Early Full Weight Bearing Research Articles

Hip Resurfacing through a Modified Anterolateral Approach, as Compared with the Ganz Trochanteric Flip Osteotomy: A Two Year follow-up Study

Hip resurfacing arthroplasty has conventionally been undertaken through the posterior approach. There has been evidence in the recently published literature to suggest that the posterior approach may compromise the blood supply to the femoral head, by disruption of the posterolateral hip capsule. Ganz et al have proposed the trochanteric 'flip' osteotomy through a lateral approach, to permit surgical dislocation of the hip without damaging the blood supply. The disadvantages, however, are that early full weight bearing is not permitted and there is an incidence of trochanteric delayed or non-union, which may require further treatment. We describe a technique of hip resurfacing through a modified anterolateral approach preserving the posterolateral capsular blood supply. We describe our experience using this approach, and compare the results with our previously used Ganz trochanteric osteotomy. At a mean follow-up of two years, the outcome scores were not significantly different, and both groups had similar abductor strength. There were two cases of delayed union in the Ganz group, one of which required revision; there were no complications in the modified anterolateral group.

Medial Opening Wedge High Tibial Osteotomy With Early Full Weight Bearing

We performed clinical and radiographic evaluation of patients with medial compartment osteoarthritis of the knee who had undergone treatment with opening wedge high tibial osteotomy (OWHTO) followed by early full weight bearing. OWHTO procedures were performed by use of TomoFix (Synthes, Bettlach, Switzerland) and bone substitute materials. OWHTO was performed in 57 knees in 52 patients with a mean age of 69 years (range, 54 to 82 years) at the time of operation. The diagnosis was primary osteoarthritis in 34 knees in 29 patients and osteonecrosis in a further 23 knees in 23 patients. We established an early weight-bearing exercise program during which these patients were permitted partial weight-bearing exercise 1 week after their osteotomy procedure. All patients performed full weight-bearing exercises at 2 weeks after surgery. The mean follow-up period was 40 months (range, 24 to 62 months). The American Knee Society Score and Function Score showed significant improvement from 50.9 +/- 12.3 to 91.7 +/- 6.9 points and 59.3 +/- 13.1 to 94.1 +/- 8.8 points, respectively. Before surgery, the mean femorotibial angle during standing was 181.3 degrees +/- 2.4 degrees (1.3 degrees anatomic varus), but it measured 169.6 degrees +/- 2.3 degrees (10.4 degrees valgus) at the time of follow-up. There were no instances of nonunion or implant failure in any of our patients. We have shown that an early weight-bearing exercise program enables full weight bearing at 2 weeks after OWHTO with TomoFix and artificial bone wedges. Overall, this combination was a highly successful course of treatment for correcting knee malalignment in patients with medial compartment osteoarthritis. Level IV, therapeutic case series.

Fresh-Frozen Free-Tendon Allografts Versus Autografts in Anterior Cruciate Ligament Reconstruction: Delayed Remodeling and Inferior Mechanical Function During Long-term Healing in Sheep

The objective of this study was to investigate the biologic healing and restoration of the mechanical function of a free soft tissue autograft and compare these to an identical nonsterilized fresh frozen allograft for anterior cruciate ligament (ACL) reconstruction in an in vivo sheep model. Forty-eight merino sheep received either an allograft or autograft ACL reconstruction with a long flexor tendon. Each group was analyzed at 6, 12, and 52 weeks for descriptive analysis of histologic changes and quantitative analysis of recellularization, revascularization, and mechanical function. Recellularization and revascularization was significantly delayed at 6 and 12 weeks of healing, while at 52 weeks, differences had become less distinct. Overall remodeling had not been completed compared to the intact ACL. Significantly lower structural and mechanical properties and anterior-posterior laxity were found at 52 weeks for allografts, with no differences at the early healing time points. Allograft remodeling is delayed in ACL reconstruction and resulted in reduced long-term stability and mechanical function compared to autologous ACL reconstruction. Caution should be used with early full-weight bearing after allograft ACL reconstruction, because remodeling is delayed and long-term stability might be affected. Clinical studies should be warranted to examine the impact of varying rehabilitation protocols on long-term outcome.

Corrective osteotomy of the shaft of the femur and tibia with an interlocking nail

The indication for nailing a femur or tibia fracture has been extended by the method of interlocking up to the meta/diaphyseal zone. For the stabilization of osteotomies in these regions, the nail was used in 16 cases of femur and 21 of tibia corrections between 1982 and 1986 in orthopedic university clinic Berlin. The osteotomies were done with a small skin incision in open way. Although there were three infections bone consolidation was succeeded in all but one patient with the planned axis. The first achieved gain in length could not be hold in five cases after removing the interlocking screws in order to give full weight bearing to the leg for callus formation. In situations of non-unions with wrong position of refracture of biologically troubled bones after plating the method of interlocking nail is stable and enables bone recovery after grafting by drilling. The possibility of early full weight bearing is a great advantage for the rehabilitation of patients, who had been suffering of the delayed healing of their leg. The nail itself preserves the right position of the bone in two dimensions, even if there are not exact fitting osteotomy fragments, and the interlocking screws secure the bone against malrotation.

The Effect of Early Weight Bearing on Migration Pattern of the Uncemented CLS Stem in Total Hip Arthroplasty

Forty-two patients (younger than 65 years) with osteoarthritis were operated on with an uncemented CLS stem and randomized to early unrestricted weight bearing combined with intensive physiotherapy or to partial weight bearing combined with self-training. Radiostereometric analysis showed 1.2 (+0.11 to −6.76) mm subsidence of the stem at 24 months in both groups. There was no significant difference in the migration pattern between the unrestricted and partial weight bearing groups. Actual loading on the operated leg, measured with the F-scan system, did not influence the migration of the stem. There was a strong correlation between the average subsidence at 3 and 24 months ( r = 0.96). Early full weight bearing and active rehabilitation can be used for the uncemented CLS stem without increased risk of early loosening.

A Modified Operation for Achilles Tendon Ruptures

Background Treatment of Achilles tendon rupture has long been at the center of debate. Hypothesis A new technique in surgical Achilles tendon repair allows for more stability and earlier rehabilitation. Study Design Case series; Level of evidence, 4. Methods One hundred Achilles tendon rupture patients (70 men, 30 women; age range, 16-54 years; mean age, 32 years) were treated by a newly modified method of repair. Twenty-one of these patients were high-level athletes, and 79 were recreational-level athletes. The average length of follow-up was 2.4 years (range, 1-6.3 years), and none of the ruptures included avulsion fractures. After adjusting the tendon to an adequate length using a Tsuge suture, each fibrous bundle was gathered in a longitudinal direction and fixed with a Bunnell-type suture. The same postoperative physical therapy protocol was applied to all patients: at 1 week, early full weightbearing with a walking cast was initiated, and at 2 weeks, patients began range of motion (ROM) exercises and were instructed to wear a hinged ankle-foot orthosis that permitted full plantar flexion but limited full dorsiflexion. From 6 weeks, patients started practicing double-legged heel raises. Results At an average of 10 weeks, ankle ROM was comparable to that of the nonoperated leg, and double-legged heel raises were achieved at an average of 7.6 weeks. On average, patients were able to do 20 continuous single-legged heel-raising motions (equivalent to manual muscle testing grade 5) at 15.4 weeks, and jogging started at 12.3 weeks. High-level athletes returned to their original sports level at an average of 5 months. Two reruptures (2%) were experienced, but no other complications occurred. Conclusion This surgical technique allows for strong repair stability and subsequent early weightbearing and ROM exercises.

Evaluation of Two Dynamic Axial Fixators for Large Ruminants

To evaluate healing of a radial osteotomy repaired by application of dynamic axial fixation devices (DAF) in large ruminants. In vivo study of bone healing after application of 2 DAF types. Model I had 2 sidebars, each with a central cylindrical cuff (internally threaded) with 2 detachable connecting rods telescoping within the cuff. Model II had 2 side bars with 2 moveable clamps with multiple holes. Bull calves (n=8; aged, 1.5-2.0 years; weighing, 175-250 kg). A mid-diaphyseal radial osteotomy was repaired by use of a model I (n=4) or model II (n=4) DAF. Calves were monitored for weight bearing, stability of fixation, and radiographically for fracture reduction, alignment and healing at intervals for 6 months. Fixators were removed when there was radiographic evidence of healing. Both the fixators were well tolerated with free movement of adjacent joints. Fragment fixation was maintained until healing in all but 1 model I calf where failure occurred within 7 days. Model II DAF provided more rigid fixation as indicated by early full weight bearing and fracture healing with less callus formation. Functional recovery of repaired limbs occurred within 60 days in surviving calves. Both bilateral DAFs were easy to apply; however, the model II DAF provided better fixation. The model II DAF made of low carbon steel was economical and may be useful for treating long bone fractures in large ruminants.

当科における人工股関節再置換術の短期成績〜ステム側の評価を中心に〜

The purpose of present study was to evaluate the short-term results of revision total hip arthroplasty (revision THA) without cement. Thirty-two hips of 31 patients who underwent revision THA from September 1998 to June 2003 were enrolled. There were 6 men 7 hips and 25 female 25 hips, and the mean age at revision THA was 65.7 years. According to Endo-Klinik classification, four hips were grade 1, seventeen hips were grade 2, nine hips were grade 3, one hip was grade 4, and there was one fracture. The average full weight bearing time was nine days after operation. There was only one hip, which showed 3 mm subsidence of the stem. When initial fixation was obtained, early full weight bearing and early social rehabilitation were possible.

Minimally Invasive Percutaneous Plating of Distal Femoral Fractures Using the Dynamic Condylar Screw

In distal femoral fractures, conventional open reduction and internal fixation causes complications because of excessive soft-tissue stripping. To prevent this, minimally invasive percutaneous plating was performed in distal femoral fractures. Sixteen supracondylar or intercondylar femoral fractures were treated by minimally invasive percutaneous plating with the dynamic condylar screw without bone graft. Five (31%) were open fractures. All fractures healed except one. The average time for fracture healing was 17 weeks (range, 14-22 weeks). Complications included one nonunion related to early full weight bearing. No patient showed malunion or deep infection. Results were evaluated by modified Neer rating, and all patients had excellent or good results. Intra-articular fractures showed less favorable range of motion and clinical scores than extra-articular fractures. Minimally invasive percutaneous plating with the dynamic condylar screw can provide favorable results in the treatment of distal femoral fractures.

Improved comfort in lower limb lengthening with the intramedullary skeletal kinetic distractor

Limb lengthening by external fixators is associated with many problems such as pain at the pin tracts, muscle transfixation, pin tract infections, reduced joint motion, and prolonged fixation time. The intramedullary skeletal kinetic distractor (ISKD) is a new internal, mechanically activated implant, which distracts by mild rotations of 3 degrees. In a prospective clinical study, four patients with an mean age of 29 years (18-36 years) underwent intramedullary lengthening via ISKD. The average lengthening of three femora and one tibia was 31 mm (26-40 mm). All patients performed the rotations for the distraction themselves without any significant problems. One patient took mild analgesics during the first days of distraction, whereas three patients did not require any analgesics. The average patient discharge occurred 10 days (8-11 days) postoperatively with no complications during the hospital stay. The planned length of distraction was achieved in all patients with normal alignment and normal joint orientation. Full weight bearing was performed on average after 10 weeks (7-14 weeks). Consolidation was noted 80 days (51-111 days) postoperatively with an average consolidation index of 2.9 days/mm. No complications were observed during the follow-up period of 14 months. The Enneking score was 26.8 points, and according to the classification of Paley all patients had an excellent result. From these preliminary results we conclude that the comfort of limb lengthening with the ISKD is increased by the elimination of fixator-associated complications and by the simple distraction mechanism, which is well tolerated by the patients. Further advantages of the ISKD are early full weight bearing and excellent limb function.

当科における人工股関節再置換術の短期成績

The purpose of present study is to report the short-term results of revision total hip arthroplasty (revision THA) without cement. Thirty-four hips of 33 patients who underwent revision THA from September 1998 to August 2002 and who could be followed up for one year or more were enrolled in the study. There were six men seven hips and 27 female 27 hips, and mean age was 73 years. In AAOS classification, Type 2 was eight hips and Type 3 was 26 hips. The average full weight bearing time was 8 days. Only one hip was movement of acetabular component and required re-operation. Initial fixation in acetabular enabled early full weight bearing and early social rehabilitation.

Compression Nailing of Long Bones

Biomechanics: The biomechanical concept of compression nailing consists of the use of an intramedullary device that is inserted into the medullary cavity without jamming and that allows a relative movement of the fragments after locking. First, the implant is firmly attached to the distal main fragment, using conventional locking screws at the nail tip. Next, the other main fragment, which contains the nail entry portal, is fixed via a locking screw in a longitudinal slot in the nail. The compression screw is inserted, and produces distraction between the proximal part of the nail and the locking screw in the slot. This distraction results in relative movement between the intramedullary nail and the proximal fragment, compressing the fixed distal fragment against the proximal. Indications: Whether or not compression nailing can be used depends on the axial stability of the fracture or osteotomy. Therefore, simple fracture patterns, nonunions and elective osteotomies are excellent indications. The same is true for fusions of the knee or the ankle joint, providing that there are no major bone defects. Benefits: The chief benefits of compression nailing are controlled fragment apposition, and superior stability, especially to rotational forces, as compared with conventional intramedullary nailing techniques. The favorable biomechanical conditions provided allow early full weight bearing, and ensure a high rate of bony union. With implants and instruments optimized for compression nailing, this technique should widen the scope and enhance the outcome of intramedullary nailing.

Mittelfristige Resultate nach Anwendung des MPT-Fixateurs bei Verletzungen des distalen Kniestreckapparates. Eine kritische Analyse

Between 1994 and 2000 at our institution 37 patients (8 women, 29 men) with fractures of the lower patellar pole and a proximal avulsion fracture of the patellar ligament underwent a primary surgical repair and patello-tibial fixateur for external protection. All patients underwent immediately after the reconstruction a functional rehabilitation program without any movement limitation and under early full weight bearing. Postoperative follow-up after an average of 58.5 months (range 14 to 102 months) was possible in 26 patients. Physical examination, roentgenographic evaluation and isokinetic testing were performed. The clinical evaluation was carried out according to the strict criteria of the IKDC-score. The radiological measurement of the patella height was carried out using the index of Blackburne & Peel; the femoropatellar changings were registered according to the score of Sperner. The clinical evaluation showed in 8 patients a normal, in 10 patients a nearly normal, in 7 patients an abnormal and only in 1 patient a severe abnormal result. The average muscle strength deficit in comparison to the contralateral knee joint was between 10 % and 20 %. All patients showed clinically and radiologically a sufficient distal knee extensor mechanism. The patella height ratio was in the average 0.82 on the injured and 0.79 on the non-injured side. In 17 cases we didn't saw any femoropatellar arthrosis. Eight patients showed a moderate femoropatellar arthrosis. There was no case with severe femoropatellar arthrosis. By good follow-up results in general we could demonstrate the value of the MPT-fixateur as a dynamic protection method after reconstructive operations of the distal knee extensor mechanism.

External patellotibial transfixation: indications, operative technique and outcome

Patellotibial transfixation with the MPT fixator is a new method of external stabilisation for lesions of the extensor mechanism of the knee joint. The biomechanical principle is the external transmission of tensile forces in the quadriceps muscle from the patella to the lower thigh and the translation of these forces into extension of the knee joint. The construction is an external patellotibial frame. In fitting method A, a Steinmann pin with central thread is inserted transversely through the patella and proximal tibia. Connection is made via laterally positioned rods with rotatable fixator jaws. In fitting method B, a Schanz screw is inserted sagittally into the proximal tibia and connected to the tibiocentral fixator jaw. In the frame construction a threaded pin is tightened into the fixator jaw. The MPT fixator is mostly used to secure suture repairs and transosseous refixations of the patellar ligament, or to reconstruct neglected patellar tendinous or osseous lesions of the distal extensor apparatus when functionally stable results cannot be obtained by osteosynthesis. The advantages of patellotibial transfixation are that: (1) a minimum of internal allogenic material is required to reconstruct the extensor apparatus and the repair is protected against excessive strain; (2) immediate functional post-operative therapy with an unlimited range of motion and early full weight-bearing is possible. Between 1990 and 1997 the MPT fixator was here used on 74 patients, 51 of whom had an acute lesion of the extensor mechanism, 19 lesions had either been neglected or subjected to an earlier operation. Among 20 of the acutely injured knee joints there were other serious associated injuries. Fitting method A was used in 48 patients and fitting method B in 26 patients. In four patients the operation was followed by severe infection, owing to the fixator in two cases. The remaining 70 patients wore the system for an average of 7.3 weeks. Eight patients with caudal comminuted fractures who had had segmental patellectomy and transosseous refixation of the patellar tendon and 15 patients who had had transosseous suture refixation of the patellar ligament after rupture at the lower pole or suture repair after intraligamentous rupture, were followed up isokinetically and radiologically with IKDC scoring for an average of 49.3 months after the operation. The outcome was classified as normal or close to normal in 19 patients and as abnormal in four. Isokinetically only five of the 23 had a 10–20% deficiency in the strength of the extensor muscles of the operated leg in comparison to the opposite side. External patellotibial transfixation with the MPT fixator produced good operative results in re-establishing the continuity of the distal extensor apparatus of the knee joint and is an effective alternative to patellotibial cerclage with wire or synthetic ligament.

How many multiple trauma patients benefit from the biomechanical advantage of intramedullary nailing of femur fractures regarding early weight bearing?

The benefit of early operative stabilization of femoral fractures is established in patients with multiple injuries. In the last few years the unreamed femoral nail is favoured for internal fixation of femoral fractures despite pathophysiological concerns. The foremost advantage of femoral nails compared with plate fixation is the possibility of early full weight bearing. The aim of this retrospective study was to investigate, under consideration of the severity of injury, the extent of injury, and the clinical course, if multiple injured patients with concomitant femoral fractures benefit from the preferred intramedullary nailing with early weight bearing. Three hundred and two (23.8 %) out of 1271 multiple injured patients (ISS > 17) had a concomitant femoral fracture. Fourty-seven out of 302 patients were children under 16 years of age, remaining 255 patients. Eighteen out of 255 patients died within the first 21 days after trauma and 66 patients required mechanical ventilation for more than three weeks (171/255). Thirty patients suffered from severe head injury (AIS-head > 3) and seven from severe pulmonary contusion with concomitant abdominal injury (134/255). Two patients had grade III open femoral fractures with vascular injury. Ipsilateral unstable pelvic fratures were seen in 11 patients, seven patients had ipsilateral intraarticular femoral fractures, and ipsilateral intraarticular fractures of the lower leg or foot were observed in 40 patients (74/255). The results demonstrate, that only 74 (29 %) out of 255 multiple injured patiens ( > 16 years of age) had a theoretical benefit of early weight bearing. Seventy percent of the patients did not benefit from intramedullary nailing considering full weight bearing. With regard to pathophysiological concerns alternative methods of fracture fixation should be discussed for these patients. Primary fracture fixation with external fixators and secondary internal fixation proved to be a save alternative method. The complication rate of plating is comparable to intramedullary nailing but associated with less severe systemic risks. Primary plating of femoral fractures would not delay mobilization of most multiple injured patients.

Early full weightbearing and functional treatment after surgical repair of acute achilles tendon rupture.

We prospectively evaluated the clinical outcomes of 20 patients (mean age, 42.8 years) with early full weightbearing and functional treatment after surgical repair of acute Achilles tendon rupture according to a prospective intra- and postoperative protocol. All patients underwent open repair using a Kessler-type suture and simple apposition sutures. The postoperative regimen included a plantigrade splint for 24 hours and 6 weeks of early full weightbearing in a removable walker. All patients were evaluated with clinical and ultrasound examination and according to a new scoring system at 3, 6, and 12 months after repair. After 3 months, the score averaged 73 of 100 points; after 6 months, 86; and after 1 year, 94. All patients reached the same level of sports activities as preoperatively and demonstrated no significant difference in ankle mobility and isokinetic strength. There were no reruptures. One patient had a deep venous thrombosis 3 weeks after the operation after having prematurely stopped thromboprophylaxis. We believe that early careful ankle mobilization and full weightbearing in a removable walker after primary Achilles tendon repair does not increase the risk of rerupture. An accelerated rehabilitation program improves early foot function with excellent recovery of plantar flexion strength and amplitude.

How many severely injured multiple-trauma patients can benefit from the biomechanical advantage of early mobilization following femoral intramedullary nailing?

The benefit of early operative stabilization of femoral fractures is established in patients with multiple injuries. In the last few years the unreamed femoral nail is favoured for internal fixation of femoral fractures despite pathophysiological concerns. The foremost advantage of femoral nails compared with plate fixation is the possibility of early full weight bearing. The aim of this retrospective study was to investigate, under consideration of the severity of injury, the extent of injury, and the clinical course, if multiple injured patients with concomitant femoral fractures benefit from the preferred intramedullary nailing with early weight bearing. Three hundred and two (23.8%) out of 1271 multiple injured patients (ISS > 17) had a concomitant femoral fracture. Fourty-seven out of 302 patients were children under 16 years of age, remaining 255 patients. Eighteen out of 255 patients died within the first 21 days after trauma and 66 patients required mechanical ventilation for more than three weeks (171/255). Thirty patients suffered from severe head injury (AIS-head > 3) and seven from severe pulmonary contusion with concomitant abdominal injury (134/255). Two patients had grade III open femoral fractures with vascular injury. Ipsilateral unstable pelvic fractures were seen in 11 patients, seven patients had ipsilateral intraarticular femoral fractures, and ipsilateral intraarticular fractures of the lower leg or foot were observed in 40 patients (74/255). The results demonstrate, that only 74 (29%) out of 255 multiple injured patients (> 16 years of age) had a theoretical benefit of early weight bearing. Seventy percent of the patients did not benefit from intramedullary nailing considering full weight bearing. With regard to pathophysiological concerns alternative methods of fracture fixation should be discussed for these patients. Primary fracture fixation with external fixators and secondary internal fixation proved to be a save alternative method. The complication rate of plating is comparable to intramedullary nailing but associated with less severe systemic risks. Primary plating of femoral fractures would not delay mobilization of most multiple injured patients.

大腿骨転子部骨折に対するＣＨＳ法とＧａｍｍａ ｎａｉｌ法との比較

We conducted a randomised prospective comparison of the Compression Hip Screw(CHS) and gamma nail for internal fixation of 60 intertrochanteric femoral fractures in elderly patients. The gamma nail group showed shorter convalescence and earlier full weight-bearing. There were however no significant differences in the operative time, blood loss, stay in hospital' and patien's mobility at the final review. Intra-operative lateral cortex fracture and post-operative cutting cut were recorded in the gamma nail group. Use of the gamma nail is thus not recommended for these complications considering the good results of CHS.

Percutaneous Repair of Achilles Tendon Rupture; Immobilization Versus Functional Postoperative Treatment

Between 1987 and 1992, 48 patients with ruptured Achilles tendons were operated on using a standardized microinvasive technique; 30 patients underwent functional postoperative treatment, whereas 18 underwent conventional cast immobilization. Validated tests and a specially designed instrument for measuring strength and endurance were used for followup examinations. Patients undergoing functional postoperative treatment were hospitalized for shorter periods and lost fewer days from work than those in the cast group. Tests of ankle mobility showed more pronounced limitations of plantar flexion in cast immobilized versus functionally treated patients. Patients in the cast group also did less well on maximal one leg tiptoeing. Percutaneous Achilles tendon repair with functional postoperative treatment and early full weightbearing was associated with significantly less severe limitations of calf muscle work by the injured leg than postoperative cast immobilization. The rerupture rate was no higher than after cast immobilization, but lower than after open surgical repair or conservative functional treatment alone. Unlike those undergoing conservative functional treatment, patients need not wear special boots at night or be observed by ultrasound studies at regular intervals. Because the procedure can be done on an outpatient basis and because patients lose significantly fewer days from work than those immobilized in a cast, cast immobilization after Achilles tendon suture repair is no longer justified.

Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction.

Meniscal repair is preferable to meniscectomy because of the recognized benefits of the meniscus and the consequences of its loss. The most appropriate rehabilitation program after meniscus repair is unclear. Many meniscus repairs occur in association with anterior cruciate ligament (ACL) reconstructions. An accelerated program permitting early full weight bearing, unrestricted motion, and no limitations on pivoting sports after the resolution of the postoperative effusion and full motion is established encourages patients and surgeon acceptance of the meniscus repair. To evaluate the success of meniscus repair in this accelerated rehabilitation program, a consecutive series of 63 patients with 65 meniscus tears undergoing arthroscopic meniscus repair were followed for a minimum of 2 years. There were seven failures (11%) at an average follow up of 38 months. The average patient age was 26 (range, 13 to 44). Arthroscopic relooks were done in 26%. Successful meniscal healing occurred in 92% of repairs done with ACL reconstructions, but only 67% of meniscus repairs performed in ACL-deficient knees, and 67% of meniscus repairs done in stable knees with no ACL injury. There was no statistical difference in the failures for acute and chronic meniscus tears, nor in the age of the patient undergoing the meniscal repair. Published rehabilitation protocols differ considerably on the three main issues of immobilization, weight bearing, and return to pivoting sports. These data show a meniscus repair success rate consistent with other published series. No modification of an ACL reconstruction accelerated rehabilitation program is needed for meniscus repairs performed in conjunction with the reconstruction.