Meniscal Injury Follow-up

Updated: Apr 24, 2020
  • Author: Sarjoo M Bhagia, MD; Chief Editor: Ryan O Stephenson, DO  more...
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Follow-up

Further Outpatient Care

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  • Patients with meniscal injuries (operative or nonoperative) are recommended to receive outpatient physical therapy for rehabilitation. Please refer to the Physical Therapy section for appropriate treatment goals and guidelines.

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Prognosis

The prognosis for pain-free return to sports is variable depending on comorbidities and severity of injury. Over the long term, meniscal injuries predispose to osteoarthritis [25] secondary to increased loads on the articular surfaces of the knee. However, the degree of correlation between meniscal injuries and osteoarthritis has not been well established in the literature.

A study by Everhart et al indicated that in middle-aged adults, meniscal tears and lateral meniscal extrusion accelerate loss of joint space. Patients with medial meniscal tears, regardless of whether or not extrusion had occurred, suffered an additional mean medial space loss of 0.05 mm/year, while those with lateral tears underwent an additional mean lateral space loss of 0.09 mm/year. Moreover, lateral extrusion was associated with an additional mean lateral space loss of 0.1 mm/year. Patients without lateral extrusion had a 0.5% annual incidence of knee arthroplasty, compared with a 1.5% rate for those with a lateral extrusion of less than 2.0 mm, and a 3.7% rate for those with an extrusion of 2.0 mm or more. [26]

A retrospective, dual-center study by Ronnblad et al of 918 patients who underwent meniscal repair indicated that surgeries using bioabsorbable arrows are more likely to fail than those employing all-inside sutures with anchors (hazard ratio [HR] = 1.8), with the failure rate also being higher for medial, rather than lateral, meniscal repairs (HR = 3.7). [27]

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Patient Education

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  • Unfortunately, most injuries to menisci occur during accidents that are, at times, not preventable. However, the following may help avoid these injuries:

    • Having strong thigh and hamstring muscles

    • Gently stretching the legs before and after exercise

    • Wearing shoes that fit properly when exercising and ensuring the shoes are appropriate for the activity being performed

    • When skiing, ensuring that ski bindings are set correctly by a trained professional so that the skis release when a fall occurs

  • For excellent patient education resources, see eMedicineHealth's patient education articles Knee Injury and Knee Pain.

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