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