Postoperative outcomes associated with therapeutic exercise and neuromuscular electrical stimulation following arthroscopic meniscal repair: a prospective non-randomized controlled study

Successful recovery following arthroscopic meniscal repair depends not only on tissue healing but also on the restoration of joint mobility, muscle strength, and neuromuscular function. This study compared postoperative outcomes associated with therapeutic exercise (TE), neuromuscular electrical stimulation (NMES), and combined TE+NMES, including inflammatory responses, pain, functional recovery, and MRI outcomes following arthroscopic meniscal repair. In this prospective non-randomized study, 90 patients with MRI-confirmed meniscal injury (Stoller grade II–III) who underwent arthroscopic meniscal repair and platelet-rich plasma (PRP) treatment were classified into CON, TE, NMES, or TE+NMES groups according to the postoperative rehabilitation strategy received. All rehabilitation interventions were supervised for 4 weeks. IL-6, TNF-α, VAS, maximum active knee flexion, and IKDC were evaluated at baseline and at 1, 3, and 6 months postoperatively, whereas MRI-based Stoller grades were assessed at baseline and 6 months. At 3 months, the TE+NMES group showed significantly lower IL-6 than the NMES group, lower TNF-α than the TE and NMES groups, and greater maximum active knee flexion than the TE group ( p < 0.05). At 6 months, the TE+NMES group showed significantly lower IL-6 and TNF-α and higher IKDC scores than the NMES group, as well as greater maximum active knee flexion than the TE group ( p < 0.05). Changes in MRI-based Stoller grade differed significantly among groups (Kruskal–Wallis H = 28.548, p < 0.001), with the TE+NMES group showing greater reductions than the CON and NMES groups ( p < 0.05). A 4-week TE+NMES program was associated with favorable postoperative outcomes, with significant advantages over TE or NMES alone observed for selected inflammatory and functional outcomes. Combined TE and NMES have potential clinical value in postoperative rehabilitation following arthroscopic meniscal repair. Chinese Clinical Trial Registry (ChiCTR2000031299), registration on 27 march 2020.