Monson Jill K, LaPrade Robert F
Physical Therapy Twin Cities Orthopedics.
Orthopedic surgery Twin Cities Orthopedics.
Int J Sports Phys Ther. 2025 Jan 1;20(1):127-136. doi: 10.26603/001c.126967. eCollection 2025.
Tears of the posterior medial meniscus root (PMMR) are common in older patients and reportedly contribute to rapid joint degeneration over time. Recognition of these tear types and the appropriate diagnosis through clinical exam and diagnostic imaging have improved significantly in recent years, as have surgical techniques to address them. Standardized post-operative rehabilitation protocols specific to PMMR repair have not been established or well understood in the scientific literature. Thus, clinicians have little guidance for managing post-operative care. Upon diagnosis of a root tear, appropriate surgical treatment, with appreciation for native anatomy and function of the meniscus root, is a critical first step for recovery. Post-operative rehabilitation protocols should account for biomechanical considerations unique to root tears, because they can destabilize the entire meniscus and compromise its native function. Rehabilitation specialists can apply known science regarding the influence of joint motion, muscle strengthening activities, gait, squatting, and progressive loading activities on the healing meniscus to guide post-operative recovery. This knowledge, complemented with existing foundational principles for sound post-operative rehabilitation, can optimize recovery for patients following PMMR repair. The purpose of this clinical commentary is to explore clinical questions related to 1) PMMR injury epidemiology, 2) diagnosis and surgical management of PMMR tears, and 3) critical considerations for safe and effective post-operative rehabilitation. Level of Evidence: 5.
后内侧半月板根部（PMMR）撕裂在老年患者中很常见，据报道，随着时间的推移，这种撕裂会导致关节快速退变。近年来，通过临床检查和诊断成像对这些撕裂类型的识别以及适当的诊断有了显著改善，治疗这些撕裂的手术技术也是如此。关于PMMR修复的标准化术后康复方案在科学文献中尚未确立或得到充分理解。因此，临床医生在术后护理管理方面几乎没有指导。在诊断为根部撕裂后，考虑到半月板根部的原始解剖结构和功能，进行适当的手术治疗是恢复的关键第一步。术后康复方案应考虑根部撕裂特有的生物力学因素，因为它们会破坏整个半月板的稳定性并损害其原始功能。康复专家可以应用关于关节运动、肌肉强化活动、步态、蹲姿和渐进性负荷活动对愈合中的半月板影响的已知科学知识来指导术后恢复。这些知识，再加上健全的术后康复的现有基本原则，可以优化PMMR修复术后患者的恢复。本临床评论的目的是探讨与以下方面相关的临床问题：1）PMMR损伤的流行病学，2）PMMR撕裂的诊断和手术管理，以及3）安全有效的术后康复的关键考虑因素。证据水平：5级。
