Gills office or your physical therapist if you are having a problem with your. Anterior cruciate ligament acl and meniscus repair. The time is takes to bounce back from meniscus surgery will vary because of the type of tear you may have. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time. Brian krabak and susanne michaud talk about the injury and their approach to getting patients. The outer onethird of the meniscus has a rich blood supply. Advance to wbat with crutches dc crutches at 4 weeks postop if gait normalized hinged knee brace. The treatment chosen will depend on the location of the tear, the athletes sport, ligamentous stability of the knee and any associated injury. Professor of orthopedic surgery chief, division of sports medicine t 6465017223 nyu langone orthopedic center 333 e 38th st, new york, ny 10016 t 6465017223 f 6467549505. Root tears are repaired whenever possible based on their importance in limiting future knee arthritis. Below is an example of a rehabilitation program suitable for both conservative treatment and following surgery for partial removal of torn knee cartilage meniscus. They may suggest some of the exercises shown below. Postoperative considerations if you develop a fever, intense calf pain, excessive drainage from the incision, uncontrolled pain or any other symptoms you have concerns about you should call your doctor.
A treatment procedure acting on the reactivation of the quadriceps muscles, recovering full knee and patellar mobility, and an effective resolution of knee swelling. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair. Oct 21, 2010 the rubbery meniscus cushions the knee, but a twist or pivot can tear this cartilage. 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. Chief, division of sports medicine associate professor of orthopaedic surgery tel. The approach for patients who go through a partial medial meniscectomy is to begin physical therapy on the first day after surgery. The primary function of the articular cartilage is to provide.
The best exercises after meniscus surgery phyiscal therapy. Rehabilitation guidelines for meniscal repair uw health. Postoperative knee meniscus repair rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Postoperative instructions knee arthroscopy meniscus root. Meniscal repair protocol brigham and womens hospital. A tear in this red zone may heal on its own, or can often be repaired with surgery. Rehabilitation following a meniscus repair is more significant than if the torn piece of meniscus is simply removed through a procedure called a partial meniscectomy. Specific changes in the program will be made by the.
The primary goal of this protocol is to protect the reconstruction while. Find out when it helps, what to expect, and how long youll need to do it for. Meniscus repair rehabilitation program gundersen health system. Regular exercise to restore strength and mobility to your knee is important for your full recovery after arthroscopic surgery. Your orthopaedic surgeon or physical therapist may recommend that you exercise for approximately 20 to 30 minutes, 2 or 3 times a day. The older you are, the more likely it is that you will get better without surgery because the meniscus is softer and you may pull off the torn part on your own. Meniscal repair postoperative rehabilitation protocol.
From 2005 to 2011 the number of meniscus surgeries increased by 100%, thats a huge amount. This protocol is a guideline for your rehabilitation after arthroscopic knee surgery. For any questions, please contact your physician at ucsf sports medicine at 415 3532808 or leave a message for your provider on ucsf my chart. Follow evaluationcriteriabased guidelines the journal of knee surgery vol. If the meniscus is cut through its periphery, its load distribution function will probably be completely disrupted. Goals rehab strategies 1 reduce joint effusion cryotherapy, elevation, ankle pumps 2 normalize range of motion determined by contralateral knee. You may vary in your ability to do these exercises and to progress to full resumption of your previous activity. If the torn meniscus is removed, the patient is usually up and walking within a day or two of surgery, and back to normal activities within several weeks. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Sports injury medicine department 9250 sw hall blvd. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair.
Tears that exist in the periphery are more likely to heal and as a result often will be. Toe touch wb ttwb with knee immobilizer and crutches immediately following surgery. Knee immobilizer used for four weeks, ted hose to be worn until. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. The meniscus can also help to limit femoral translation on the tibia. Rest and elevate the knee when not doing your rehabilitation exercises. Nov 16, 2016 below is an example of a rehabilitation program suitable for both conservative treatment and following surgery for partial removal of torn knee cartilage meniscus. Pdf rehabilitation and return to play following meniscal repair. There are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. Student paper knee rehabilitation after meniscus surgery atanasiu laurentiu ovidiu 25. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr.
Bledsoe style brace for concomitant gr iii mcl injury if present. Physical therapy pt and exercises for a meniscus tear rehab. Menisci deepen the socket of the tibia to increase contact with the femoral condyles. Repair can be achieved by a transtibial tunnel repair, a suture anchor repair or a side to side repair. Summit medical group is making it easier than ever for patients to seek care while limiting exposure to covid19. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. If you have questions, contact the referring physician. Manual stretching for extension with overpressure or recurvatum. Rehab protocol knee meniscal root repair 5 phase i.
Jan 21, 20 if the meniscus is cut through its periphery, its load distribution function will probably be completely disrupted. Famous physical therapists bob schrupp and brad heineck present exercises and rehab for your knee after meniscus surgery. After an injury or surgery, an exercise conditioning program will help you return. A meniscus repair involves suturing the torn edges of the meniscus back into place and letting. The gundersen sports medicine meniscus repair rehabilitation program is an. There is a growing body of evidence that physical therapy and conservative treatment may be as or more beneficial than surgery as soon as a year after the initial injury. Immediate postop 02 weeks after surgery rehabilitation goals. Meniscal injury knee anatomy knee injuries are fairly common problems, not just in athletes. Physical therapy pt can be useful for a torn meniscus whether or not you have surgery. Knee meniscus disorders involve the medial meniscus or lateral meniscus, two semicircular pads of cartilage in the knee between the joint surfaces of pdf version united states department of labor. Apr 9, 2014 medial meniscus, tear of median meniscus of the left knee and left knee sprain.
When the meniscus root is repaired there will be a prolonged. Meniscal repair postoperative rehabilitation protocol orthoindy. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes. Rehabilitation exercises a meniscus tear is a common knee joint injury. Rehabilitation and return to play following meniscal repair. 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. Pain control, knee immobilizer a solution containing a long acting local anesthetic will be injected around your femoral nerve. As tolerated should be understood to include with safety for the reconstructionrepair. The meniscus especially the posterior horn of the medial meniscus can be a secondary stabilizer in an acl deficient knee. To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Early after surgery, 92% of patients had excellent or good results, in term of knee pain, swelling, rom, squatting, but at a mean of eight years after surgery, only 62% of the patients rated their knees as excellent or good50. The following is a protocol for postoperative patients following meniscus repair.
There have been multiple studies that have demonstrated the clinical success of meniscal repair. Knee arthroscopy meniscus root repair day of surgery a. Postoperative instructions knee arthroscopy meniscus root repair day of surgery a. The state of the literature in the nonoperative management of meniscus and articular cartilage lesions is rapidly evolving and will be explored and presented in the next iteration of this cpg.
Treatment of a torn meniscus may include observation and physical therapy with muscle strengthening to stabilize the knee joint. 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. In some cases the recovery from meniscus surgery is measured in days t0 weeks, and in. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and flexibility in your knee as possible. While the postop dressing is in place, icing should be done. We recommend seeking professional advice before beginning rehabilitation. After meniscal surgery, rehabilitation with a physical therapist or athletic trainer is needed to restore range of motion, strength, movement control and guide the athletes return to sport. The torn meniscus rehabilitation program is split into 4. This blood supply is necessary for a tear or a repair to heal.
How well the knee will heal and whether surgery will be needed depends in large part on the type of tear and how bad the tear is. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the quadriceps. Many surgeons differ in their preference and depending on other work that may have been done at the time of surgery the rehab can vary significantly. May 19, 2017 famous physical therapists bob schrupp and brad heineck present exercises and rehab for your knee after meniscus surgery. Your recovery will also depend on whether or not you had a meniscus repair sutures or if you simply had the torn pieces removed partial menisectomy. Despite accumulating evidence that questions the rationalisation and effectiveness of the treatment, meniscus surgery is still widely performed in the treatment of degenerative meniscus.
Evidence based management of meniscal tears kenneth g. They demonstrate appropriate stretches and strengthening exercises. Knee arthroscopy exercise guide regular exercise to restore strength and mobility to your knee is important for your full recovery after arthroscopic surgery. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and. Most of the time, rest, ice, and pain meds are enough to help you feel better. Meniscus tear treatment and rehabilitation information uw. Meniscus surgery is a well established orthopedic procedure however it is often underestimated on the effect it has on patients by the medical. Our telemedicine options include virtual video visits, telephone checkins, and patient portal communication. Acl reconstruction with meniscus repair postoperative physical therapy protocol. Meniscus rehab exercises the physical therapy advisor. The following is a protocol for postoperative patients following an isolated meniscus repair. This rehabilitation protocol was developed for patients who have isolated meniscal root or radial tear repairs. Postoperative instructions knee arthroscopy meniscus root repair. To prepare for your presurgical appointment, please watch videos for preparing for surgery for patients given home exercises, please watch vidoes for nonoperative home exercises.
When conservative measures are ineffective treatment may include surgery to repair or remove the damaged cartilage. Arthroscopic surgery is frequently used for meniscus tears. Oct 28, 2019 as stated before, this is just an example of a possible rehab protocol after meniscus repair surgery. The success of meniscus repair depends on tear pattern recognition and location for the capacity to heal. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. 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.
Symptoms of a torn meniscus include knee pain, swelling, popping, and giving way. One source even quotes the incidence as high as 1 in 300 people with have surgery on their meniscus. Some surgeons are pursuing a more aggressive rehab plan. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint.
710 1030 602 1373 989 790 204 726 1195 1062 1083 288 1485 805 413 772 1345 1066 1362 299 308 359 1455 1131 257 1492 1370 28 1325 623 1544 816 1019 156 912 259 294 202 591 1029 611 753 460 1473