative Rehabilitation Protocol After Isolated Meniscal Repair: A Systematic Review
Bibliographic record
Abstract
Background: The meniscus plays a critical role in knee stability and load distribution, with meniscal tears often resulting from trauma or degeneration. Rehabilitation protocols after meniscal repair lack standardization, particularly regarding weightbearing restrictions and their effect on outcomes. Hypothesis/Purpose: This systematic review hypothesizes that accelerated weightbearing protocols after isolated meniscal repair would lead to improved patient-reported outcomes and comparable failure rates relative to restricted rehabilitation protocols. The purpose was to evaluate the influence of different postoperative rehabilitation strategies on failure rates and functional outcomes after isolated meniscal repair. Study Design: Systematic review; Level of evidence, 4. Methods: Comprehensive searches of Embase, OVID Medline, and Emcare databases were conducted through November 2024. Studies were included if they reported on adult patients undergoing arthroscopic repair for isolated meniscal tears, described postoperative rehabilitation protocols, and had ≥10 months of follow-up. The primary outcome was repair failure (retears, revision surgery, or persistent symptoms). Secondary outcomes included patient-reported outcome measures (PROMs) and postoperative complications. Descriptive statistics summarized findings, with discrepancies resolved by a third investigator. Results: Ten studies (n = 313 patients) met the inclusion criteria. Most tears were medial (62%-93%) and primarily vertical or longitudinal, located in vascular zones. Rehabilitation protocols included accelerated/immediate weightbearing as tolerated (WBAT) (n = 7 studies), restricted weightbearing (n = 5 studies), and modified progressive programs (n = 1 study). Failure rates were 24.1% (accelerated WBAT), 28.3% (restricted), and 4.3% (modified progressive). PROMs (Lysholm and Tegner scores) were generally higher in accelerated WBAT protocols, with scores exceeding 85 and 7.2, respectively. Modified progressive rehabilitation yielded the lowest failure rate (4.3%) and favorable PROMs in the 1 study that utilized this method. Conclusion: The relationship between meniscal tear characteristics, repair techniques, and postoperative rehabilitation protocols plays a pivotal role in determining outcomes after isolated meniscal repair. Accelerated rehabilitation protocols may offer benefits such as faster recovery and improved patient satisfaction; nonetheless, they must be balanced against the increased risk of repair failure, particularly in complex tear patterns. Individualized rehabilitation protocols, accounting for tear characteristics, patient health, and surgical techniques, may optimize outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.054 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".