Prill Robert, Ma C Benjamin, Wong Stephanie E, Beaufils Philippe, Monllau Juan Carlos, Arhos Elanna K, Becker Roland, Villa Francesco Della, Goodloe J Brett, Irrgang James J, Klugarova Jitka, Klosterman Emma L, Królikowska Aleksandra, Krych Aaron J, LaPrade Robert F, Manske Robert, van Melick Nicky, Monson Jill K, Ostojic Marko, Paterno Mark V, Piontek Tomasz, Perelli Simone, Rambaud Alexandre, Robinson James, Schmitt Laura C, Senorski Eric Hamrin, Snaebjornsson Thorkell, Tagliero Adam J, Giordano Airelle O, Pujol Nicolas
Department of Orthopedics and Traumatology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg/Havel, Brandenburg an der Havel, Germany.
Brandenburg Medical School Theodor Fontane, Faculty of Health Sciences Brandenburg, Brandenburg an der Havel, Germany.
Knee Surg Sports Traumatol Arthrosc. 2025 Aug;33(8):3014-3024. doi: 10.1002/ksa.12689. Epub 2025 Jun 12.
Part two of this consensus aimed to provide recommendations for the prevention of meniscus injuries, non-operative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures.
This consensus followed the European Society of Knee Surgery, Sports Traumatology and Arthroscopy (ESSKA) formal consensus methodology. For this combined ESSKA-American Orthopedic Society for Sports Medicine (AOSSM)-American Academy of Sports Physical Therapy (AASPT) initiative, 67 experts from 14 countries, including orthopedic surgeons and physiotherapists, were involved. The 26 Steering Group members established guiding questions, screened the existing evidence, and proposed statements, and provided Grades of recommendations. The 41 Rating Group members assessed the statements according to a Likert scale (1-9). Final documents were assessed by an international peer review group for geographical adaptability.
Low to moderate scientific level of evidence was available, so that grades of recommendations were low (three Grade A ratings, four Grade B, three Grade C and 13 Grade D), underlining the relevance of this consensus. One strong and 17 relative agreements with overall median of 8 (8-9) and a mean of 7.92 ± 0.37 were achieved for 23 statements on 18 questions. Prevention of meniscus injuries is possible with general knee injury reduction programmes and through avoidance of certain activities. Non-operative treatment including physical therapy is the first line approach for degenerative meniscus lesions and may be an option for some acute tears. Return to sports after meniscus tear surgery should be both criterion-based and time-based. Patient reported outcomes in combination with performance-based measures are recommended to evaluate the rehabilitation process.
This international EU-US consensus established recommendations for prevention strategies, describes rehabilitation of non-operated patients and of patients after partial meniscectomy, meniscus repair and meniscus reconstruction, and establishes return to sport criteria. These updated and structured recommendations may be applied by surgeons and physiotherapists.
Level I, consensus.
本共识的第二部分旨在为半月板损伤的预防、急性撕裂和退行性病变的非手术治疗、恢复运动以及患者报告的结局指标提供建议。
本共识遵循欧洲膝关节外科、运动创伤学与关节镜学会（ESSKA）的正式共识方法。对于ESSKA - 美国运动医学骨科协会（AOSSM） - 美国运动物理治疗学会（AASPT）的联合倡议，来自14个国家的67名专家参与其中，包括骨科外科医生和物理治疗师。26名指导小组成员确定指导问题、筛选现有证据、提出声明并给出推荐等级。41名评级小组成员根据李克特量表（1 - 9）对声明进行评估。最终文件由一个国际同行评审小组评估其地理适应性。
现有证据的科学水平为低到中等，因此推荐等级较低（3个A级评级、4个B级、3个C级和13个D级），突出了本共识的相关性。关于18个问题的23项声明达成了1项强烈共识和17项相对共识，总体中位数为8（8 - 9），平均值为7.92 ± 0.37。通过一般的膝关节损伤减少计划以及避免某些活动，可以预防半月板损伤。包括物理治疗在内的非手术治疗是退行性半月板病变的一线治疗方法，对于一些急性撕裂也可能是一种选择。半月板撕裂手术后恢复运动应基于标准和时间。建议结合基于患者报告的结局指标和基于表现的指标来评估康复过程。
这一国际欧美共识确立了预防策略的建议，描述了未接受手术患者以及部分半月板切除术、半月板修复和半月板重建术后患者的康复情况，并确立了恢复运动的标准。这些更新且结构化的建议可供外科医生和物理治疗师应用。
I级，共识。
