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IMPROVING REHABILITATION OUTCOMES AFTER
ARTHROSCOPIC MENISCECTOMY THROUGH THE USE OF
PHYSIOTHERAPEUTIC PROCEDURES.
D.R.Ruziboev
D.M. Djumaniazova
Tashkent Medical Academy,
National Center for Rehabilitation and
Prosthetics for Persons with Disabilities
Tashkent, 2025.
https://doi.org/10.5281/zenodo.15690147
ARTICLE INFO
ABSTRACT
Qabul qilindi: 10-Iyun 2025 yil
Ma’qullandi: 14-Iyun 2025 yil
Nashr qilindi: 18-Iyun 2025 yil
This study is based on the analysis of postoperative
outcomes and rehabilitation in 60 patients who
underwent surgery for meniscal pathology of the knee
joints. Follow-up was conducted over a period of 1.5 to 6
months after surgery from 2023 to 2024 at the 2nd Clinic
of the National Center for Rehabilitation and Prosthetics
for Persons with Disabilities. The study presents the
results of a comprehensive assessment, including clinical
(orthopedic and neurological), radiological, MRI, and
physiological examinations.
KEYWORDS
meniscus tear, arthroscopy,
rehabilitation, physiotherapy,
complication.
Relevance:
Meniscal injuries are among the most common intra-articular injuries of the knee joint and
lead to disruption of its normal function [1–3]. According to Azizov M.Zh, the medial meniscus
is damaged in 80–90% of cases, whereas the lateral meniscus is affected in 10–20%. This
distribution is related to the anatomical features of the medial meniscus. In recent years,
ultrasound (US), MRI, and diagnostic arthroscopy of the knee joint have been widely used for
diagnosis [4,5].
One of the key advantages of MRI is its ability to detect even minimal soft tissue damage,
making it an indispensable tool for diagnosing conditions such as osteoarthritis, meniscal
tears, inflammatory diseases, as well as ligament and cartilage injuries. MRI allows precise
localization of injuries, assessment of their severity, and planning of appropriate treatment.
However, despite its advantages, MRI has limitations—particularly in cases of knee joint
synovitis. The accuracy of MRI diagnosis can depend on various factors: equipment quality,
specialist expertise, and patient-specific conditions (e.g., the presence of metal implants can
distort results). According to several studies, MRI accuracy in diagnosing knee joint injuries
ranges from 70% to 90%, indicating existing limitations in its use [7,8].
In recent years, arthroscopy and arthroscopic treatment have gained significant
importance in orthopedics [1,6]. Like in other medical fields, modern technologies are actively
developing in orthopedics. Despite significant progress, unsatisfactory outcomes persist in the
postoperative period. As with other surgeries, complications after arthroscopic meniscectomy
may occur, negatively affecting patients' quality of life.
Many researchers note that the primary cause of complications is incomplete diagnosis
considering concomitant diseases, as well as delayed rehabilitation.
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Given the above issues, this study is timely and relevant.
Objective:
To improve rehabilitation outcomes after arthroscopic meniscectomy using
physiotherapeutic procedures.
Materials and Methods:
In 2024, arthroscopic meniscectomy was performed on 60 patients at the 2nd Clinic of
the National Center for Rehabilitation and Prosthetics for Persons with Disabilities. Patient
ages ranged from 25 to 60 years; 48 were men and 12 women, with a mean age of 35. The
distribution by meniscal injury type was as follows: 49 patients with medial meniscus tears
(group 1), 9 patients with lateral meniscus tears (group 2), and 2 patients with tears of both
menisci (group 3).
To assess early rehabilitation outcomes after arthroscopic meniscectomy, patients were
divided into two groups. The control group included 30 patients who received no
postoperative rehabilitation such as therapeutic exercise (TE) or physiotherapy. The main
group included 30 patients who received a complex of physiotherapeutic procedures,
including magnetotherapy, ultrahigh-frequency therapy (UHF), shockwave therapy, and
electrical stimulation.
All patients underwent clinical and laboratory evaluations, including complete blood
count, C-reactive protein (CRP) level, coagulation profile, MRI of the knee joint, and basometry
using goniometry to assess range of motion and functional impairment. CRP level was used to
evaluate inflammation, as it is a marker of inflammatory processes. Coagulation tests assessed
hemostasis and thrombotic risk, important in the postoperative period. MRI provided detailed
visualization of knee joint anatomy, including menisci, ligaments, and cartilage, and detected
tissue damage. Basometry with goniometry measured angular joint motion limitations
precisely. Pain syndrome in the knee was also assessed to evaluate pain intensity, its
dynamics, and correlation with other clinical parameters.
Results and Discussion:
All 60 patients underwent surgery after thorough evaluation of complaints, history,
clinical examination, and diagnostic findings. Clinical examination revealed meniscal pain and
positive signs of meniscal tears (Baikov, Voskresensky, Khitrov, Perelman signs). Active and
passive knee movements caused pain, worsening with flexion. Patients exhibited limping on
the operated leg, indicating functional load disturbance and restricted joint range of motion.
Pronounced swelling indicated inflammation requiring monitoring and treatment.
Standard arthroscopy under spinal anesthesia was performed. In the main group, 25 had
medial meniscus injuries, 4 had lateral meniscus tears, and 1 had both menisci injured. In the
control group, 24 had medial meniscus injuries, 5 lateral, and 1 had both menisci injured.
Partial meniscectomy and knee joint lavage were performed.
The postoperative period included a two-day hospital stay followed by recommended
self-directed therapeutic exercise at home, adjusted for pain and swelling severity.
Control group patients did not receive physiotherapy or perform prescribed therapeutic
exercises. Main group patients began physiotherapy on postoperative day 10 and underwent
daily therapeutic exercise in outpatient settings for 10 days at a specialized rehabilitation
center.
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This protocol allowed assessment of the impact of early physiotherapy and systematic
exercise on postoperative recovery dynamics.
Physiotherapeutic Procedures Used:
1.
Magnetotherapy – improves microcirculation and reduces inflammation.
Application: Low-frequency magnetotherapy (30–100 Hz) applied to the operated limb for 10
minutes daily over 10 days.
2.
Ultrahigh-Frequency Therapy (UHF) – reduces swelling, inflammation, and pain.
Frequencies: 40.68 MHz to 27.12 MHz provide deep tissue warming, improving
microcirculation and accelerating tissue recovery. Initially performed every other day or 2–3
times per week, then daily for 10–15 minutes over 10 days.
3.
Shockwave Therapy (SWT) – prevents muscle hypotrophy and accelerates
muscle
strength
recovery.
Five sessions every two days targeting muscles such as quadriceps, iliopsoas, and biceps
femoris for treatment of injuries and inflammation.
4.
Electrical
Stimulation
–
20
minutes
daily
for
10
days.
Devices such as “Amicron” and “Diadens” were used, offering various modes and intensities
for effective tissue and muscle recovery.
DynamicStudy:
In the control group, patients were evaluated every 15 days postoperatively for joint range of
motion, swelling, pain, muscle tone, and limping. These parameters were compared with the
main group.
In the first 15 days post-op, 18 control patients had swelling, limited motion (especially
flexion ≤ 90°), pain (VAS score 6), and muscle pain rated 4. Most exhibited limping, varying
from mild to moderate, indicating partial joint dysfunction and insufficient recovery.
At 30 days, 5 control patients still showed swelling, movement limitations, pain (VAS 4–
5), and moderate limping, suggesting slow recovery and need for physiotherapy.
At 45 days, 3 control patients continued to exhibit swelling, movement restriction, pain,
and limping. For these, comprehensive physiotherapy was recommended to improve range of
motion, reduce swelling and pain, restore normal muscle tone, and correct limping.
Control group clinical progression showed gradual symptom reduction, but full
functional recovery required additional rehabilitation including physiotherapy.
MainGroupClinicalResults:
Within 15 days post-op, 5 patients showed limping, moderate swelling, flexion limited to 90°,
and mild pain (VAS 3). Muscle pain was rated at 4. By 30 days, complaints persisted in only 1
patient, indicating significant improvement. At 45 days, clinical symptoms including swelling,
movement limitation, pain, and muscle soreness disappeared completely in all main group
patients.
These results confirm faster and more pronounced functional recovery in the main
group, likely due to effective rehabilitation involving physiotherapy and therapeutic exercise.
Comparative outcomes 15 days post-operation
Symptom
Main Group (n=30) Control Group (n=30)
Flexion limited to 90°
5 patients
18 patients
Swelling
5 patients
18 patients
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Pain (VAS score)
5 (VAS 3)
18 (VAS 6)
Muscle tone (score)
5 (4 points)
18 (4 points)
Limping
5 patients
18 patients
Comparative outcomes 30 days post-operation
Symptom
Main Group (n=30) Control Group (n=30)
Flexion limited to 90°
1 patient
5 patients
Swelling
1 patient
5 patients
Pain (VAS score)
1 (VAS 0 — no pain)
5 (VAS 4–5)
Muscle tone (score)
1 (0 points)
5 (4–5 points)
Limping
1 patient
5 patients
Comparative outcomes 45 days post-operation
Symptom
Main Group (n=30) Control Group (n=30)
Flexion limited to 90°
0 patients
3 patients
Swelling
0 patients
3 patients
Pain (VAS score)
0 (VAS 0 – no pain)
3 (VAS 0 – no pain)
Muscle tone (score)
0 patients
3 patients
Limping
0 patients
3 patients
Case example and study results
Patient O., born in 1969, diagnosed with a post-traumatic chronic tear of the posterior
horn of the medial meniscus of the left knee joint accompanied by pain syndrome. The results
of the study confirm the high effectiveness of physiotherapeutic procedures in the
rehabilitation process after arthroscopic meniscectomy, which significantly accelerated pain
reduction and improved functional status of the knee joint. Specifically, the use of
physiotherapeutic methods expedited the restoration of range of motion and reduced
swelling, which in turn positively influenced the normalization of joint activity. Analysis of
patient progress dynamics demonstrated that a complex of physiotherapeutic interventions
promotes faster normalization of functions such as movement, muscle tone, and pain
reduction, confirming the effectiveness of the chosen methods. Our data are consistent with
the findings of Rotini M. [9], who also established that early application of physiotherapy after
meniscectomy significantly accelerates recovery, reduces time to full functional restoration,
and minimizes pain manifestations. This underscores the importance of physiotherapeutic
intervention as an integral part of postoperative treatment, facilitating knee joint recovery.
Nevertheless, despite considerable functional improvements within the first months post-
operation, some patients did not achieve full functional recovery three months after
completion of the rehabilitation course. Residual symptoms, including limping, persisted in
some cases. Limping, despite improvement in joint condition, remained in a small number of
patients, which is associated with incomplete restoration of range of motion and mild pain at
the surgical site. This factor likely indicates the need for prolonged rehabilitation or the
introduction of additional corrective methods for residual joint dysfunction. Thus, the study
results show that despite marked improvements in the early postoperative period, full
restoration of knee joint function and elimination of symptoms such as limping may require a
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longer rehabilitation period and additional physiotherapeutic procedures aimed at enhancing
functional parameters and reducing residual effects.
Conclusion:
1. The use of physiotherapeutic methods after arthroscopic meniscectomy significantly
reduces pain syndrome, improves joint mobility, and accelerates recovery of static and
dynamic function of the operated joint.
2. The most effective methods are magnetotherapy, shockwave therapy, and electrical
stimulation.
3. Early physiotherapy after arthroscopic meniscectomy allowed reduction of patients'
temporary disability period by 1.5 months, ensuring economic benefits of the surgery and
rehabilitation process.
References:
1. Azizov M.Zh. Our method of surgical treatment of habitual patellar dislocation // Questions
of Theoretical and Clinical Medicine. – Yerevan, 2018. – No.12. – pp. 17-20.
2. Azizov M.Zh. Autoplastic surgery method for dysplastic patellar dislocation // Materials of
the Interdisciplinary Scientific and Practical Conference with International Participation
(Treatment of osteoarthritis except joint replacement), May 13–14, Kazan, 2016. – pp. 6-8.
3. Korolev A.V., Magnitskaya N.E. Relationship of bone tunnel positioning in arthroscopic
anterior cruciate ligament reconstruction, surgeon’s intraoperative wishes, and patient
anthropometric data. Traumatology and Orthopedics of Russia. 2016;(1): 85-95.
4. Kuznetsov I.A., Fomin N.F. Modern approaches to surgical treatment of chronic posterior
knee instability // Russian Scientific Research Institute of Traumatology and Orthopedics
named after R.R. Vreden, Ministry of Health of Russia. – 2015. – 107 p.
5. Kholkhudjayev F.I., Oripov F.S. Structural components of bones of the hip joint in different
periods of life. International Journal of Pharmaceutical Research | Jan–Jun 2020 | Vol 12.
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tendons or tendon of long fibular muscle // The Journal of Academic Research in Educational
Sciences, Vol 2, Issue 2, Feb 2021 – pp. 1214-1219.
7. Mamatkulov K.M., Kholkhudjayev F.I. Our experience of anterior cruciate ligament
reconstruction using the "all inside" method with tendons of popliteal flexors or long fibular
muscle tendon // Polish Journal of Science, №45, Vol 1, 2021 – pp. 42-44.
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