Barber F A
Plano Orthopedic and Sports Medicine Center, Texas 75075.
Arthroscopy. 1994 Apr;10(2):206-10. doi: 10.1016/s0749-8063(05)80095-7.
Although meniscus tears suitable for repair are infrequent, meniscal repair is preferable to meniscectomy. Unfortunately, the postoperative restrictions commonly recommended preclude the athlete's rapid return to sports and can lead to the selection of meniscectomy over meniscus repair. Wide variations presently exist in the published postmeniscus repair rehabilitation programs. No objective assessment of these variables has been made to date. To assess the value of postoperative limits to motion, weight bearing, and agility activities, a comparison was made of our previously published "standard" rehabilitation program with an "accelerated" program permitting unlimited weight bearing, full motion, and no restrictions on pivoting sports. Group 1 (58 repairs), treated conventionally, had 11 failures (19%) at an average of 38 months postsurgery. The average age in group 1 was 23 years (range 14-45). Group 2, which included 40 repairs treated with the "accelerated" program, had four failures (10%) at an average follow-up of 20 months. The average age in group 2 was 26 years (range 15-40). Arthroscopic second looks were performed in 35% of group 1 and 25% of group 2. These data fail to show any statistical difference and do not support the need for activity restrictions after a meniscus repair.
尽管适合修复的半月板撕裂并不常见，但半月板修复术优于半月板切除术。不幸的是，目前普遍推荐的术后限制措施会妨碍运动员迅速重返运动，并且可能导致选择半月板切除术而非半月板修复术。目前已发表的半月板修复术后康复计划存在很大差异。迄今为止，尚未对这些变量进行客观评估。为了评估术后对运动、负重和敏捷性活动进行限制的价值，我们将之前发表的“标准”康复计划与允许无限制负重、全范围活动且对旋转运动无限制的“加速”计划进行了比较。第1组（58例修复）采用传统治疗方法，术后平均38个月有11例失败（19%）。第1组的平均年龄为23岁（范围14 - 45岁）。第2组包括40例采用“加速”计划治疗的修复病例，平均随访20个月时有4例失败（10%）。第2组的平均年龄为26岁（范围15 - 40岁）。第1组35%的患者和第2组25%的患者接受了关节镜二次检查。这些数据未显示出任何统计学差异，也不支持半月板修复术后需要进行活动限制的观点。
