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Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose and hypothesis

Post-operative weight bearing after meniscal repair is a point of debate among physicians. This study sought to evaluate whether patients adhering to an immediate WBAT rehabilitation programme have a higher failure rate compared to those adhering to a more traditional, protected, NWB status following meniscal repair. The null hypothesis was that there would be no difference in failure between the two groups.

Methods

A retrospective review of meniscal repair patients greater than 5 years from surgery was performed for patients receiving meniscal repair treatment. Patients were categorized by post-surgical weight-bearing status, either NWB or WBAT, and then analysed for failure of repair. Failure was defined as re-operation on the torn meniscus. The study controlled for variables including age at surgery, sex, height, weight, and BMI, classification of tear type, acuity of the tear, repair location (medial or lateral), repair location within the meniscus, repair technique, and concomitant procedures.

Results

Re-operations were performed in 61 of 157 patients [38.9%]. There was no difference between weight-bearing groups for failure of meniscus repair (n.s.). The tears were acute vertical tears located in the posterior horn and body. For the 61 patients with re-operation, the average time to re-operation was 2.2 years with 10 [16%] > 5 years from surgery, 17 [28%] 2–5 years from surgery, and 34 [56%] < 2 years from surgery. In isolated meniscal repair patients (n = 62), there was no difference between weight-bearing groups for rate of re-operation (n.s.).

Conclusion

Weight bearing as tolerated after meniscal repair for peripheral, vertical tears does not result in a higher failure rate than traditional, non-weight bearing over a five-year follow-up period. The clinical relevance is that, based on these data, it may be appropriate to allow weight bearing as tolerated following meniscal repair of peripheral, vertical tears.

Level of evidence

Retrospective cohort study, Level III.

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Acknowledgements

We would like to acknowledge Julie Agel for her help with statistics as well as Cris Hansen and Tanya Doble for their help in manuscript preparation.

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Authors and Affiliations

Authors

Contributions

BP helped with design of the study, data collection, and manuscript preparation. AY and KG participated in data collection, data analysis, and manuscript preparation. MT conceived of the study and participated in the design of the study, data analysis, and manuscript preparation. All authors gave their approval of the final manuscript.

Corresponding author

Correspondence to Marc A. Tompkins.

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Conflict of interest

The authors declare that they have no competing interests.

Funding

No funding was received for this study.

Ethical approval

This study was reviewed by our institutional review board and approved as study #1504M67624. All ethical standards of maintaining patient confidentiality have been employed, including those in accordance with the US Health Insurance Portability and Accountability Act (HIPPA).

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Perkins, B., Gronbeck, K.R., Yue, R.A. et al. Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. Knee Surg Sports Traumatol Arthrosc 26, 2245–2250 (2018). https://doi.org/10.1007/s00167-017-4665-9

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  • DOI: https://doi.org/10.1007/s00167-017-4665-9

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