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Effectiveness of Supervised Physical Therapy in the Early Period After Arthroscopic Partial Meniscectomy

PC Goodwin, MCSP, is a doctoral student, Centre for Applied Biomedical Research, GKT School of Biomedical Sciences, King's College London, London, United Kingdom
MC Morrissey, PT, ScD, is Lecturer, Centre for Applied Biomedical Research, GKT School of Biomedical Sciences, King's College London, Shepherd's House, Guy's Campus, London SE1 1UL, United Kingdom (matt.morrissey{at}kcl.ac.uk). Address all correspondence to Dr Morrissey
RZ Omar, PhD, is Senior Lecturer, Department of Statistical Sciences, University College London
M Brown, MCSP, is Senior I Physiotherapist, Forest Healthcare Trust, London, United Kingdom
K Southall, MCSP, is Physiotherapy Manager, Holly House Hospital, Buckhurst Hill, Essex, United Kingdom
TB McAuliffe, FRCS, is Orthopaedic Consultant, Forest Healthcare Trust
Mr Goodwin, Dr Morrissey, Dr Omar, Mr Brown, and Ms Southall provided concept/idea/research design. Mr Goodwin, Dr Morrissey, Mr Brown, and Ms Southall provided writing. Mr Goodwin, Dr Morrissey, Mr Brown, and Ms Southall provided data collection. Mr Goodwin, Dr Morrissey, and Dr Omar provided data analysis and fund procurement. Mr Goodwin and Dr Morrissey provided project management. Mr McAuliffe provided subjects. Ms Southall provided facilities/equipment, and Mr Brown and Ms Southall provided institutional liaisons. The authors thank orthopedic surgeons Matthew Barry, Thomas Bucknill, Mustafa El-Zebdeh, David Goodier, John Ireland, John B King, Kin C Kong, Mandeep Lamba, Benigmus E Okafor, and Vairavippillai Siva and physical therapists Jane Dredge, Salu Fellows, Jo Jones, Maria Klarneta, Philippa Knight, and Dylan Morrissey for their support of this study

Background and Purpose. Controversy exists about the effectiveness of physical therapy after arthroscopic partial meniscectomy. This randomized controlled trial evaluated the effectiveness of supervised physical therapy with a home program versus a home program alone. Subjects. Eighty-four patients (86% males; overall mean age=39 years, SD=9, range=21–58; female mean age=39 years, SD=9, range=24–58; male mean age=40, SD=9, range=21–58) who underwent an uncomplicated arthroscopic partial meniscectomy participated. Methods. Subjects were randomly assigned to either a group who received 6 weeks of supervised physical therapy with a home program or a group who received only a home program. Blinded test sessions were conducted 5 and 50 days after surgery. Outcome measures were: (1) Hughston Clinic questionnaire, (2) Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and EuroQol EQ-5D (EQ-5D) questionnaires, (3) number of days to return to work after surgery divided by the Factor Occupational Rating System score, (4) kinematic analysis of knee function during level walking and stair use, and (5) horizontal and vertical hops. Results. No differences between groups were found for any of the outcomes measured. Discussion and Conclusion. The results indicate that the supervised physical therapy used in this study is not beneficial for patients in the early period after uncomplicated arthroscopic partial meniscectomy.

Key Words: Arthroscopy • Home program • Randomized controlled trial • Therapeutic exercise

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