title: Early and intensive physiotherapy accelerates recovery postarthroscopic meniscectomy: results of a randomized controlled study.
abstract: The efficacy of an early, intensive, supervised rehabilitation program to accelerate knee strength recovery in the first 3 weeks postmeniscectomy by arthroscopy was evaluated using a randomized controlled trial design. The maximal voluntary isokinetic strength of 31 men, randomly allocated to either a treatment (EXP) or a control (CTL) group, was measured twice by a blind rater: preoperatively (pretest) and 3 weeks postsurgery (posttest), using a computer-controlled Kin-Com dynamometer (Chattecx Corporation, Chattanooga, TN). Strength deficits of the operated leg at the pretest and posttest were established in percent of the values obtained for the sound leg at the pretest. In the interval between the surgery and the posttest, the patients of the EXP group (n = 15) received nine supervised treatments combined to home exercises whereas patients of the control group (n = 16) had no specific physiotherapy treatment but were given instructions in postsurgical management and prescribed exercises by the orthopedic surgeons. Patients of the EXP group had better knee extensor strength recovery than patients of the CTL group (ANCOVA, p < 0.001). The size of the strength difference (3 weeks postsurgery) between EXP and CTL subgroups (n = 8) matched according to preoperative deficits was as large as 26% and the residual deficits of the untreated patients were two to three times larger than those of the treated patients. The results of this study highlight the importance of instituting an early intensive and supervised rehabilitation program, especially for workers returning to a strenuous job requiring good knee extensor muscle function.
authors.affiliation: Physiotherapy Department, Faculty of Medicine, Laval University, Québec, Canada.
authors.forename: H
authors.initials: H
authors.lastname: Moffet
authors.forename: C L
authors.initials: CL
authors.lastname: Richards
authors.forename: F
authors.initials: F
authors.lastname: Malouin
authors.forename: G
authors.initials: G
authors.lastname: Bravo
authors.forename: G
authors.initials: G
authors.lastname: Paradis
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000704:Analysis of Variance; D001182:Arthroscopy; D006699:Home Care Services; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D009119:Muscle Contraction; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology; D010349:Patient Compliance; D026741:Physical Therapy Modalities / Q000379:methods*; D011182:Postoperative Care; D015995:Prevalence; D016059:Range of Motion, Articular; D013813:Therapy, Computer-Assisted; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D014947:Wounds and Injuries / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery