2017 ISAKOS Biennial Congress ePoster #1326

 

Effect of Immediate Post-operative Weight Bearing Vs. Protected Weight Bearing Following Meniscal Repair Greater than 5 Years Post Surgery

Bryan Perkins, BA, Omaha, NE UNITED STATES
Kyle Gronbeck, BS, Minneapolis, MN UNITED STATES
Ruixian Alexander Yue, BS, Minneapolis, MN UNITED STATES
Marc Tompkins, MD, Minneapolis, MN UNITED STATES

TRIA Orthopaedic Center, Minneapolis, MN, UNITED STATES

FDA Status Not Applicable

Summary

Weight bearing as tolerated after meniscal repair does not result in a higher failure rate than traditional, non-weight bearing over a five-year follow-up period.

Abstract

Background

Postoperative weight bearing after meniscal repair is a point of debate among physicians. This study sought to evaluate whether patients adhering to an immediate weight bearing as tolerated (WBAT) rehabilitation program have a higher failure rate compared to those adhering to a more traditional, protected, non-weight bearing (NWB) status for 6 weeks following meniscal repair. The null hypothesis was that there would be no difference in failure between the two groups.

Methods

A retrospective review of 157 meniscal repair patients greater than five 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 analyzed for failure of repair. Failure was defined as re-operation on the torn meniscus. Patients were contacted by phone at a minimum of 5 years follow up and asked if they had undergone another surgery on the same knee and the same meniscus. For those who had undergone a re-operation, the duration of time between the first and second surgeries was also evaluated. The study controlled for variables including age at surgery, sex, height, weight, and BMI, classification of tear type (vertical, horizontal, radial), acuity of the tear, meniscus laterality (medial or lateral), tear location within the meniscus (posterior horn, body, anterior horn), repair technique (inside out or all inside), and concomitant procedures (ACL reconstruction or other procedures). These variables were evaluated for their potential effect on the results between weight bearing groups using independent samples t-tests and chi-square tests.

Results

The overall re-operation rate was 38.9%. There was no difference between weight bearing groups for failure of meniscus repair (p=0.81). There was also no difference between weight bearing groups for any of the variables, including age, sex, height, weight, BMI, meniscal laterality, repair technique, or concomitant procedures. 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 16% > 5 years from surgery, 28% 2-5 years from surgery, and 56% < 2 years from surgery. In isolated (without concomitant procedures) meniscal repair patients (n=54), there was no difference between weight bearing groups for rate of re-operation (p = 0.68).

Conclusion

Weight bearing as tolerated after meniscal repair does not result in a higher failure rate than traditional, non-weight bearing over a five-year follow-up period.