• Full Name: DR JOANNA JIJI VARGHESE
• Affiliation/Institution: SRIHER
• Country: India

• Full Name: DR SANJAY A.K.
• Affiliation/Institution: SRIHER
• Country: India

• Full Name: DR SAI ADITYA RAMAN
• Affiliation/Institution: SRIHER
• Country: India

• Full Name: DR SURESH PERUMAL
• Affiliation/Institution: SRIHER
• Country: India

• Full Name: DR THIAGARAJAN K.A.
• Affiliation/Institution: SRIHER
• Country: India

• Full Name: DR ARUMUGAM S.
• Affiliation/Institution: SRIHER
• Country: India

Background:

Meniscal root tears are a significant pathology often leading to rapid joint degeneration if left untreated. While arthroscopic pull-out repair is the gold standard surgical intervention, postoperative rehabilitation protocols—specifically weight-bearing restrictions—remain a subject of debate. This study aims to compare the clinical, functional, and muscle activation outcomes of a delayed Non-Weight Bearing (NWB) protocol versus an Immediate Full Weight Bearing (FWB) protocol following arthroscopic meniscal root repair.

Methods:

51 patients (31.55 ± 7.8 years) undergoing arthroscopic meniscal root repair were assessed. Patients were assigned to two rehabilitation protocols: Group A (n=25) followed a strict Non-Weight Bearing (NWB) protocol with walker support for 6 weeks, while Group B (n=26) underwent Immediate Full Weight Bearing (FWB) as tolerated. Both groups followed a standardized physiotherapy regimen. Primary outcome measures included the International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, Visual Analog Scale (VAS) for pain, and quadriceps muscle activation, assessed at 1-month and 3-month postoperative intervals.

Results:

Both groups demonstrated improvement over the study period, but the immediate weight-bearing group showed superior early functional metrics. At the 1-month assessment, Group B (FWB) demonstrated significantly higher IKDC scores (37.4 ± 6.2 vs. 26.8 ± 4.5, p<0.001) and better muscle activation grades (p<0.001) compared to the NWB group. While Group B reported higher mean VAS pain scores at 1 month (3.8 vs. 2.9, p=0.004), pain levels equalized by the 3-month mark (p=0.58). Furthermore, there was no statistically significant difference in joint effusion between the groups (p=0.32), suggesting the repair withstood early loading without adverse inflammatory reaction. At 3 months, Group B maintained a lead in functional outcomes (IKDC p=0.002; Tegner p<0.001).

Conclusion:

Both rehabilitation protocols demonstrate statistically equivalent potential for successful long-term functional recovery, suggesting that repair integrity is maintained regardless of initial weight-bearing status. However, the immediate weight-bearing protocol is advantageous for attaining early rehabilitation milestones significantly faster, specifically regarding muscle activation and return to daily function. While the long-term clinical endpoint appears similar for both groups, the immediate weight-bearing approach offers a distinct "early win" by accelerating the initial recovery trajectory and minimizing early postoperative disability.