Muscle rehabilitation after arthroscopic meniscectomy with or without tourniquet control

Abstract

Nineteen patients with isolated meniscus lesions were randomly assigned to operation with or without tourni quet. All patients underwent arthroscopic meniscec tomy. Measurements of CK (creatinin-kinase), CK-B (isoenzymes MB of creatinin-kinase), LD (lactate dehy drogenase), ASAT (aspartate aminotransferase), and ALAT (alanine aminotransferase) were performed pre operatively and postoperatively over 6 days. The mus cle torque was measured on a Cybex ∥ isokinetic dynamometer preoperatively, 1 week and 4 weeks postoperatively. The mean CK level rose significantly in both groups, but did not pass the upper normal serum level. There was no effect on the other muscle en zymes. Quadriceps torque was significantly lowered in both groups 1 week after operation. Four weeks post operatively, it was still lowered in the nontourniquet group, which also had a slower increase in torque between weeks 1 and 4 than the tourniquet groups. There was no effect from the operation on isometric or hamstrings torque. The slight rise in CK was similar to that seen after hard physical exercise. The decrease in muscle torque was, therefore, mostly due to pain inhi bition. The slightly slower rehabilitation in the nontour niquet group may be caused by the technique of raising saline flow and pressure during the arthroscopy to control bleeding. This causes extravasation of fluid which may increase postoperative pain and stiffness.