Meniscal repair postoperative rehabilitation protocol orthoindy. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Meniscus repair rehabilitation protocol the following is a protocol for postoperative patients following meniscus repair. Therefore, patients having meniscus surgery should be aware that rehab may be more extensive and restrictive if a meniscus repair is performed. The subgroups of meniscal repair consisted of 30 patients who had undergone medial meniscus repairs mm, 19 lateral meniscus repairs lm and 12 repairs of medial and lateral meniscus bm. Anterior cruciate ligament acl and meniscus repair. Sports injury medicine department 9250 sw hall blvd. Knee arthroscopy meniscus root repair day of surgery a. Brace knee immobilizer used for four weeks, ted hose to be worn until ambulation has returned to normal presurgery level or two weeks. The intent of this protocol is to provide the clinician with a guideline of the post operative rehabilitation course of a patient that has undergone a meniscal repair. Manual stretching for extension with overpressure or recurvatum.
Medial meniscus repair patients with a varus deformity and lateral meniscus repair patients with a valgus deformity may need a more conservative approach in their rehabilitation as the compressive loads in the respective involved compartment are higher. Meniscus repair in acldeficient knees has a higher failure rate than those repaired in knees in which the acl has been reconstructed. You have both an inner medial and outer lateral meniscus that help distribute the forces in the knee when you are weightbearing. Rehabilitation and return to play following meniscal repair article pdf available in operative techniques in sports medicine 253 july 2017 with 7,034 reads how we measure reads. There are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Acl reconstruction with meniscus repair postoperative physical therapy protocol.
Op rehabilitation protocol the following is a protocol for postoperative patients following an isolated meniscus repair. Rehabilitation guidelines for meniscal repair of root and complex tears. Rehabilitation exercises a meniscus tear is a common knee joint injury. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. The aim of phase 3 of a meniscus tear rehabilitation program is to ensure full range of movement in the knee, regain normal strength with the ability to perform a full squat and start to return to running and normal training. Hold for 35 seconds, then return the leg to the ground and repeat with the opposite leg. Knee arthroscopy with meniscus repair rehab protocol longitudinal bucket handle tears this protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Rehab following meniscus repair surgery is more extensive than rehab after a partial meniscectomy surgery to remove the meniscus tear. Rehabilitation and return to play following meniscal repair. The meniscus is a cshaped piece of cartilage in the knee that cushions and acts as a shock absorber between your thigh bone femur and shin bone tibia. Find out when it helps, what to expect, and how long youll need to do it for. The primary goal of this protocol is to protect the reconstruction while. Physical therapy pt can be useful for a torn meniscus whether or not you have surgery.
The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Meniscus repair rehab protocol orthopaedic medical group. The gundersen sports medicine meniscus repair rehabilitation program is an. This blood supply is necessary for a tear or a repair to heal. While the postop dressing is in place, icing should be done continuously. Because your surgeon will not know with certainty if a meniscus repair can be performed prior to arthroscopic knee surgery, patients should understand that their rehabilitation will not be certain until the exact surgical procedure is known. Meniscus repairs located in the periphery heal rapidly, whereas complex multiplanar repairs tend to heal more slowly and require greater caution. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair. Indications, techniques, rehabilitation, and clinical outcome timothy p. Physical therapy pt and exercises for a meniscus tear rehab. Noyes, md3 the purpose of this paper is to provide current knowledge regarding the indications, operative. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes.
If you have questions, contact the referring physician. Knee immobilizer used for four weeks, ted hose to be worn until. Meniscus repair rehabilitation program gundersen health system. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving. It is no means intended to be a substitute for ones clinical decision making regarding the. A tear in this red zone may heal on its own, or can often be repaired with surgery.
The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Rehab after meniscus repair current thoughts in 2017. Meniscus rehab exercises the physical therapy advisor. Specific changes in the program will be made by the. Do the above exercises every other day for 3 sets of 10 repetitions. Re 17 chris ales m 7 rtho ln rownsbur i 6112 317263632 rthoindcom acl reconstruction with meniscal repair rehabilitation protocol basic acl protocol but no passive range of motion prom greater than 90 degrees for four weeks. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time. The authors have reported the efficacy of the rehabilitation programs and the results of meniscus repair and transplantation in many studies. One report showed that less than 10% of meniscal tears occurring in patients greater than forty years of age were repairable. Meniscus repair rehabilitation protocol general guidelines use the cryotherapy cuff continuously for the first 72 hours, then as needed thereafter ensure that the cuff never contacts the skin directly apply to the knee after performing rehabilitation exercises for the first 6 weeks. However, the ideal indication for meniscal repair is an acute 1 to 2 cm longitudinal peripheral tear that can be repaired in conjunction with anterior cruciate ligament acl reconstruction in young patients16,22,23,24. Rest and elevate the knee when not doing your rehabilitation exercises. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is.
Once the dressing is removed on the third postoperative day, ice is applied for 20minute periods 3. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. As tolerated should be understood to include with safety for the reconstructionrepair. Accelerated rehabilitation protocols are not associated with higher failure rates following meniscal repair. Pwb with crutches and brace locked at 00 prom 0 900 gradual increase in flexion rom based on symptoms ice, compression and elevation patellarscar tissue mobilization exercises. Postoperative instructions knee arthroscopy meniscus root.
Repair can be achieved by a transtibial tunnel repair, a suture anchor repair or a side to side repair. The outer onethird of the meniscus has a rich blood supply. Tears are noted by how they look, as well as where the tear occurs in the meniscus. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a meniscal repair. Dependent upon the location and size of the repair, weight bearing status postoperatively. Knee arthroscopy with meniscus repair rehab protocol. Do not do these exercises if there is pain or grinding at the kneecap. Postoperative knee meniscus repair rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Add the wall slide and chair squat exercises every other day as described below. Rehabilitation guidelines for meniscal repair of root and. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Surgeons may elect to delay weight bearing andor place these individuals in an unloader brace. Because you have to allow the torn meniscus to heal, certain activities must be restricted to avoid placing excessive stress on the healing meniscus. Figure 6 shows the blood vessels perimeniscular capillary plexus entering the outer portion of the meniscus.
Use crutches for 7 to 10 days to reduce swelling, the patient may discontinue with crutches when they can ambulate without a limp. Lay on your back with your knees bent to prepare for the bridge exercise. Articular cartilage is made up of collagen, proteoglycans and water which lines the end of the bones that meet to form a joint. Meniscus repair rehabilitation the following protocol is a guideline for rehabilitation following meniscus repair. The transtibial meniscal root repair is emerging as the gold standard treatment due to its ability to restore a large footprint at the meniscal roots native attachment site and restore normal joint contact pressures. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. Rehabilitation guidelines for meniscal repair uw health. Keep your pelvis level as you lift your hipspelvis and buttocks into the air. In general, knee is protected with a brace, rom limited to pdf. Meniscal repairs located in the vascular zones of the periphery or outer third of the meniscus are progressed more rapidly than those repairs that are. Right left knee medial lateral meniscal repair phase i 08 wks. Knee meniscus repair post operative rehabilitation protocol. The indications for meniscal repair have remained controversial. Knee meniscal root repair 1 overview this is a protocol that provides you with general information and guidelines for the initial stage and progression of rehabilitation according to the listed timeframes.
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