Robert Prill, C. Benjamin Ma, Stephanie E. Wong, Philippe Beaufils, Juan Carlos Monllau, Elanna K. Arhos, Roland Becker, Francesco Della Villa, J. Brett Goodloe, James J. Irrgang, Jitka Klugarova, Emma L. Klosterman, Aleksandra Królikowska, Aaron J. Krych, Robert F. LaPrade, Robert Manske, Nicky van Melick, Jill K. Monson, Marko Ostojic, Mark V. Paterno, Tomasz Piontek, Simone Perelli, Alexandre Rambaud, James Robinson, Laura C. Schmitt, Eric Hamrin Senorski, Thorkell Snaebjornsson, Adam J. Tagliero, Airelle O. Giordano, Nicolas Pujol
{"title":"正式的欧盟-美国半月板康复2024共识：ESSKA-AOSSM-AASPT倡议。第二部分：预防、非手术治疗和恢复运动。","authors":"Robert Prill, C. Benjamin Ma, Stephanie E. Wong, Philippe Beaufils, Juan Carlos Monllau, Elanna K. Arhos, Roland Becker, Francesco Della Villa, J. Brett Goodloe, James J. Irrgang, Jitka Klugarova, Emma L. Klosterman, Aleksandra Królikowska, Aaron J. Krych, Robert F. LaPrade, Robert Manske, Nicky van Melick, Jill K. Monson, Marko Ostojic, Mark V. Paterno, Tomasz Piontek, Simone Perelli, Alexandre Rambaud, James Robinson, Laura C. Schmitt, Eric Hamrin Senorski, Thorkell Snaebjornsson, Adam J. Tagliero, Airelle O. Giordano, Nicolas Pujol","doi":"10.1002/ksa.12689","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Part two of this consensus aimed to provide recommendations for the prevention of meniscus injuries, non-operative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This consensus followed the European Society of Knee Surgery, Sports Traumatology and Arthroscopy (ESSKA) formal consensus methodology. For this combined ESSKA—American Orthopedic Society for Sports Medicine (AOSSM)—American Academy of Sports Physical Therapy (AASPT) initiative, 67 experts from 14 countries, including orthopedic surgeons and physiotherapists, were involved. The 26 Steering Group members established guiding questions, screened the existing evidence, and proposed statements, and provided Grades of recommendations. The 41 Rating Group members assessed the statements according to a Likert scale (1–9). Final documents were assessed by an international peer review group for geographical adaptability.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Low to moderate scientific level of evidence was available, so that grades of recommendations were low (three Grade A ratings, four Grade B, three Grade C and 13 Grade D), underlining the relevance of this consensus. One strong and 17 relative agreements with overall median of 8 (8–9) and a mean of 7.92 ± 0.37 were achieved for 23 statements on 18 questions. Prevention of meniscus injuries is possible with general knee injury reduction programmes and through avoidance of certain activities. Non-operative treatment including physical therapy is the first line approach for degenerative meniscus lesions and may be an option for some acute tears. Return to sports after meniscus tear surgery should be both criterion-based and time-based. Patient reported outcomes in combination with performance-based measures are recommended to evaluate the rehabilitation process.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This international EU–US consensus established recommendations for prevention strategies, describes rehabilitation of non-operated patients and of patients after partial meniscectomy, meniscus repair and meniscus reconstruction, and establishes return to sport criteria. These updated and structured recommendations may be applied by surgeons and physiotherapists.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level I, consensus.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 8","pages":"3014-3024"},"PeriodicalIF":5.0000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12689","citationCount":"0","resultStr":"{\"title\":\"The formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT initiative. Part II—Prevention, non-operative treatment and return to sport\",\"authors\":\"Robert Prill, C. Benjamin Ma, Stephanie E. Wong, Philippe Beaufils, Juan Carlos Monllau, Elanna K. Arhos, Roland Becker, Francesco Della Villa, J. Brett Goodloe, James J. Irrgang, Jitka Klugarova, Emma L. 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The formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT initiative. Part II—Prevention, non-operative treatment and return to sport
Purpose
Part two of this consensus aimed to provide recommendations for the prevention of meniscus injuries, non-operative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures.
Methods
This consensus followed the European Society of Knee Surgery, Sports Traumatology and Arthroscopy (ESSKA) formal consensus methodology. For this combined ESSKA—American Orthopedic Society for Sports Medicine (AOSSM)—American Academy of Sports Physical Therapy (AASPT) initiative, 67 experts from 14 countries, including orthopedic surgeons and physiotherapists, were involved. The 26 Steering Group members established guiding questions, screened the existing evidence, and proposed statements, and provided Grades of recommendations. The 41 Rating Group members assessed the statements according to a Likert scale (1–9). Final documents were assessed by an international peer review group for geographical adaptability.
Results
Low to moderate scientific level of evidence was available, so that grades of recommendations were low (three Grade A ratings, four Grade B, three Grade C and 13 Grade D), underlining the relevance of this consensus. One strong and 17 relative agreements with overall median of 8 (8–9) and a mean of 7.92 ± 0.37 were achieved for 23 statements on 18 questions. Prevention of meniscus injuries is possible with general knee injury reduction programmes and through avoidance of certain activities. Non-operative treatment including physical therapy is the first line approach for degenerative meniscus lesions and may be an option for some acute tears. Return to sports after meniscus tear surgery should be both criterion-based and time-based. Patient reported outcomes in combination with performance-based measures are recommended to evaluate the rehabilitation process.
Conclusion
This international EU–US consensus established recommendations for prevention strategies, describes rehabilitation of non-operated patients and of patients after partial meniscectomy, meniscus repair and meniscus reconstruction, and establishes return to sport criteria. These updated and structured recommendations may be applied by surgeons and physiotherapists.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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