Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction

Meniscal repair is preferable to meniscectomy because of the recognized benefits of the meniscus and the consequences of its loss. The most appropriate rehabilitation program after meniscus repair is unclear. Many meniscus repairs occur in association with anterior cruciate ligament (ACL) reconstructions. An accelerated program permitting early full weight bearing, unrestricted motion, and no limitations on pivoting sports after the resolution of the postoperative effusion and full motion is established encourages patient and surgeon acceptance of the meniscus repair. To evaluate the success of meniscus repair in this accelerated rehabilitation program, a consecutive series of 63 patients with 65 meniscus tears undergoing arthroscopic meniscus repair were followed for a minimum of 2 years. There were seven failures (11%) at an average follow up of 38 months. The average patient age was 26 (range, 13 to 44). Arthroscopic relooks were done in 26%. Successful meniscal healing occurred in 92% of repairs done with ACL reconstructions, but only 67% of meniscus repairs performed in ACL-deficient knees, and 67% of meniscus repairs done in stable knees with no ACL injury. There was no statistical difference in the failures for acute and chronic meniscus tears, nor in the age of the patient undergoing the meniscal repair. Published rehabilitation protocols differ considerably on the three main issues of immobilization, weight bearing, and return to pivoting sports. These data show a meniscus repair success rate consistent with other published series. No modification of an ACL reconstruction accelerated rehabilitation program is needed for meniscus repairs performed in conjunction with the reconstruction.