Meniscus repair rehabilitation the following protocol is a guideline for rehabilitation following meniscus repair. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Physical therapy pt can be useful for a torn meniscus whether or not you have surgery. Gallandkirby acl reconstruction with meniscus repair postsurgical rehabilitation protocol postop days 1 14 dressing. Sports medicine physical therapy rehabilitation protocols. Postoperative considerations if you develop a fever, intense calf pain, excessive drainage from the incision, uncontrolled pain or any other symptoms. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. It is important to recognize that all times are approximate and that progression should be based on careful monitoring of the patients functional status. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Meniscus debridement protocol meniscectomy weeks 12 ice massage pain modalities as indicated weight bearing as tolerated use crutches until can walk without a limp edema control therapy range of motion exercise goal. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time.
Rehabilitation of meniscal root repairs follows a linear periodization protocol based on progressive loading of the repair. Factors affecting success include tear age, location and pattern, age of the patient, as well as any associated injuries. Be sure to follow the more conservative protocol with regards to range of motion, weight bearing, and rehab progression when there are concomitant injuries i. The postoperative program for meniscus repair and transplantation is shown in table 3 and has been described elsewhere in detail. No loaded knee flexion beyond 450 for 4 weeks no loaded knee flexion beyond 900 for 8 weeks. Regain knee motion, limiting knee flexion to 90 degrees 3. A meniscal repair is a surgical procedure to repair a torn meniscus via keyhole surgery. Mpfl reconstruction rehabilitation the following is a protocol for postoperative patients following medial patellofemoral ligament reconstruction. Hospital has accepted this protocol as our standard protocol for the management of patients sp arthroscopic partial medial or lateral meniscectomy. Symptoms of a degenerative meniscus tear include swelling, pain along the joint line, catching and locking.
Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. The following protocol is a guideline for rehabilitation following meniscus repair. 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 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. Focus on restoring normal mechanics, preserve quad controlengagement, lecore strength progression at this point rehab begins to strongly focus on the gluteus medius and maximus by implementing the powers program. As tolerated should be understood to include with safety for the reconstruction repair. The first 6 weeks are focused on nonweight bearing nwb protection, followed by 2 to 3 weeks of gradual progressive wb.
Tears are noted by how they look, as well as where the tear occurs in the meniscus. Acl reconstruction w meniscus repair mizzou sports doc. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the quadriceps. Please call 3028318893 to schedule an appointment parking patient parking is. 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. In general, knee is protected with a brace, rom limited to meniscus rehab exercises. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Even if an exercise or activity is listed at a particular time frame, some patients may not be ready to perform it.
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. The treatment chosen will depend on the location of the tear, the athletes sport, ligamentous stability of the. Posterior chain extensibility exercises if indicated. Find out when it helps, what to expect, and how long youll need to do it for. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and sometimes, other healthcare providers. This blood supply is necessary for a tear or a repair to heal. Rehabilitation and return to play following meniscal repair. If you have questions, contact the referring physician.
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. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. Bledsoe style brace for concomitant gr iii mcl injury if present. While the postop dressing is in place, icing should be done continuously. Hospital has accepted this protocol as our standard protocol for the management of patients sp meniscal repair. Higher numbers of repetitions 15 20 favor increased muscle endurance while building muscle strength as well. Protect the knee from overstress and allow healing 2. Regular manual mobilizations to surgical wounds and associated soft tissue to. Meniscus repair rehabilitation protocol the following is a protocol for postoperative patients following meniscus repair. It is by no means intended to substitute for ones clinical decision making regarding the progression of a patients post. Regular assessment of gait to avoid compensatory patterns.
Acl reconstruction wmeniscal repair protocol missouri orthopaedic institute weeks 612. Physical therapy pt and exercises for a meniscus tear rehab. One report showed that less than 10% of meniscal tears occurring in patients greater than 40 years of age were repairable. Acl reconstruction w meniscal repair rehabilitation protocol seth l. Quadriceps strengthening, making sure that closed chain exercises occur. Acl reconstruction with meniscal repair rehabilitation protocol. Specific changes in the program will be made by the. Dependent upon the location and size of the repair, weight bearing. Rehabilitation protocols ohio state sports medicine. Meniscal repair postoperative rehabilitation protocol. Discontinue crutches and brace when gait in nonantalgic about 6 weeks post op and patient has adequate quad control. 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. Meniscal repair postoperative rehabilitation protocol orthoindy. Hours we are open convenient hours for appointments monday through friday 7.
Meniscus repair rehab protocol orthopaedic medical group. Weight shift exercises at 3 weeks if weight bearing is allowed. Acl reconstruction with meniscus repair protocol dr bradley bruner 01012009 guidelines. Rehabilitation guidelines for meniscal repair uw health. Surgical knee will be in a hinged rehab brace locked in full extension for 4 weeks postop. Figure 6 shows the blood vessels perimeniscular capillary plexus entering the outer portion of the meniscus. Knee arthroscopy meniscus root repair day of surgery a. Acl reconstruction with meniscus repair postoperative physical therapy protocol.
Brace knee immobilizer used for four weeks, ted hose to be worn until ambulation has returned to normal presurgery level or two weeks. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Pdf rehabilitation and return to play following meniscal repair. Meniscus repair protocol mr gilbert and mr coupe sports knee clinic, wrightington hospital phase 1 week 12 week exercise goals 12 rom 090 rom exs patellar mobs ankle pumps gastrocsoleus stretch hamstringitb stretch prone hangsheel props strength static qs slrs hip strengthening weight bearing pwb control pain and inflammation ice. Root tears are repaired whenever possible based on their importance in limiting future knee arthritis. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. 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. It is a minimally invasive procedure often undergone as an outpatient. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair.
Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. Acl reconstruction, pcl reconstruction, chondroplasty precautions. As tolerated with crutches for balance x 2448 hours progress to wbat range of motion aarom arom as tolerated o goal. Meniscus rehab exercises the physical therapy advisor. Knee immobilizer used for four weeks, ted hose to be worn until. Rehabilitation guidelines for meniscal root repair the intent of this protocol is to provide the clinician with a general guideline of the postoperative course of the patient that has undergone the above stated procedure. Rehabilitation guidelines for meniscal repair of root and. Change dressing, keep wound covered, continue ted hose pod 710.
The primary function of the articular cartilage is to provide. For many aspects of acl rehabilitation there are either no studies that qualify as bestevidence or the number of. There are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Meniscal repair protocol brigham and womens hospital. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes. As tolerated should be understood to include with safety for the reconstructionrepair. 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. Discontinue crutches and brace when gait in nonantalgic about 6 weeks post op and patient has. Do not do resisted long or short arc quads, to avoid adversely stressing the graft. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving pre. Knee arthroscopy with meniscus repair rehab protocol. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Anterior cruciate ligament acl and meniscus repair. If an athlete suffers a meniscal root tear, the three options for treatment include.
Acl reconstruction with meniscal repair rehabilitation. Acl reconstruction w meniscal repair protocol missouri orthopaedic institute weeks 612. 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. Arthroscopic meniscectomychondral debridement name. Rehabilitation exercises a meniscus tear is a common knee joint injury. Middle of road rehab guidelines for meniscus repair rehabilitation 1st question. The intent of this protocol is to provide the clinician with a guideline of the post. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol transitional therapy a strength and conditioning program that is lead by medical professionals with a sports medicine background with the goal of transitioning from therapy back to. Acl reconstruction rehabilitation protocol 10 caring for your knee 1 the first night and day after the surgery you can expect the bandages to get bloody. 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. 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.
We want the blood to drain out of the knee on to the dressings rather than. Small clinical studies support rehabilitation protocols that allow early motion. Arthroscopic partial medial or lateral meniscectomy, loose body removal or debridement protocol. Repair can be achieved by a transtibial tunnel repair, a suture anchor repair or a side to side repair. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving. In general, knee is protected with a brace, rom limited to protocol following meniscal repair. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Wide variance in protocols some believe that wb helps squeeze repair together most believe nwb allows sutured meniscus to heal current protocol wb sutured meniscus td wb 24 weeks stable, unstable 46 wks. Right left knee medial lateral meniscal repair phase i 08 wks. Postoperative instructions knee arthroscopy meniscus root.