Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Rehabilitation guidelines for meniscal repair of root and. 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. Meniscus repair rehabilitation the following protocol is a guideline for rehabilitation following meniscus repair. Knee immobilizer used for four weeks, ted hose to be worn until. Brace knee immobilizer used for four weeks, ted hose to be worn until ambulation has returned to normal presurgery level or two weeks. The gundersen sports medicine meniscus repair rehabilitation program is an. 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. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. 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.
You have both an inner medial and outer lateral meniscus that help distribute the forces in the knee when you are weightbearing. 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. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the quadriceps. Accelerated rehabilitation protocols are not associated with higher failure rates following meniscal repair. Meniscus repair rehabilitation program gundersen health system. One report showed that less than 10% of meniscal tears occurring in patients greater than forty years of age were repairable. 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. Knee arthroscopy meniscus root repair day of surgery a. Find out when it helps, what to expect, and how long youll need to do it for. Do not do these exercises if there is pain or grinding at the kneecap. The outer onethird of the meniscus has a rich blood supply. Because you have to allow the torn meniscus to heal, certain activities must be restricted to avoid placing excessive stress on the healing meniscus. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint.
Rehab after meniscus repair current thoughts in 2017. 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. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving. Meniscus rehab exercises the physical therapy advisor.
Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Anterior cruciate ligament acl and meniscus repair. Meniscus repair rehabilitation protocol the following is a protocol for postoperative patients following meniscus repair. Knee arthroscopy with meniscus repair rehab protocol. 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. Postoperative knee meniscus repair rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes. Meniscus repair in acldeficient knees has a higher failure rate than those repaired in knees in which the acl has been reconstructed. Meniscal repair postoperative rehabilitation protocol. The primary goal of this protocol is to protect the reconstruction while.
Tears are noted by how they look, as well as where the tear occurs in the meniscus. Rehabilitation guidelines for meniscal repair uw health. Rest and elevate the knee when not doing your rehabilitation exercises. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. Meniscal repair postoperative rehabilitation protocol orthoindy.
Meniscus repair rehab protocol orthopaedic medical group. Knee meniscus repair post operative rehabilitation protocol. 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. Physical therapy pt can be useful for a torn meniscus whether or not you have surgery. 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. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time.
As tolerated should be understood to include with safety for the reconstructionrepair. 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. Do the above exercises every other day for 3 sets of 10 repetitions. 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. Op rehabilitation protocol the following is a protocol for postoperative patients following an isolated meniscus repair. 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. While the postop dressing is in place, icing should be done continuously.
Lay on your back with your knees bent to prepare for the bridge exercise. Physical therapy pt and exercises for a meniscus tear rehab. Postoperative instructions knee arthroscopy meniscus root. The indications for meniscal repair have remained controversial. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Rehab following meniscus repair surgery is more extensive than rehab after a partial meniscectomy surgery to remove the meniscus tear. A tear in this red zone may heal on its own, or can often be repaired with surgery.
It is no means intended to be a substitute for ones clinical decision making regarding the. 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. Rehabilitation and return to play following meniscal repair. Hold for 35 seconds, then return the leg to the ground and repeat with the opposite leg. If you have questions, contact the referring physician. Sports injury medicine department 9250 sw hall blvd. 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. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Add the wall slide and chair squat exercises every other day as described below.
The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Manual stretching for extension with overpressure or recurvatum. Acl reconstruction with meniscus repair postoperative physical therapy protocol. The authors have reported the efficacy of the rehabilitation programs and the results of meniscus repair and transplantation in many studies.
Follow the outline on the first page of phase three where the ankle weight program is described. Noyes, md3 the purpose of this paper is to provide current knowledge regarding the indications, operative. Dependent upon the location and size of the repair, weight bearing status postoperatively. 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. Once the dressing is removed on the third postoperative day, ice is applied for 20minute periods 3. Indications, techniques, rehabilitation, and clinical outcome timothy p.
Articular cartilage is made up of collagen, proteoglycans and water which lines the end of the bones that meet to form a joint. 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. Specific changes in the program will be made by the. Figure 6 shows the blood vessels perimeniscular capillary plexus entering the outer portion of the meniscus. Acl reconstruction with meniscal repair rehabilitation.
Rehabilitation exercises a meniscus tear is a common knee joint injury. 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. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. In general, knee is protected with a brace, rom limited to pdf. Use crutches for 7 to 10 days to reduce swelling, the patient may discontinue with crutches when they can ambulate without a limp. Keep your pelvis level as you lift your hipspelvis and buttocks into the air. This blood supply is necessary for a tear or a repair to heal. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. Meniscus repair rehab follows same timeframe with or without acl reconstruction acl reconstruction aids in healing response of meniscus repair tenuta ajsm 94 90% healing wrec. Right left knee medial lateral meniscal repair phase i 08 wks. Surgeons may elect to delay weight bearing andor place these individuals in an unloader brace. Repair can be achieved by a transtibial tunnel repair, a suture anchor repair or a side to side repair. Therefore, patients having meniscus surgery should be aware that rehab may be more extensive and restrictive if a meniscus repair is performed. Rehabilitation guidelines for meniscal repair of root and complex tears.
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