Koch Matthias, Memmel Clemens, Zeman Florian, Pfeifer Christian G, Zellner Johannes, Angele Peter, Weber-Spickschen Sanjay, Alt Volker, Krutsch Werner
Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany.
Centre of Clinical Studies, University Medical Centre Regensburg, Regensburg, Germany.
Rehabil Res Pract. 2020 Mar 29;2020:3989535. doi: 10.1155/2020/3989535. eCollection 2020.
Meniscus therapy is a challenging process. Besides the respective surgical procedure such as partial meniscectomy, meniscus repair, or meniscus replacement, early postoperative rehabilitation is important for meniscus regeneration and return to sport and work as well as long-term outcome. Various recommendations are available. However, the current literature lacks information concerning the actual early rehabilitation in daily routine recommended by orthopedic surgeons. Thus, the purpose of this study was to investigate currently used standard early rehabilitation protocols in the daily routine of orthopedic surgeons. This study investigated the recommendations and concepts for early rehabilitation after meniscus therapy given by German, Austrian, and Swiss orthopedic institutions. Standardized criteria such as weight bearing, range of motion, use of an orthosis, and rehabilitation training were analyzed according to the conducted surgical procedure: partial meniscectomy, meniscus repair, or meniscus replacement. The analysis of standard rehabilitation concepts for partial meniscectomy ( = 15), meniscus repair ( = 54), and meniscus replacement ( = 7) showed significantly earlier functional rehabilitation in all criteria after partial meniscectomy in contrast to meniscus repair techniques ( < 0.001). In addition, significant restrictions were found in full weight bearing, full range of motion, and the use of braces. In summary, a wide range of recommendations for weight bearing, ROM, brace therapy, and mobilization is available, particularly after meniscus repair and meniscus replacement. Most concepts are in accordance with those described in the current literature. Further research is necessary to enhance the scientific evidence on currently used early rehabilitation concepts after meniscus therapy.
半月板治疗是一个具有挑战性的过程。除了诸如部分半月板切除术、半月板修复或半月板置换等相应的外科手术外，术后早期康复对于半月板再生、恢复运动和工作以及长期预后都很重要。有各种相关建议可供参考。然而，目前的文献缺乏关于骨科医生在日常实践中实际采用的早期康复的信息。因此，本研究的目的是调查骨科医生日常实践中目前使用的标准早期康复方案。本研究调查了德国、奥地利和瑞士的骨科机构给出的半月板治疗后早期康复的建议和理念。根据所实施的外科手术（部分半月板切除术、半月板修复或半月板置换），对诸如负重、活动范围、矫形器的使用和康复训练等标准化标准进行了分析。对部分半月板切除术（n = 15）、半月板修复（n = 54）和半月板置换（n = 7）的标准康复理念分析表明，与半月板修复技术相比，部分半月板切除术后在所有标准方面的功能康复明显更早（P < 0.001）。此外，在完全负重、全活动范围和支具使用方面发现了显著限制。总之，对于负重、活动范围、支具治疗和活动度有广泛的建议，特别是在半月板修复和半月板置换后。大多数理念与当前文献中描述的一致。有必要进行进一步研究以加强关于目前半月板治疗后使用的早期康复理念的科学证据。
