Summary
The SFT has the potential to be a valuable objective measurement for return to play decisions in patients who have undergone an isolated meniscus repair.
Abstract
Background
Standard functional tests (SFT) are commonly used as physical performance measures to evaluate dynamic knee stability and provide objective information about whether a patient is ready to return to their sport following an ACL reconstruction. Currently there is no standardized objective test to help determine return to sport for patients who are undergoing rehabilitation following an isolated meniscus repair. It is not uncommon that meniscus injury results from similar movement patterns to ACL injury and therefore it may be important to assess patients’ function prior to a return to sport after meniscal repair just as it is after ACL reconstruction.
Purpose
This retrospective study sought to determine whether or not a functional test could be used as an assessment tool for return to activity following meniscus repair, as well as to understand the timing of return of function following isolated meniscal repair.
Methods
The results of an SFT completed between 80-160 days post-operation (simulating 4-months post-op) in isolated meniscal repair patients were evaluated for the involved limb, uninvolved limb, and limb symmetry index (LSI). Secondly, involved limb performance and LSI for patients with their first SFT who underwent an isolated ACL reconstruction between 80-150 days post-operation (4-months) were recorded; the same results were recorded for an ACL group between 150-220 days post-operation (6-months). It is important to note that the 4 month ACL cohort represents only the patients who are doing the best with rehab, since at 4 months ACL patients would not be allowed to perform hop tests unless they were doing well enough to perform the tests safely. Both ACL groups were compared to the meniscus cohort; the ACL groups were age, height, and weight matched to the meniscal cohort.
Results
The meniscus cohort (n=18) performed well (LSI of 88% or better) overall on all 11 tests that comprise this institution’s SFT, including all hop tests, however, not all patients performed well on the SFT. The meniscus group performed better with LSI than the ACL 4-month cohort on hop tests (n=36, p=0.0088 for single leg squat, p=0.055 for crossover triple hop, and p=0.13 for single leg hop). There was no significant difference between the 6-month ACL group (n=40) compared to the meniscus group for any of the tests.
Conclusion
The SFT has the potential to be a good objective measurement for return to play decisions in patients who have undergone a meniscus repair. Since there were isolated meniscal repair patients who demonstrated continued functional deficits at 4 months, based on the SFT, there is value in a functional assessment of these patients prior to a return to activity. When comparing to ACL reconstruction patients, on average by 4 months, isolated meniscal repair patients are performing similar to an ACL cohort at 6 months post-operative.