Is post-surgical rehabilitation sufficient? Would it be better to rehabituate?

Bąkowska-Żywicka

BMC Musculoskelet Disord

2020

Background Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists. Methods A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care. Results The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1–2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p = 0.007) and were more likely to use objective physical tests (p = 0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p = 0.001) and admitted that patient age does matter for meniscus repair qualification (p = 0.002). Conclusions There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.

Section: Discussionmentioning

confidence: 99%

Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among polish arthroscopy society members

Bąkowska-Żywicka

BMC Musculoskelet Disord

2020

“…There is a lack of consensus regarding the optimal postoperative protocol following meniscus repair [32]. Diverse treatment methods require individual and various rehabilitation approaches, which is why direct cooperation between the physiotherapist and the patient is so important [40]. Only 42% of Polish surgeons recommend standardized rehabilitation, and 86% con rm the dependence of the rehabilitation programme on the performed procedure.…”

Section: Discussionmentioning

confidence: 99%

Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among Polish Arthroscopy Society members.

Bąkowska-Żywicka²,

2020

Preprint

Background: Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists.Methods: A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1-2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p=0.007) and were more likely to use objective physical tests (p=0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p=0.001) and admitted that patient age does matter for meniscus repair qualification (p=0.002).Conclusions: There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.

“…consensus is constantly timely and necessary. Recently the ESSKA (European Society for Sports Traumatology, Knee Surgery and Arthroscopy) European consensus provided recommendations for the treatment of meniscus tears based on both scienti c evidence and the clinical experience of knee experts [10,11]. Other studies have shown that the surgeon's level of expertise signi cantly affects the clinical outcomes in patients undergoing knee arthroscopy [12,13].…”

Section: Introductionmentioning

confidence: 99%

Clinical Practice and Post-Operative Rehabilitation After Knee Arthroscopy: Comparison Between Polish Experts and Non-Experts.

Bąkowska-Żywicka²,

2020

Preprint

Background: The purpose of this study was to compare the clinical practices between polish expert and non-expert arthroscopy knee surgeons.Methods: 205 registered orthopedic surgeons took part in surveys. The survey included 35 questions regarding general arthroscopy and postoperative management, including physician’s level of expertise, arthroscopy anesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care.Results: The most important finding of this study is an agreement in almost all aspects of knee arthroscopy approach. A consensus between polish surgeons was noticed in choosing regional anesthesia for knee arthroscopy, no need for knee braces nor knee medications, using LMW heparin as thromboprophylaxis, 1-2 days hospitalization, recommendation of rehabilitation and magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus sewing procedures (p = 0.009). Experts recommended starting rehabilitation already on the day of surgery (p=0.007) and more likely used objective physical tests (p=0.003). Nonexpert surgeons recommended longer period from meniscus suture to a full range knee motion (p=0.001) and admitted that patient’s age does matter for meniscus repair qualification (0.002).Conclusions: Clinical practice varies among orthopeadists performing knee arthroscopy procedures, based on their level of expertise. Polish knee arthroscopy experts agreed with non-experts in the type of anesthesia during knee arthroscopy and numerous aspects of postoperative treatment. Surgical expertise was associated with the performance of advanced meniscus suturing techniques.