## 3 Discussion

Table 5: Objective outcomes of injured and uninjured legs after 10-year follow-up. isolated meniscus lesion, when damage has occurred in the circumferential hoop fibers of the meniscus, weight bearing during rehabilitation should generally be restricted for 6 weeks after initiating rehabilitation, and the limit of knee flexion ROM should also set to 90 degrees [21]. However, in the case of a vertical long tear, as in this case, the hoop tensile effect is preserved, so partial weight bearing of about 20 kg at 90 degrees is allowed from the first 4 weeks, and, thereafter, weight bearing is performed to the patient's pain-free level [45]. Additionally, the restricted protocol is more appropriate in the case of the radial tear mechanism, whereas the axial compressive load may relieve the lesions in cases of excessive mobility of the LM and a long vertical tear; therefore, an accelerated protocol could be suggested in this case [46; 47; 48; 49]. Furthermore, cases of inside-out meniscal repair with an ACL-accompanied injury showed an early return to the game after performing exercises with full weight bearing without limiting ROM [40; 50]. In a study of 22 patients who underwent outside-in repair surgery, three patients developed a re-tear owing to immediate weight bearing with no ROM restriction [44]. Regarding an anteroposterior vertical tear, maximum weight bearing is allowed as much as possible while wearing a brace [23]. Moving forward from the previous literature where the rehabilitation periods were 4-6 months [27; 51; 52; 53; 54; 55], the patient in this case returned to play in 71 days and won top scorer, contradicting the doctor's expectation that it would take more than 4 months. In this case, the patient showed a strong desire to return to sport, and, accordingly, accelerated rehabilitation was carried out compactly, divided into mornings and afternoons, 5 days a week, and restrictions in rehabilitation were significantly adjusted according to the player's subjective awareness of pain and discomfort. This suggests that partial freeing hastened the time to return to sport after rehabilitation. A discussion of the rehabilitation program from surgery until return to sport is as follows. In this report, heel raise, wall slide, weight shift, and squat exercises were performed early on in the rehabilitation, allowing the patient to autonomously limit the ROM level before experiencing pain. Then, weight bearing became possible at Phase II, such that the patient could perform single-leg exercises within 3 weeks after surgery; therefore, this could be suggested as an appropriate case of applying accelerated rehabilitation. Here, compared to the existing literature [45], it was confirmed that full weight bearing occurred about a week earlier. Furthermore, based on previous research showing that loads in a state where the knee is excessively flexed should be avoided for four months after surgery [56], the lunge motion was not deepened in Phase II, but the rest of the rehabilitation exercises were performed aggressively and within the range where the patient did not feel pain. Additionally, because information on proprioception, balance, and coordination is essential during rehabilitation after meniscal injury [57; 58; 59], Phase I encompassed the performance of proprioceptive exercises that improved compensatory movements to avoid pain, and this allowed for most of the exercises planned in Phases II and III to be performed without difficulty. Therefore, the patient's subjective feedback on their performance indicated improvement. However, the efficacy of supervised meniscal tear rehabilitation remains controversial. In one study, those who were supervised had higher vertical jump heights and single-hop distances than those who were not [60; 61]. In another study, there was no significant difference in patient-oriented outcomes at the early and intermediate follow-ups [62].