Monson Jill K, Tollefson Luke V, LaPrade Christopher M, LaPrade Robert F
Twin Cities Orthopedics - Eagan, 2700 Viking Circle, Eagan, MN, 55121, USA.
Training HAUS, 2645 Viking Circle Suite 200, Eagan, MN, 55121, USA.
Curr Rev Musculoskelet Med. 2025 May 9. doi: 10.1007/s12178-025-09967-6.
The purpose of this review is to synthesize current science on meniscus anatomy and biomechanics and repair techniques to create an empirical foundation for postoperative rehabilitation precautions and guidelines, including timelines, clinical and performance-based criteria for return to activity, to maximize both meniscal healing potential and patient recovery.
Recent literature has focused on meniscus repair rather than debridement, and rehabilitation protocols should be designed to optimize healing. Complex, unstable tears, like root and radial tears, disrupt hoop stress and warrant a more conservative protocol including 6 weeks of non-weightbearing; however, more stable tears, like ramp and vertical tears, can often weight bear immediately after surgery. All protocols should emphasize early protected joint motion. Return to activity guidelines remain ill-defined but this review explores evidence-based recommendations for timelines, strength and performance testing. Patients typically should wait ≥ 4 months for a return to activity and the presence of joint line tenderness or effusion could be a sign of delayed/failed healing. It is essential for therapists to know the size, type, and location of a meniscus repair to optimize patient outcomes. Guidelines for weight bearing, range of motion, strength training, and return to activity should vary per tear type and repair technique and recovery should be both time- and criteria-based. Return to activity should align with healing time, objective clinical and performance testing, and clinical and imaging exam findings. Future research should aim to optimize repair techniques and rehabilitation protocols, specifically further study on the timing to initiate weightbearing, early motion, and return to activity.
本综述的目的是综合当前关于半月板解剖学、生物力学及修复技术的科学知识，为术后康复预防措施和指南建立实证基础，包括时间线、基于临床和功能表现的恢复活动标准，以最大限度地提高半月板愈合潜力和患者恢复效果。
近期文献聚焦于半月板修复而非清创术，康复方案应设计为促进愈合。复杂的不稳定撕裂，如根部和放射状撕裂，会破坏环向应力，需要更保守的方案，包括6周不负重；然而，更稳定的撕裂，如斜坡状和垂直撕裂，术后通常可立即负重。所有方案都应强调早期受保护的关节活动。恢复活动指南仍不明确，但本综述探讨了基于证据的时间线、力量和功能测试建议。患者通常应等待≥4个月才能恢复活动，关节线压痛或积液可能是愈合延迟/失败的迹象。治疗师了解半月板修复的大小、类型和位置对于优化患者治疗效果至关重要。负重、活动范围、力量训练和恢复活动的指南应根据撕裂类型和修复技术而有所不同，恢复应基于时间和标准。恢复活动应与愈合时间、客观的临床和功能测试以及临床和影像学检查结果相一致。未来的研究应致力于优化修复技术和康复方案，特别是进一步研究开始负重、早期活动和恢复活动的时机。
