CONSENSUS RECOMMENDATION One low quality study (Katsuri, 2020) was included. While this investigation demonstrated that physical therapy/rehabilitation (i.e. conservative management) improved pain, range of motion, and functional ability in patients with meniscal tears, generalizability and application of the findings is limited due to a lack of information regarding the parameters of the rehabilitation scheme and the appropriateness of the statistical approach. In the absence of additional evidence, it is the opinion of the workgroup that physical therapy/rehabilitation may be beneficial to patients who present with an acute non-displaced isolated meniscal tear not amenable to repair when implemented as a non-operative treatment option as well as for those recovering from meniscal surgery. Complications developing or increasing, such as pain or tear size, are not noted with a trial of rehabilitation following atraumatic or traumatic mechanisms of injury.
Benefits & Harms:
No additional harm noted for a trial of conservative rehabilitation.
Cost Effectiveness/Resource Utilization:
Nonoperative rehabilitation that treats the symptoms of an acute meniscal tear provides cost-saving by avoiding surgical intervention. However, patients who fail rehabilitation and then undergo surgery obviously incur the cost of pre-surgical rehabilitation in addition to the surgical intervention.
Acceptability:
Physical therapy, including Mulligan techniques, is widely available at reasonable cost. There is little risk or downside to physical therapy.
Feasibility:
Physical therapy is widely available at reasonable cost. Mulligan technique is a mode of intervention within manual physical therapy with no additional cost.
Future Research:
Topics to be addressed with future research include:
The benefit of a home exercise program compared to a supervised program?
If and when patients return to high-level (dynamic, pivoting) or moderate-level (running, cycling) sports (was not objectively measured)