The formal EU-US Meniscus Rehabilitation 2024 Consensus. An ESSKA-AOSSM-AASPT Initiative. Part I –Rehabilitation Management After Meniscus Surgery (Meniscectomy, Repair, Reconstruction)
Year: 2025
Type: article
Abstract: Purpose The aim of part-one of this EU-US consensus was to combine literature research and expertise to provide recommendations for the usage of rehabilitation (including physical therapy) of patients undergoing surgical treatment for degenerative meniscus lesions or acute meniscus tears (including meniscectomy, repair, or reconstruction). Prevention programs, non-operative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures (PROMS) will be presented in a part-II article. Methods This consensus followed ESSKA “formal consensus” methodology. For this combined ESSKA (European Society for Sports Traumatology and Arthroscopy), AOSSM (American Orthopedic Society for Sports Medicine), ASSPT (American Academy of Sports Physical Therapy) initiative, 67 experts (26 in the steering group and 41 in the rating group) from 14 countries (USA and 13 European countries) including orthopedic surgeons, sports medicine doctors and physiotherapists were involved. Steering group members established guiding questions, searched the literature, proposed statements. Rating group members assessed the statements according to a Likert scale and provided grades of recommendations reaching final agreement about rehabilitation of the knee after meniscus surgery. Final documents were then assessed by a peer review group to adress the geographical adaptability. Results The overall level of evidence of the literature was low. Of the 19 questions (leading to 29 statements), one received a grade A of recommendation, two a grade B, nine a grade C and 17 a Grade D. Nevertheless, the mean median rating of all questions was 8.2/9 (9 being the highest rating on a scale of 1-9) and the global mean rating was 8.4+/-0.2, indicating a high agreement. Rehabilitation depends on the type of lesion, the treatment performed and is the same after medial or lateral meniscus surgery. Rehabilitation after meniscectomy should follow a criterion-based rehabilitation protocol, based on milestones rather than a time-based protocol. After meniscus repair and reconstruction, rehabilitation should be progressed according to both time and criterion-based milestones. Conclusion Rehabilitation after meniscus surgery is a debated topic that may influence surgical outcomes if not optimally performed. This international formal consensus established clear, updated, and structured recommendations for both surgeons and physiotherapists treating patients after meniscus surgery. Level of Evidence I, Consensus.
DOI: 10.26603/001c.137095
Authors: Nicolas Pujol, Airelle O. Giordano, Stephanie E. Wong, Philippe Beaufils, Juan Carlos Monllau, Elanna K. Arhos, Roland Becker, Francesco Della Villa, J. Brett Goodloe, James J. Irrgang, Jitka Klugarova, Emma L. Klosterman, Aleksandra Królikowska, Aaron J. Krych, Robert F. LaPrade, Robert Manske, Nicky van Melick, Jill K. Monson, Marko Ostojic, Mark V. Paterno, Tomasz Piontek, Simone Perelli, Alexandre Rambaud, James Robinson, Laura C. Schmitt, Eric Hamrin Senorski, Thorkell Snaebjornsson, Adam J. Tagliero, C. Benjamin Ma, Robert Prill
Institutions: Centre Hospitalier de Versailles, University of Delaware, University of California System, Hospital Del Mar, Northwestern University, Medizinische Hochschule Brandenburg Theodor Fontane, Fédération Internationale de Football Association, University of Virginia Health System, University of Pittsburgh, Palacký University Olomouc, Michigan Medicine, Wroclaw Medical University, Mayo Clinic, Twin Cities Orthopedics, Wichita State University, Ascension Via Christi, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Rehasport Clinic, Universitat Autònoma de Barcelona, Hospital Universitario Dexeus, The Ohio State University, University of Gothenburg, University of Iceland
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410305776