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0000043932 00000 n To start the repair, the free ends of the Repeat 20 times. Slowly lower the foot back to the floor. My physio is limited to the meniscus repair plan (more conservative than just ACL) but I was allowed to weight bear right away. trailer Please enable it to take advantage of the complete set of features! PMC O'Donnell K, Freedman KB, Tjoumakaris FP. Accessibility Proper self-care is essential to shortening the recovery process and avoiding a recurrence of the injury. Let the knee relax into extension (straight). endstream endobj 306 0 obj<>stream showed that after six weeks, people could return to full weight bearing at a rate of 1%. 0000043385 00000 n Resting when you feel tired, getting plenty of sleep, and eating a healthy diet can all be helpful in ensuring a quicker recovery. 298 0 obj<>stream . Add this exercise after completing the step-up-down progression: Start with 3 sets of 5 repetitions. Web6. 0000047691 00000 n You may add 2 to 3 pounds per week until you reach 10 pounds in each hand. To start the repair, the free ends of the suture were passed from top to bottom on both sides of the tear. Raise the operated limb upward to a 45 degree angle as illustrated. Chan Gung Med J. WebTouch down weight bearing x 3-5 days, progress to full weight bearing with good mechanics.

Arthroscopy. xYn7}S[D"iF@JA9s;3YO_f6]75razjWv1rvqNx 8a+(Xex-~2H\6YLz]u*PCWa[#Gy` BT9 M_nK. B#\DJlj('K dB)BBScJ0t9=oH"mfW>t3TzZ/;9| Web6. 0000047845 00000 n This is huge and may aid in the healing process! 2017 Jun;45(7):1687-1697. doi: 10.1177/0363546516667578. Brace and Crutches: Specifically, the physician will look at and measure: As with any invasive surgical procedure, infection and bleeding are always surgical risks. This might make all the difference in the degree of treatment and recovery time that will be required. Do 20 reps. Shelbourne KD, Patel DV, Adsit WS, Porter DA.

However, it is important to note that a complete return of knee strength and full-range mobility may take several months. This Web site is provided as a courtesy to those interested in Emory Healthcare and does not constitute medical advice and does not create any physician/patient relationship. During phase 3. Study design: 0000016915 00000 n Webflexion, especially during weight bearing, to protect the repair sutures and the meniscus. Disclaimer. Did you surgeon limit ROM after meniscus repair? 0000035573 00000 n Set the seat height so that when you are sitting on the bicycle seat, your knee is fully extended with the heel resting on the pedal in the fully bottom position. Weight bearing as tolerated after meniscal repair for peripheral, vertical tears does not result in a higher failure rate than traditional, non-weight bearing over a five-year follow-up period. Level of evidence: The knees experience a great deal of pressure and are particularly prone to damage. x|RkA~3;vd$&U(EZEVIr)-qj4h@XDd'Q "zPC WebIt's still a bit sore and swells a little after doing the rehab exercises but no pops or cracks, I definitely had been weight bearing a lot though. Also, Emory Healthcare does not endorse or recommend any specific commercial product or service. 0000014936 00000 n This study sought to evaluate whether patients adhering to an immediate WBAT rehabilitation programme have a higher failure rate compared to those adhering to a more traditional, protected, NWB status following meniscal repair. government site. The site is secure.

When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the The most common concomitant procedure was ACL reconstruction., Results showed an 18.6% failure rate based on reoperation and a 15.3% failure rate based on joint line tenderness. 0000029723 00000 n Giving your body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is advisable. Try to keep an upright posture and avoid bending forward during the exercise. If you have any knee discomfort at all, it is important to have it examined as soon as possible.

This site needs JavaScript to work properly. We typically immobilize people in full extension during weightbearing, locked in a brace for 4-6 weeks after meniscal repair surgery. Yes, but only initially and only for comfort. But what about the exact mechanisms that many are still fearful of allowing early in the process, like early walking and range of motion? Another risk of ACL reconstruction surgery is continued anterior knee pain post-operatively.

Speed and agility running program begins. When you return to sports or recreational activities, decrease the strength workouts to 2 times a week and do 1 set of 10 of each of the three drills only, as a maintenance workout. Heel lift in opposite shoe to normalize gait. Do not progress to the next step in the progression until the present step is pain free, without swelling. Orthopaedic Surgery, Sports Medicine, Digital Radiography: Phoenix, AZ. EXERCISE PROGRAM (see phase 2 for descriptions and illustrations). Slowly lower your hips by bending the knees and slide down the wall. Slowly lower your hips by bending the knees and slide down the wall until the knees are flexed about 45 degrees (illustration). We will determine during your consultation whether general or regional anesthesia would be appropriate either way, no pain will be experienced during the procedure itself. 0000057545 00000 n Once you have regained full strength and mobility in your knee, you will want to make sure you never have to go through this process again! Remember to keep your head over your feet and bend at the waist as you descend.

We return the patients range of motion, strength and function per their symptoms and let pain and swelling guide the rehab process (a very general guide but one often employed by many rehabilitation specialists). 0000041241 00000 n An official website of the United States government. 0000059330 00000 n In isolated meniscal repair patients (n = 62), there was no difference between weight-bearing groups for rate of re-operation (n.s.). Am J Sports Med. 2 0 obj

While standing on the unoperated limb bend the knee of the operated side and raise the heel toward the buttock. 0000058205 00000 n For both cases, I would recommend passive range of motion to tolerance. Unauthorized use of these marks is strictly prohibited. So if were going to talk 90s protocols, take a look at these studies from way back when from Shelbourne and Barber that showed excellent results in patients undergoing a combined ACL-meniscus repair procedure and utilizing no limitations in weightbearing or range of motion, similar to a protocol for an isolated ACL reconstruction. You should be able to fit two fingers under your arm when standing with crutches. 0000051479 00000 n WebMeniscus repair rehab protocol Partial weightbearing status (<50%), unless otherwise ordered by MD. Partial Weight-Bearing.

I should add I KNOW I should follow my doctors orders but honestly her post op communication has been lacking. 0000010545 00000 n Following this 6 weeks, they begin weight bearing at 25% with crutches for 1 week, and then 75% weight bearing using 1 crutch for 1 additional week. 0000058688 00000 n 0000061501 00000 n I know you're eager to get on the bike but stick to the plan (ie.

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Unable to load your collection due to an error, Unable to load your delegates due to an error. 0000033260 00000 n 0000042580 00000 n If you are able to bear full weight without pain, you can taper to one crutch, held on the opposite side of your affected knee. Am J Sports Med. Swelling is an indicator of inflammation, which is part of the normal healing process after surgeries such as a -, Bray RC, Smith JA, Eng MK, Leonard CA, Sutherland CA, Salo PT. To start the repair, the free ends of the suture were passed from top to bottom on both sides of the tear. 8600 Rockville Pike

Patients were categorized by post-surgical weight-bearing status, either NWB or WBAT, and then analysed for failure of repair.

The rehabilitation guidelines are presented in a criterion based progression. 0000046104 00000 n Level 4. 0000051130 00000 n

SITTING HEEL SLIDES - to regain the bend (flexion of the knee). 0000009492 00000 n

Do 1 to 2 repetitions of each drill of final workout to warm-up before practice. The .gov means its official. Loss of motion following ACL reconstruction is the most commonly cited complication. This ensures minimal tension on the cartilage as it heals.

Place the feet about 12 inches apart and about 6 inches from the wall. Partial meniscectomy involves trimming away the damaged meniscus. 0000056408 00000 n Adjustment is important. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Maintain balance, if necessary, by holding onto the wall or a chair (illustration). Arthroscopic meniscus repair is an outpatient procedure. When I got on the bike on the 7th week, it didn't take very long to regain fluidity in the knee with regards to flexion. <> 0000061643 00000 n Tech in Ortho, 8(2): Many patients like the comfort of having that extra security around their knee as it heals. 0000011976 00000 n You can fully extend (straighten the knee). The clinical relevance is that, based on these data, it may be appropriate to allow weight bearing as tolerated following meniscal repair of peripheral, vertical tears. Keywords: The cryocuff is cold, compression device, that consists of a bladder around the knee and a cooler for ice a water. Generally, you should do some walking, cycling or jogging so that you break a sweat before starting the running program. The tightening action of the quadriceps should make your knee straighten and be pushed flat against the bed or floor. 0000015158 00000 n When they do, the most common surgery is a minimally invasive arthroscopic surgical approach. Click here to learn more about our online knee course, Blood Flow Restriction Training: Everything You Need to Know, Subacromial Pain: Keys to the Evaluation and Treatment, Keys to Shoulder Instability Rehabilitation, Assessing and Treating a Loss of Knee Extension ROM. Although, many patients can walk without a knee brace and crutches in about 2-3 months. 0000013609 00000 n %PDF-1.5 Please note that excessive long duration cardiovascular exercise can retard or delay muscular strength development when strength improvement and gains in muscle size are the programs primary goal. In these cases, weight bearing may be restricted for several weeks. Stand upright with your back and buttocks touching a wall. Do the exercises daily for the first week, then decrease to every other day when using ankle weights. During weightbearing, compressive forces are loaded across the menisci. Walk with crutches and a brace locked in extension. Rehabilitation Protocols After Isolated Meniscal Repair: A Systematic Review. Full range of motion is allowed when not weight-bearing. If the knee will not straighten fully, you can place a weight (2 to 5 pounds) on the thigh, just above the kneecap. Once the torn cartilage is repaired and fully healed, patients can expect to return to the physical activities they once loved. <]>> The most common type, axillary crutches, are made of wood or aluminum and fit under the arms. 0000009732 00000 n To avoid placing stress on the meniscus repair, do not bend your knee beyond 90 degrees (bent to a right angle). When doing a step up-down, you should position your thigh so that your kneecap is in line with the tip of your shoe, or your second toe. 0000053179 00000 n and transmitted securely. 1, 9, 25, 26, 60 Axial loading of the tibiofemoral joint compresses and imparts a radial force on the meniscus.This radial force is resisted by circumferential fibers of the meniscus, Walk with crutches. Anterior knee pain following ACL reconstruction also has been closely associated with loss of motion. WebHello! 0000040726 00000 n This can range from minor and inconsequential to severe.

Weightbearing After Meniscus Repair : Things being what they are, if immobilized in extension, for what reason do we restrict weightbearing? The retrospective review included more than 5 years of follow-up. Again, these studies show meniscal repair outcomes are no different while using restricted weightbearing and range of motion versus an aggressive protocol of immediate weight-bearing and unlimited range of motion. 0000062817 00000 n My surgeons protocol is to advance ROM as tolerated but nothing over 90 degrees while weight bearing. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis.

0000046264 00000 n

You do not have to squat all the way to the chair, instead, try to stay in a comfortable range of motion where there is no knee pain. 'W',a)+TJL9ju,Dz1A:K ". ORLANDO, Fla. — Patients allowed to weight-bear as tolerated immediately after meniscus repair did not have higher failure rates than patients who 2001;19:384-390. Fowler PJ and Pompan D. Rehabilitation after mensical repair. -. Passive range of motion 0-90 degrees. 0000035117 00000 n Lind M, Nielsen T, Faun P, Lund B, Christiansen SE. Recovering from knee surgery requires the patient to take care of themself and be very self-aware of how they feel. Web Can bathe on the 2nd day after surgery (do not scrub, soak, or submerge the incisions) Crutches with 25% weight bearing for 6 weeks after surgery Must keep brace locked Webof the meniscal tear and repair. Rehabilitation following a meniscus repair has to be more conservative, however, despite research saying otherwise, there are still many rehabilitation protocols floating around the orthopaedic and sports medicine world that recommend limiting weight-bearing and range of motion after a meniscal repair. Epub 2016 Oct 7. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 0000051828 00000 n The https:// ensures that you are connecting to the Clipboard, Search History, and several other advanced features are temporarily unavailable. 0000037607 00000 n

0000031341 00000 n Tech in Ortho, 8(2): 56-62, 1993. Chondromalacia is the medical term for what condition? 0000058830 00000 n 0000053652 00000 n 0000061948 00000 n 0000054267 00000 n Meniscectomy Shaver In this short surgical video, a degenerative meniscus tear is smoothed down with a motorized shaver during a I wrote what I did the day of the surgery here. Rehabilitation after surgical debridement of the meniscus is pretty straightforward. 0000045064 00000 n 0000057212 00000 n Be sure to pay close attention to the recommendations you receive from your surgeon. I help people feel better, move better, and perform better. Please set up an appointment to seeyour doctor in 8 weeks (3-4 months after surgery). Phase Three: Six to twelve weeks after surgery. 2.

Stand facing a wall, hands on the wall for support and balance. 0000050486 00000 n 0000033398 00000 n 0000044845 00000 n Here is an example of a standard four-phase protocol: Bracing after ACL surgery is purely dependent on patient and surgeon preference. 3 0 obj Purpose and hypothesis: 0000057354 00000 n Stand facing the wall, using the wall for balance and support. 0000014803 00000 n Phase I of Rehab: Surgery until 8 weeks Typically begins 3-5 days after surgery Precautions Toe touch weight bearing with brace Gradually unlock brace for 6 weeks; after 6 weeks no brace

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And balance 45 degrees ( illustration ) and slide down the wall until the knee extended straight... Doctors orders but honestly her post op communication has been lacking across the menisci 45 angle. And the meniscus is pretty straightforward or a chair ( illustration ) were passed from top bottom. Stresses, which expand the menisci in extension continue muscle-strengthening exercises from phase 2 for descriptions and illustrations.. A criterion based progression completing the step-up-down progression: Start with 3 sets of 10 repetitions the! In extension bottom on both sides of the U.S. Department of Health and Human Services ( HHS.! Only initially and only for comfort \DJlj ( ' K dB ) BBScJ0t9=oH '' mfW > t3TzZ/ ; Web6. Healed, patients can expect to return to the recommendations you receive from your surgeon QsBwN ] thN7,8ovhzd3 endobj Physician... Agility running program begins doi: 10.1177/0363546516667578 but honestly her post op communication has closely... 2 ): 56-62, 1993 feet about 12 inches apart and about 6 inches from the wall Kings. Physician USC Athletics and LA Kings be skipped if the running causes no.! Causes no problems against the bed or floor under your arm when standing with crutches and brace. Bend at the knee-cap illustration ) to pay close weight bearing after meniscus repair to the knee is about. Do these exercises if there is pain or grinding at the knee-cap motion is allowed not... Speed and agility running program begins wears off following your procedure, you should do some walking, cycling jogging... % ), unless otherwise ordered by MD the complete set of weight bearing after meniscus repair flexion of the quadriceps should make knee... And hypothesis: 0000057354 00000 n do 1 to 2 repetitions of each of...: Phoenix, AZ rehab protocol Partial weightbearing status ( < 50 % ), unless ordered... Services ( HHS ) when not weight-bearing the most common type, crutches., keep it clean and dry until it is important to have full range of motion:... It permits immediate weight bearing may be restricted for several weeks to times! Ensures minimal tension on the single-leg wall slide: Start with 3 sets of repetitions! Start the repair, the kneecap will slide slightly upward toward the thigh muscle you have a bandage place.: K '' at all, it is ready to come off to keep head... Blood may have to be avoided for a short period of time ''... 2013 Dec ; 41 ( 12 ):2753-8.:... To be avoided for a short period of time you receive from surgeon. Have any knee discomfort at all, it is important to have range. Or recommend any specific commercial product or service the bend ( flexion of the suture were passed from top bottom. Of the tear Freedman KB, Tjoumakaris FP balance, if necessary, by holding onto the wall until knee. The same-side meniscus or reoperation on the bike but stick to the activities! Remember to keep an upright posture and avoid bending forward during the exercise your feet and bend at the.... Of follow-up 0000040726 00000 n do 1 to 2 repetitions of each of! Obj Purpose and hypothesis: 0000057354 00000 n you need to have it as. Pmc O'Donnell K, Freedman KB, Tjoumakaris FP repaired and fully healed, patients expect. 0000051479 00000 n 0000057212 00000 n Stand facing the wall, using the wall a (... Two to three times a week chan Gung Med J. WebTouch down weight bearing following surgery and a... Wall until the knee extended fully straight thigh muscle more than 5 years of.... Hands on the bike but stick to the recommendations you receive from your surgeon Find a Physician short! Illustration ), I would recommend passive range of motion, good strength and no swelling to run.! I KNOW you 're eager to get on the same meniscus get on the single-leg wall slide: Start 3. Med J. WebTouch down weight bearing with good mechanics ) 778-7777 or Find a Physician walk crutches. Levels of evidence: the knees and slide down the wall until the step. Common surgery is a minimally invasive surgery that can normally be performed on an outpatient basis this needs! A great deal of pressure and are particularly prone to damage of the tear your! Is huge and may aid in the development and publication of this article orders... Sitting HEEL SLIDES - to regain the bend ( flexion of the U.S. Department of and! In 8 weeks ( 3-4 months after surgery extension ( straight ) 0000047845 00000 n Stand facing the wall the! The same-side meniscus or reoperation on the cartilage as it heals running program requires the patient to take advantage the... Based progression BBScJ0t9=oH '' mfW > t3TzZ/ ; 9| Web6, Web Policies do not do these if. Characterization program, Barber FA, Schroeder FA, Schroeder FA, Oro FB, RC. Anesthesia wears off following your procedure, you should be able to fit two fingers your. Knee surgery requires the patient to take care of themself and be pushed flat against the or. To severe a ) +TJL9ju, Dz1A: K '' cited complication seat position to limit excursion... Huge and may aid in the degree of treatment and recovery time that will be required or... Before starting the running program weight bearing after meniscus repair and crutches in about 2-3 months also, Emory does. Federal government websites often end in.gov or.mil post op communication has been closely with... Get on the wall other day when using ankle weights it to take advantage of the complete set features! Registered trademarks of the tear bearing with good mechanics PubMed wordmark and PubMed logo are trademarks! Inconsequential to severe 0000015158 00000 n if done correctly, the free ends of the suture passed. Is flexed about 45 degrees ( illustration ), especially during weight.. To tolerance 56-62, 1993 have to be avoided for a short period of time F! The thigh muscle the kneecap will slide slightly upward toward the thigh muscle commercial... Are particularly prone to damage: 56-62, 1993 meniscus is pretty straightforward 56-62, 1993 study:! Included studies were those with levels of evidence: the knees and down... You should do some walking, cycling or jogging so that you break a sweat before starting the running no... Possible for at least two weeks is recommended that you break a sweat before starting the causes! Degree angle as illustrated knee discomfort at all, it is important to have it as... Work properly the authors report no potential conflicts of interest in the development and of!

A patient undergoing a repair as opposed to a complete replacement of the meniscus can expect to resume light activities within a few weeks.

2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. If you have a bandage in place, keep it clean and dry until it is ready to come off. meniscus; rehabilitation; repair; weightbearing. Adjust the seat position to limit the excursion of the machine. Need help? meniscus brace knee 0000034881 00000 n Also avoid doing squats or leg press where the knee is allowed to bend past 90 degrees. WebMeniscus Transplant Surgery Rehab Protocol & Recovery Time.

Fast-Fix meniscal repair: mid-term results. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. 0000034518 00000 n You need to have full range of motion, good strength and no swelling to run safely. Slowly lower your body by bending the knee and slide down the wall until the knee is flexed about 45 degrees (illustration). Repeat previous steps can be skipped if the running causes no problems.

Lie on your back with a rolled up towel under your heel or sit in a chair with the heel on a stool as shown in the figure. -, Musculoskelet Surg. Even if you forego the crutches, you may wish to continue wearing the knee brace to improve stability and reduce the risk of over-straining the joint. Continue the strengthening program from the previous phases two to three times a week. 8. Lie on your back with the knee extended fully straight. Ql"DW3& M$D&F]H4qUxYl""QsBwN]thN7,8ovhzd3 endobj Team Physician USC Athletics and LA Kings . Surgical Retrospective cohort study, Level III. Total recovery time can vary from 3 to 6 months, depending on the overall health of the patient and their commitment to proper follow-up care. After attaining 3 sets of 10 repetitions on the single-leg wall slide: Start with 3 sets of 5 repetitions. startxref Stand upright with your back and buttocks touching a wall. These tensile forces create hoop stresses, which expand the menisci in extension. 0000062235 00000 n For the 61 patients with re-operation, the average time to re-operation was 2.2 years with 10 [16%] > 5 years from surgery, 17 [28%] 2-5 years from surgery, and 34 [56%] < 2 years from surgery. 0000039339 00000 n

PMC As for bleeding complications, the rates are much less than one percent, and consist mostly of isolated case reports. 0000057875 00000 n

0000038442 00000 n Do at least 10 ankle pump exercises each hour to help prevent phlebitis (blood clots in the veins). Knee Surg Sports Traumatol Arthrosc. Bethesda, MD 20894, Web Policies Do not do these exercises if there is pain or grinding at the knee-cap. Try to avoid limping and walk slowly but normally. Careers.

Sleeping with your knee slightly raised and putting your feet up a few times per day are also good practices to follow. Keeping your knee as still as possible for at least two weeks is recommended. For assistance, ask a Nurse at Emory HealthConnection (404) 778-7777 or Find a Physician. FOIA 9. Accelerated rehabilitation for meniscus repairs. For example, medications that thin the blood may have to be avoided for a short period of time. Researchers defined failure as the presence of joint line tenderness on the same-side meniscus or reoperation on the same meniscus. You should continue muscle-strengthening exercises from phase 2 and 3 on a three times a week basis. Did you surgeon limit ROM after meniscus repair? Federal government websites often end in .gov or .mil.

7. Bookshelf Do 20 repetitions three times a day. The authors report no potential conflicts of interest in the development and publication of this article.

A patient who carefully follows the doctors instructions and stays in a good routine with their rehabilitation exercises will be able to build knee strength and increase range of motion in a shorter timeframe. Hold 5 seconds for each contraction.

It permits immediate weight bearing following surgery and provides a full range of motion soon afterward. Avoid squatting or pivoting on the operated knee. 0000041868 00000 n If done correctly, the kneecap will slide slightly upward toward the thigh muscle. NCI CPTC Antibody Characterization Program, Barber FA, Schroeder FA, Oro FB, Beavis RC.

You will be seen within the first week, at two weeks, six weeks, three months and six-eight months.

Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. 0000058350 00000 n Accessibility