Additional Functional Exercise Training Improves Knee Recovery After Meniscus Repair: A Randomized Controlled Trial

This study evaluated whether adding functional exercise training (FET) to conventional rehabilitation improves postoperative knee recovery after meniscus repair. In this prospective randomized controlled trial, 96 patients who underwent meniscus repair between April 2023 and September 2024 were randomly assigned to conventional rehabilitation (CON; n = 48) or conventional rehabilitation plus FET (n = 48) using a computer-generated randomization sequence. All participants completed the 6-month follow-up and were included in the intention-to-treat analysis. Outcomes assessed at baseline, 1 month, and 6 months included the Lysholm rating scale (LRS), International Knee Documentation Committee (IKDC) score, visual analog scale (VAS) pain score, range of motion (ROM), prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT), passive 60° position sense, and 60° motion sense; postoperative complications within 1 month were also recorded. At 6 months, ROM was greater with FET than with CON (134.36° ± 3.04° vs. 127.62° ± 3.66°; mean difference, 6.74°; 95% confidence interval [CI], 5.37-8.10; adjusted P < 0.001). After Holm-Bonferroni adjustment for multiple secondary comparisons, IKDC scores were higher with FET at 1 and 6 months, LRS scores were higher at 1 month, and VAS scores were lower at both follow-up assessments. PGE2 and 5-HT levels and passive 60° position-sense error and 60° motion-sense values were lower with FET at 1 month. Differences in ROM at 1 month and passive 60° position sense at 6 months did not remain statistically significant after multiplicity adjustment. No significant between-group differences were observed at 6 months for LRS, PGE2, 5-HT, or 60° motion sense, and postoperative complication rates did not differ significantly between groups. Adding FET to conventional rehabilitation may improve postoperative recovery after meniscus repair, with the strongest evidence supporting improved ROM. Findings for secondary outcomes require cautious interpretation and further validation, particularly given the retrospective trial registration and multiplicity of secondary outcomes.