The knee is a hinge joint at the connection point between the femur and tibia bones. 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. Conservative treatment for meniscus rehabilitation. Guidelines for rehabilitation arthroscopic meniscectomyloose body removaldebridement division of orthopaedic surgery suite 800, 55 queen street east toronto, on, m5c 1r6 tel. 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. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers. Department of exercise, health, and sports science. Most patients can return to strenuous work in four to six weeks. Jan 09, 2016 postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. You should begin the exercises prescribed for you on the first day after your surgery. Fritz in a case study described the rehabilitation protocol used in the recovery phase of a young man after meniscus transplantation. He was treated for the knee pain with rice rest, ice compression and.
Click on your rehabilitation protocol to download a pdf file containing specific exercises and instructions for each phase of your recovery. Does concomitant meniscectomy or meniscal repair affect. Physical therapy management of meniscus tears morphopedics. 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. You can get informed about these procedures on our website. Rehabilitation time for a meniscus repair is about 3 months. Manske claimed that meniscus transplants are under more stress in a joint with early degenerative processes, consequently a conservative rehabilitation protocol results more appropriate49. Partial menisectomy of the knee rehabilitation protocol daniel redziniak, md the orthopedic and sports medicine center office.
Mediallateral partial meniscectomy postoperative rehabilitation protocol. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. With proper diagnosis, treatment, and rehabilitation, patients often return to their preinjury abilities. 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. This rehabilitation protocol has been designed for patients following acl reconstruction who. Standard open or arthroscopic rotator cuff repair protocol. Rehab protocols southeast georgia rehabilitation program. 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. This protocol provides you with general guidelines for the rehabilitation of patients following a standard open, mini open andor arthroscopic rotator cuff repair. 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. Chief, division of sports medicine associate professor of orthopaedic surgery tel. Mediallateral partial meniscectomy rehabilitation protocol. Guidelines for rehabilitation arthroscopic meniscectomy loose body removaldebridement division of orthopaedic surgery suite 800, 55 queen street east toronto, on, m5c 1r6 tel. Knee arthroscopy meniscectomy anatomy and biomechanics.
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. However, you complete recovery may take 23 months to get all your strength back. Diminish inflammation and swelling restore rom full knee ext, knee flex to 90. A sizematched cadaver donor meniscus is transplanted into the site of the original meniscus. Pcl non operative rehabilitation guideline sanford health. Meniscectomy recovery timeline answers on healthtap. Rehabilitation exercises a meniscus tear is a common knee joint injury. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving pre. Following meniscus repair, you will be restricted from performing certain activities.
The meniscus is anchored anatomically by bony fixation centrally and nonabsorbable vertical mattress sutures peripherally exits through accessory posterior incision. Pain management and rehabilitation discectomy postop protocol penrose physical therapy penrose physical therapy this is a sample surgical protocol that we typically use. Change dressing, keep wound covered, continue ted hose pod 710. The intensity of the exercises for the knee can be increased in phase 3 following knee menisectomy surgery. Knee arthroscopy meniscectomychondroplasty missouri orthopaedic institute knee arthroscopy meniscectomychondroplasty. 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.
Limit double leg strengthening exercises to 70 deg. The diagnosis and management of spontaneous and post. Our rehab protocols outline timing, precautions and progression criteria for returning to. Quadriceps isometrics exercises, straight leg raises, and range of motion exercises should be started immediately. Meniscal allograft transplantation rehabilitation protocol. This may vary from a minor trimming of a frayed edge to anything short of. Meniscal repair protocol this rehabilitation protocol was developed for patients who have isolated meniscal root or radial tear repairs. 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. Rehabilitation following arthroscopic meniscectomy. Knee arthroscopy meniscectomy south shore orthopedics. 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.
Brace locked in extension for ambulation for 4 weeks. 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. Provide patient with home exercise program per protocol weeks 26 period of protection. It is not intended to be a substitute for ones clinical decision making. 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. This rehabilitation protocol was developed for patients who have isolated meniscal root or radial tear repairs. Gallandkirby isolated meniscal repair postsurgical rehabilitation protocol postop days 1 14 dressing. 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. 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. This blood supply is necessary for a tear or a repair to heal. Acl reconstruction protocol without meniscus repair.
Gallandkirby acl reconstruction with meniscus repair postsurgical rehabilitation protocol postop days 1 14 dressing. Reduce painswelling ice 3xs daily for 1520 minutes directly on knee full knee rom as soon as possible full weight bearing as tolerated. Arthroscopic partial medial or lateral meniscectomy, loose. Answers from doctors on meniscectomy recovery timeline. 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. Rehabilitation guidelines for meniscal repair of root and. A meniscectomy requires less time for healing approximately 3 to 4 weeks. 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. Mediallateral meniscectomy and rehabilitation anatomical considerations. Protocol s5 conservative physical therapy protocol for. It is the surgical therapy that dictates the aftercare, and with regards to the latter, there are clear differences between meniscectomy and meniscal repair.
The overall goals of the repair and rehabilitation are to. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. If you have questions, contact the referring physician. Meniscus tears and repair advanced orthopaedic centers.
The meniscus is a crescentshaped piece of cartilage that is located between the femur and the tibia. The protocols for rehabilitation of a meniscal injury take into consideration biomechanical principles and the results of the physical examination. Brace knee immobilizer ted hose to be worn until ambulation has returned to normal presurgery level or two weeks crutches. Arthroscopic partial medial or lateral meniscectomy, loose body removal or debridement protocol.
Postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. It is held together by several important ligaments. Specific changes in the program will be made by the physician as appropriate for an individual patient. Apr 24, 2020 the protocols for rehabilitation of a meniscal injury take into consideration biomechanical principles and the results of the physical examination.
Abstract spontaneous osteonecrosis of the knee sponk and osteo. Knee arthroscopy partial meniscectomychondroplasty. Discectomy postop protocol penrose physical therapy. 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. Does concomitant meniscectomy or meniscal repair affect the. If you have any questions regarding the progress of the patient, the.
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. Return to play after articular cartilage repair of the knee. 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. Knee rehabilitation following meniscectomy, meniscal repair. Meniscal allograft transplantation rehabilitation protocol description of procedure. Treatment of these defects presents a clinical challenge for physicians and physiotherapists for two reasons. Control pain, swelling, and hemarthrosis regain normal knee range of motion regain. Rehabilitation protocol the following is a protocol for postoperative patients following an isolated meniscus repair. Knee rehabilitation following meniscectomy, meniscal. Protocol s5 conservative physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for a large to massive.
Generally a patient can recover and return to work and sports after 34 weeks following a knee scope for synovectomy. Return to play after articular cartilage repair of the knee written by scott d. Knee arthroscopy meniscectomychondroplasty rehabilitation. Rehabilitation guidelines for arthroscopic knee meniscectomy. Patients in 1973 and 1978, all residents of the lund district who. Knee partial meniscectomy post operative rehabilitation. Return to play after articular cartilage repair of. The details of the postoperative rehabilitation protocol can be found in appendix 1.
Control pain, swelling, and hemarthrosis regain normal knee range of motion regain a normal gait pattern and neuromuscular stability for. The diagnosis and management of spontaneous and postarthroscopy osteonecrosis of the knee. These exercises were explained to you by your physical therapist or athletic. At southeast georgia health system, we follow strict rehab protocols.
Rehabilitation protocols ohio state sports medicine. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. 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. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. Knee arthroscopy meniscectomy chondroplasty missouri orthopaedic institute knee arthroscopy meniscectomy chondroplasty. Acl reconstruction rehabilitation protocol sports medicine north. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Hearon wrist hand protocols advanced orthopedic associates. 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. Acl reconstruction w meniscus repair mizzou sports doc. Rehabilitation protocol for meniscal repair rehabilitation guidelines. Debridement rehabilitation protocol for physical therapy. Data generated from this investigation is clinically relevant, as it can help determine if more focused rehabilitation protocols need to be developed. The knee is also cushioned during weight bearing by two cartilaginous discs, called the medial inside and lateral outside menisci.
Low back exercises concentrate on strengthening with the abdominal muscles, to be able to give stabilization of the spine. 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. Brace locked in extension at night for 2 weeks or until full terminal extension is attained. Rehabilitation guidelines this handout is a guideline for your rehabilitation after anterior cruciate ligament reconstruction.
When the meniscus root is repaired there will be a prolonged. Fortysix individuals that were cleared for participation following acl reconstruction were invited to participate in this study. 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. 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. Knee arthroscopy with meniscal debridement rehabilitation. It is designed for rehabilitation following a pcl injurytear, typically grade i. Ohio states rehabilitation guidelines are instrumental to patient recovery. Should achieve full extension and ability to slr with no extensor lag. Arthroscopic meniscectomychondral debridement name.
There is little evidence suggesting that ultrasound treatment is effective in treating the impairments following meniscus tears. Study protocol open access arthroscopic partial meniscectomy in middleaged patients with mild or no knee osteoarthritis. 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. 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. It is also an important secondary stabilizer of the.
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