Author(s): LEE, H., YI, X.2, KIM, A.R.1, YOOK, J.S.3, Institution: DANKOOK UNIVERSITY, Country: KOREA, SOUTH, Abstract-ID: 592

INTRODUCTION:
Postoperative inflammation and delayed functional recovery remain clinically important challenges after meniscal repair, and postoperative rehabilitation strategies are considered central to optimizing outcomes in this population [1]. While therapeutic exercise (TE) and neuromuscular electrical stimulation (NMES) are common rehabilitation modalities, their combined long-term efficacy on structural healing and systemic inflammation remains under-explored. This study evaluated whether a combined TE+NMES program provides superior clinical outcomes compared to single interventions or standard care.
METHODS:
Participants (n = 112, aged 60-75) were randomized to control (standard care), TE, NMES, or TE+NMES. All received standardized postoperative care including platelet-rich plasma injections. Interventions were supervised for four weeks post-surgery. Outcomes included inflammatory cytokines (IL-1, IL-6, TNF-alpha), pain (Visual Analogue Scale [VAS]), functional scores (IKDC, WOMAC, Lysholm), range of motion (ROM), recovery rate, and MRI-based Stoller grades at baseline, 1, 3, and 6 months.
RESULTS:
All intervention groups improved significantly versus control (p<.05). At 3 months, TE+NMES produced the largest reductions in IL-1, TNF- alpha, and VAS, with higher IKDC, WOMAC, Lysholm, and ROM scores (p<.05). IL-6 was lower in TE+NMES versus control and NMES. At 6 months, TE+NMES maintained the most pronounced improvements in inflammation, pain, function, ROM, recovery rate, and Stoller grades (p<.05).
CONCLUSION:
Consistent with evidence that multi-modal loading engages distinct neuromuscular and molecular pathways to optimize skeletal muscle remodeling [2], our findings indicate that a 4-week combined program of TE and NMES effectively mitigates postoperative inflammation and accelerates recovery. The sustained 6-month benefits highlight this dual-modality approach as a superior rehabilitation strategy, supporting its integration into clinical protocols for older populations following meniscal repair.
References
1. Howard JS, Mattacola CG, Romine SE, Lattermann C. Rehabilitation after meniscus repair. Clin Sports Med. 2020;39:147-61.
2. Franchi MV, Reeves ND, Narici MV. Skeletal Muscle Remodeling in Response to Eccentric vs. Concentric Loading: Morphological, Molecular, and Metabolic Adaptations. Front Physiol. 2017;8:447.
Contact: [yookjs@postech.ac.kr]