BACKGROUND: Medial meniscus posterior root tear (MMPRT) can lead to biomechanical disruption of the medial compartment and accelerate the progression of osteoarthritis. Although surgical repair may improve pain and functional outcomes, postoperative rehabilitation is also considered important for recovery. The quadriceps plays a central role in knee joint stability, load distribution, and functional recovery, yet its role in rehabilitation following MMPR repair remains unclear. This study aimed to systematically summarize the available evidence regarding quadriceps strength and quadriceps-focused rehabilitation following MMPR repair. METHODS: Databases including PubMed, Embase, the Cochrane Library, Web of Science, Scopus, PEDro, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched from inception to June 2025. Studies were included if they involved patients who underwent medial meniscal posterior root (MMPR) repair and received quadriceps-focused rehabilitation. Methodological quality was assessed using the MINORS tool. Because of substantial heterogeneity in reported outcomes, only qualitative synthesis was performed. This study was registered with PROSPERO (CRD420251145452). RESULTS: Three studies involving 93 patients were included. All patients underwent transtibial pull-out repair and were followed for 1 year. Weaker preoperative quadriceps strength was associated with greater postoperative medial meniscal extrusion (MME) and progression of medial joint space narrowing (MJS). Protocols emphasizing quadriceps-focused rehabilitation, including isometric exercises, straight-leg raises, resistance training, and neuromuscular electrical stimulation, were generally associated with improved muscle strength, better functional scores (IKDC, KOOS, and Lysholm), and faster Timed Up and Go (TUG) recovery. In addition, groups with greater quadriceps strength or more quadriceps-focused rehabilitation tended to show less progression of MME and MJS on imaging. All studies had a MINORS score of 11, indicating acceptable clarity of study aims and follow-up, but limitations in prospective design and sample size estimation. CONCLUSION: Quadriceps-focused rehabilitation may play an important role in recovery following MMPR repair. Greater quadriceps strength was associated with better muscle strength, functional outcomes, and potentially more favorable structural findings. However, the current evidence is limited and mainly based on retrospective studies, so these findings should be interpreted cautiously. Further high-quality, multicenter prospective studies are needed to clarify the optimal role and components of quadriceps-focused rehabilitation after MMPR repair.
Zhao et al. (Wed,) studied this question.