Home-based rehabilitation suitable for recovery after arthroscopic isolated meniscectomy
Researchers have recently highlighted the fact that home-based rehabilitation (HBP) may be an effective management approach after arthroscopic isolated meniscectomy (AM) in the general population, according to the study published in the JAMA Open Network.
rthroscopic meniscectomy is one of the most common orthopedic procedures. The optimal postoperative approach remains debated.
Hence, Sebastiano Nutarelli and colleagues from the Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland carried out the present study to compare outcomes associated with home-based rehabilitation programs (HBP) vs standard inpatient and/or outpatient supervised physical therapy (IOP) following arthroscopic isolated meniscectomy (AM).
A systematic literature search was conducted and randomized clinical trials of patients treated with HBP vs IOP after AM were included for the research. The primary outcome was the Lysholm score (scale of 0-100 with higher scores indicating better knee function) and secondary outcomes were subjective International Knee Documentation Committee (IKDC) score, knee extension and flexion, thigh girth, horizontal and vertical hop test, and days to return to work, as indicated in the PROSPERO registration. Outcomes were measured in the short-term (ranging from 28 to 50 days) and the midterm (6 months).
The following results were posted-
- In this meta-analysis of 8 RCTs including 434 patients, IOP was associated with a greater short-term improvement in Lysholm score compared with HBP, with a mean difference of −8.64 points (95% CI, −15.14 to −2.13 points; P = .02) between the 2 approached, but the sensitivity analysis showed no difference.
- Similarly, no statistically significant difference was detected at midterm for Lysholm score, with a mean difference between groups of −4.78 points (95% CI, −9.98 to 0.42 points; P = .07).
- HBP was associated with a greater short-term improvement in thigh girth, with a mean difference between groups of 1.38 cm (95% CI, 0.27 to 2.48 cm; P = .01), whereas IOP was associated with a better short-term vertical hop score, with a mean difference between groups of −3.25 cm (95% CI, −6.20 to −0.29 cm; P = .03).
- No differences were found for all the other secondary outcomes.
Therefore, the authors concluded that "no intervention was found to be superior in terms of physical and functional outcomes as well as work-related and patient-reported outcomes, both at short-term and midterm follow-up. Overall, these results suggest that HBP may be an effective management approach after AM in the general population."