[RESEARCH] Return to Play Following Meniscus Injury

Return to Play Following Meniscus Injury

The menisci are semicircular, wedge-shaped cartilages in the knee joint.
They have been identified to play a role in shock absorption, load bearing, and stabilization of the knee.
Over the past few decades, an abundance of research has been dedicated to meniscal preservation procedures, as both cadaveric and clinical studies have demonstrated a risk for early degenerative changes in the knee with complete loss of meniscal tissue (ie, total meniscectomy).
The vascular supply to the meniscus has also been extensively researched and demonstrates that the outer peripheral 1/3 has adequate blood supply (red-red zone), whereas the inner 2/3 tends be more avascular (red-white zone and white-white zone).
This has particular implications on the potential healing of a meniscus repair.
Knowledge of the zones of blood supply as well as age of the patient and tear characteristics, such as chronicity, tear pattern, and tear location, can aid in making treatment decisions.
Studies have suggested that there is an overall incidence of meniscal tears requiring surgery of 60 to 70 per 100,000 person years and approximately 1/3 of these tears are sport related.
This review describes the post-op rehab protocol for each procedure and evaluates the outcomes in existing literature as it pertains to the athlete.

KEY POINTS:

Meniscectomy offers a faster return to play and is a more attractive option to the in-season athlete.
Meniscus repair should be performed when possible in the young athletically active patient.
Accelerated rehabilitation protocols for meniscus repair offer equivalent functional outcomes when compared with traditional regimens.
Meniscal allograft transplantation is a viable salvage procedure, although return to collision or contact sports must be carefully weighed.

SOURCE:

Brelin & Rue, 2016. Return to Play Following Meniscus Surgery. Clin Sports Med, Oct;35(4):669-78.

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics.

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