Acute traumatic tears occur most frequently in the athletic population as a result of a twisting injury to lateral meniscus medial meniscus figure 1 meniscus cartilage shown here from above the knee, without the femur image property of primal pictures, ltd. The intensity of the exercises for the knee can be increased in phase 3 following knee menisectomy surgery. Acl reconstruction rehabilitation protocol sports medicine north. The knee is also cushioned during weight bearing by two cartilaginous discs, called the medial inside and lateral outside menisci. Change dressing, keep wound covered, continue ted hose pod 710. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Click on your rehabilitation protocol to download a pdf file containing specific exercises and instructions for each phase of your recovery. Rehabilitation guidelines for meniscal repair of root and. Answers from doctors on meniscectomy recovery timeline. Mediallateral meniscectomy and rehabilitation anatomical considerations. Protocol s5 conservative physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for a large to massive. This may vary from a minor trimming of a frayed edge to anything short of. In one case report by muche 10, a patient who had been in a coma for a month and a half complained of knee pain upon waking up which was diagnosed as a posterior horn meniscus tear. Hearon wrist hand protocols advanced orthopedic associates.
Guidelines for rehabilitation arthroscopic meniscectomyloose body removaldebridement division of orthopaedic surgery suite 800, 55 queen street east toronto, on, m5c 1r6 tel. It is not intended to be a substitute for ones clinical decision making. Mediallateral partial meniscectomy postoperative rehabilitation protocol. The overall goals of the repair and rehabilitation are to. Patients in 1973 and 1978, all residents of the lund district who. Partial menisectomy of the knee rehabilitation protocol daniel redziniak, md the orthopedic and sports medicine center office. Specific changes in the program will be made by the physician as appropriate for an individual patient. Knee partial meniscectomy post operative rehabilitation. Knee bracesa compressive knee brace or knee support should be worn for protection and reduction in the swelling around knee joint following partial or complete menisectomy. You may vary in your ability to do the exercises and progress from one phase to the next during the corresponding timeline, but you will ultimately progress and achieve your goals.
With proper diagnosis, treatment, and rehabilitation, patients often return to their preinjury abilities. Meniscus tears and repair advanced orthopaedic centers. Limit double leg strengthening exercises to 70 deg. The meniscus is a crescentshaped piece of cartilage that is located between the femur and the tibia.
Guidelines for rehabilitation arthroscopic meniscectomy loose body removaldebridement division of orthopaedic surgery suite 800, 55 queen street east toronto, on, m5c 1r6 tel. A sizematched cadaver donor meniscus is transplanted into the site of the original meniscus. Does concomitant meniscectomy or meniscal repair affect. You should begin the exercises prescribed for you on the first day after your surgery. Provide patient with home exercise program per protocol weeks 26 period of protection. The problem damage to the articular cartilage of the knee in athletes presents one of the most difficult challenges in the care of elite and recreational athletes. Physical therapy management of meniscus tears morphopedics. If you have any questions regarding the progress of the patient, the. Acl reconstruction protocol without meniscus repair. Brace knee immobilizer ted hose to be worn until ambulation has returned to normal presurgery level or two weeks crutches. There is little evidence suggesting that ultrasound treatment is effective in treating the impairments following meniscus tears. Meniscectomy recovery timeline answers on healthtap. Brace locked in extension for ambulation for 4 weeks.
Following meniscus repair, you will be restricted from performing certain activities. 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. Gallandkirby acl reconstruction with meniscus repair postsurgical rehabilitation protocol postop days 1 14 dressing. Control pain, swelling, and hemarthrosis regain normal knee range of motion regain a normal gait pattern and neuromuscular stability for. Arthroscopic partial medial or lateral meniscectomy, loose. Rehab protocols southeast georgia rehabilitation program. Knee rehabilitation following meniscectomy, meniscal. Treatment of these defects presents a clinical challenge for physicians and physiotherapists for two reasons. It is the surgical therapy that dictates the aftercare, and with regards to the latter, there are clear differences between meniscectomy and meniscal repair.
Our rehab protocols outline timing, precautions and progression criteria for returning to. Apr 24, 2020 the protocols for rehabilitation of a meniscal injury take into consideration biomechanical principles and the results of the physical examination. Mediallateral partial meniscectomy rehabilitation protocol. Low back exercises concentrate on strengthening with the abdominal muscles, to be able to give stabilization of the spine. If you have questions, contact the referring physician. Pdf meniscal injury is a common cause of knee pain and major cause of functional impairment of the knee at young athletic population. Knee arthroscopy meniscectomychondroplasty rehabilitation.
Knee arthroscopy meniscectomy chondroplasty missouri orthopaedic institute knee arthroscopy meniscectomy chondroplasty. Quadriceps isometrics exercises, straight leg raises, and range of motion exercises should be started immediately. Postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. This rehabilitation protocol has been designed for patients following acl reconstruction who.
New exercises should be added such as by increasing weights, increasing the distance covered in swimming and cycling to improve the strength and range of motion of the knee joint and promote early recovery following knee surgery like partial or complete menisectomy. Rehabilitation guidelines for arthroscopic knee meniscectomy. Abstract spontaneous osteonecrosis of the knee sponk and osteo. Knee arthroscopy meniscectomychondroplasty missouri orthopaedic institute knee arthroscopy meniscectomychondroplasty. Pain management and rehabilitation discectomy postop protocol penrose physical therapy penrose physical therapy this is a sample surgical protocol that we typically use. Acl reconstruction protocol without meniscus repair general begin passive range of motion rom immediately after surgery unless instructed otherwise full extension is emphasized at each visit and for daily exercises weight bearing status. The procedure can be a complete meniscectomy where the meniscus and the meniscal rim is removed or partial where only a section of the meniscus is removed. Knee arthroscopy meniscectomy anatomy and biomechanics. Knee rehabilitation following meniscectomy, meniscal repair. Reduce painswelling ice 3xs daily for 1520 minutes directly on knee full knee rom as soon as possible full weight bearing as tolerated. The purpose of this study was to determine the effect of concomitant meniscal surgery on the recovery of quadriceps activation and strength at a time when individuals return to sport following anterior cruciate ligament acl reconstruction.
The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Chief, division of sports medicine associate professor of orthopaedic surgery tel. 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 partial meniscectomy, loose body removal or debridement. Meniscal allograft transplantation rehabilitation protocol. The diagnosis and management of spontaneous and post. Meniscal repair protocol this rehabilitation protocol was developed for patients who have isolated meniscal root or radial tear repairs. Each phase is adaptable based on the individual patients and special circumstances. Summary table post op phasegoals therapeutic exercise precautions phase i weeks 14 goals. At southeast georgia health system, we follow strict rehab protocols. These exercises were explained to you by your physical therapist or athletic. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. This rehabilitation protocol was developed for patients who have isolated meniscal root or radial tear repairs. Rehabilitation protocols ohio state sports medicine. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making.
The knee is a hinge joint at the connection point between the femur and tibia bones. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. Pcl non operative rehabilitation guideline sanford health. All participants completed a standard postoperative rehabilitation at one orthopedic outpatient clinic that consisted of two to three physical therapy appointments per week that began during the first postoperative week following surgery and concluded. Acl reconstruction w meniscus repair mizzou sports doc. Gallandkirby isolated meniscal repair postsurgical rehabilitation protocol postop days 1 14 dressing. Data generated from this investigation is clinically relevant, as it can help determine if more focused rehabilitation protocols need to be developed. The meniscus is anchored anatomically by bony fixation centrally and nonabsorbable vertical mattress sutures peripherally exits through accessory posterior incision. Rehabilitation protocol for meniscal repair rehabilitation guidelines. Knee arthroscopy partial meniscectomychondroplasty. It is held together by several important ligaments. Standard open or arthroscopic rotator cuff repair protocol.
However, you complete recovery may take 23 months to get all your strength back. Arthroscopic partial medial or lateral meniscectomy, loose body removal or debridement protocol. An arthroscopic meniscectomy is a procedure to remove some or all of a meniscus from the tibiofemoral joint of the knee using arthroscopic keyhole surgery. Does concomitant meniscectomy or meniscal repair affect the.
Conservative treatment for meniscus rehabilitation. Department of exercise, health, and sports science. Debridement rehabilitation protocol for physical therapy. Knee arthroscopy meniscectomy south shore orthopedics. Return to play after articular cartilage repair of the knee. Rehabilitation protocol the following is a protocol for postoperative patients following an isolated meniscus repair. He was treated for the knee pain with rice rest, ice compression and. Generally a patient can recover and return to work and sports after 34 weeks following a knee scope for synovectomy.
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. Meniscal injuries are reported to be the most common injury sustained by athletes, with sports injuries being responsible for over 30% of the total number of lesions. When the meniscus root is repaired there will be a prolonged. Jan 09, 2016 postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. The diagnosis and management of spontaneous and postarthroscopy osteonecrosis of the knee. Postoperative rehabilitation serves the purpose of improving functional deficits and pain, as well as of restoring a good range of motion and preventing secondary damage. Medial andor lateral menisectomy protocol 2 days postop remove dressings, clean wounds, dress with bandaids rom exercise hip isotonics quad sets ham sets slr crutch training modalities for swelling and pain 2 days 1 week continue modalities for swelling and pain stationary bike progress to full weight bearing, start with one crutch. Factors such as the extent and location of the lesion, the amount of articular cartilage degeneration on weightbearing surfaces, the duration of injury, and the joint stability affect the pace and. Rehabilitation time for a meniscus repair is about 3 months. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving pre. Should achieve full extension and ability to slr with no extensor lag. Partial weightbearing status meniscectomy or meniscal repair did not affect the recovery of quadriceps activation and strength at a time when individuals return to sport following acl reconstruction. This blood supply is necessary for a tear or a repair to heal. It is also an important secondary stabilizer of the.
To our knowledge, this is the first investigation to examine the potential additive effect of concomitant meniscectomy or meniscal repair on neural alterations and strength postreconstruction. Manske claimed that meniscus transplants are under more stress in a joint with early degenerative processes, consequently a conservative rehabilitation protocol results more appropriate49. Protocol s5 conservative physical therapy protocol for. Diminish inflammation and swelling restore rom full knee ext, knee flex to 90. Most patients can return to strenuous work in four to six weeks. Control pain, swelling, and hemarthrosis regain normal knee range of motion regain. Fritz in a case study described the rehabilitation protocol used in the recovery phase of a young man after meniscus transplantation. Jan 21, 20 manske claimed that meniscus transplants are under more stress in a joint with early degenerative processes, consequently a conservative rehabilitation protocol results more appropriate49.
Return to play after articular cartilage repair of the knee written by scott d. Rehabilitation guidelines this handout is a guideline for your rehabilitation after anterior cruciate ligament reconstruction. This protocol provides you with general guidelines for the rehabilitation of patients following a standard open, mini open andor arthroscopic rotator cuff repair. You can get informed about these procedures on our website. Focal articular cartilage defects in the knee joint are highly prevalent and are a common cause of functional restrictions and pain during daily life and sport activities1,2,3. Study protocol open access arthroscopic partial meniscectomy in middleaged patients with mild or no knee osteoarthritis. Ohio states rehabilitation guidelines are instrumental to patient recovery.
Partial weightbearing status pdf meniscal injury is a common cause of knee pain and major cause of functional impairment of the knee at young athletic population. Material and methods the study was approved by the ethics committee at the medical faculty of lund university. Meniscal allograft transplantation rehabilitation protocol description of procedure. Discectomy postop protocol penrose physical therapy. Rehabilitation exercises a meniscus tear is a common knee joint injury. It is designed for rehabilitation following a pcl injurytear, typically grade i. A meniscectomy requires less time for healing approximately 3 to 4 weeks. The meniscus is an important loadbearing structure that supports 70% of the load transmitted through the lateral compartment and 50% medially, thus decreasing contact pressures on the articular cartilage. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers. The details of the postoperative rehabilitation protocol can be found in appendix 1. Fortysix individuals that were cleared for participation following acl reconstruction were invited to participate in this study. Rehabilitation following arthroscopic meniscectomy. The protocols for rehabilitation of a meniscal injury take into consideration biomechanical principles and the results of the physical examination.
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