Effect of Immediate Post-Operative Weight Bearing vs. Protected Weight Bearing Following Meniscal Repair Greater than 5 years Post Surgery

Abstract

Postoperative weight bearing after meniscal repair is a point of debate among physicians. This study sought to evaluate whether patients adhering to an immediate WBAT rehabilitation program have a higher failure rate compared to those adhering to a more traditional, protected, NWB status following meniscal repair. The null hypothesis was that there would be no difference in failure between the two groups. 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. The study controlled for variables including age at surgery, sex, height, weight, and BMI, classification of tear type, acuity of the tear, repair location (medial or lateral), repair location within the meniscus, repair technique, and concomitant procedures. The overall re-operation rate was 38.9%. There was no difference between weight bearing groups for failure of meniscus repair (p=0.81). 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 meniscal repair patients (n=54), there was no difference between weight bearing groups for rate of re-operation (p = 0.68). Weight bearing as tolerated after meniscal repair for peripheral, vertical tears does not result in a higher failure rate than traditional, non-weight bearing over a five-year follow-up period.