Effectiveness of physiotherapy after meniscectomy

Abstract

To evaluate the effect of physiotherapy after partial arthroscopic meniscectomy, we performed a prospective, randomised and partially blinded study. This pilot study was performed from October 1996 to June 1997. The control group received the standard treatment, consisting of verbal and written advice and exercises. The physiotherapy group performed exercises according to a dynamic protocol under the supervision of a physiotherapist. During a 3-week period, nine treatment sessions were given of 30 min each. Twenty patients, who had undergone arthroscopic meniscectomy without any other pathology of the knee, were randomised into two groups of ten patients each. The effects of therapy were evaluated by a blinded observer. We measured the distance and height of one-leg jumps (hops), the VAS pain scale, the Tegner and Lysholm scores and the SARS/FORS score. Recovery and satisfaction with the treatment were also evaluated. The effect measurements were performed at 7 (T1), 14 (T2), 21 (T3) and 28 days (T4) following surgery. Statistical analysis was performed with the Student's t-test. The physiotherapy group showed significantly better results than the control group regarding the SARS score, the hop test and the distance jumps. Moreover, the measurements showed clear progression in favour of the physiotherapy group. In conclusion, exercising under the supervision of a physiotherapist led to high patient satisfaction and good functional rehabilitation after partial arthroscopic meniscectomy.

The Effectiveness of Postoperative Physical Therapy Treatment in Patients Who Have Undergone Arthroscopic Partial Meniscectomy: Systematic Review With Meta-analysis

“…30 For studies comparing outpatient physical therapy with home exercise to home exercise alone, there were some disagreements among the individual studies. In 3 RCTs, 25,34,47 differences were found in favor of using outpatient physical therapy for the outcomes of ROM, patient-reported knee function, and functional tests. However, the other 3 RCTs 3,14,24 found no differences between the groups.…”

“…In the study by Vervest et al, 47 a comparison of outpatient physical therapy plus home exercise (mean  SD age, 31.1  7.1 years) versus home exercise (mean  SD age, 35.7  5.7 years) showed that for the outcomes single-leg vertical and horizontal hop test and for the sports activity rating scale questionnaire, there was a statistical difference in favor of the first group. For other outcomes, there were no differences between groups.…”

“…For other outcomes, there were no differences between groups. FIGURES 5 and 6 refer to the metaanalyses of studies that evaluated patient-reported knee function through the Lysholm questionnaire 25,34,47 and ROM of knee flexion. 24,25 For patientreported knee function evaluated at 4 weeks postsurgery, comparing the outpatient physical therapy plus home exercise versus home exercise groups, a statistically significant difference was found in favor of the first group (mean difference, 10.35; 95% CI: 1.33, 19.36; P = .02) (FIGURE 5).…”

“…St-Pierre et al 44 Vervest et al 47 [ research report ] 10 days and the inpatient plus outpatient physical therapy group had a mean treatment time of 5 weeks.…”

Lateral Meniscus Repair in a Professional Ice Hockey Goaltender: A Case Report With a 5-Year Follow-up

“…Previous studies on the effect of supervised versus home-based rehabilitation programs have shown a trend towards better functional results for physiotherapist-led programs in the rehabilitation of patients after meniscectomy in a short-term follow-up of 6 months. 30, 44 Barber 5 reported a failure rate of the meniscal repair in 10% of patients following an accelerated rehabilitation program (mean follow-up of 20 months). Shelbourne et al 40 reported a similar failure rate in patients following an accelerated program with a mean follow-up time of 3.5 months and a return-to-sport time of 10 weeks.…”