Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years followup were. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the. The meniscus cartilage in the knee includes a medial inside meniscus and a lateral outside meniscus. Manual stretching for extension with overpressure or recurvatum. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Acl reconstruction with meniscus repair protocol dr bradley bruner 01012009 guidelines. It is a minimally invasive procedure often undergone as an outpatient. Longleg postoperative x x x range of motion minimum goals. Discontinue crutches and brace when gait in nonantalgic about 6 weeks post op and patient has adequate quad control. Symptoms of a degenerative meniscus tear include swelling, pain along the joint line, catching and locking. Ambulate without crutches or brace at end of 6 weeks. The primary function of the articular cartilage is to. Post operatively these patients will need to avoid combined. In general, knee is protected with a brace, rom limited to meniscus repair rehabilitation dr.
In order for the meniscus repair to heal, the tear must be near this outer edge in an area of good blood supply nutrients from the blood vessels are necessary for healingthis is the socalled red vascularwhite nonvascular region of the meniscus. Meniscal repair protocol brigham and womens hospital. Meniscal repair protocol this will delay the protocol for aclr 1. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving pre. This protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair.
Tears in the peripheral third of the meniscus are more likely to heal due its vascular nature. The primary function of the articular cartilage is to provide. Each phase is adaptable based on the individual patient. Right left knee medial lateral meniscal repair phase i 08 wks. Meniscus repair rehab follows same timeframe with or without acl reconstruction acl reconstruction aids in healing response of meniscus repair tenuta ajsm 94 90% healing wrec. The most important factor in determining repairability is the location of the tear, as tears in the vascular periphery of the meniscus can produce a healing response. Change dressing, keep wound covered, continue ted hose pod 710. Toe touch 12 body weight 34 to full toe touch 14 body weight 12 to 34 body weight full p c p c c c. This evidencebased meniscal repair rehabilitation protocol is criterionbased.
Click here to download pdf rehabilitation after knee meniscus repair. One report showed that less than 10% of meniscal tears occurring in patients greater than forty years of age were repairable. Dependent upon the location and size of the repair, weight bearing status postoperatively as well as the intensity and time frame of functional activities may vary. Harold schock iii, md meniscus repair protocol 1160 kepler drive 1 p a g e green bay, wi 54311 9202885555 if an acl reconstruction is performed in conjunction with a meniscus repair, please follow meniscus repair protocol. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. The decision to repair a tear in the meniscus is based largely on the location of the tear. Rehabilitation guidelines for meniscal repair of root and complex tears there are two types of cartilage in the knee. Physical therapy rehabilitation protocols and rtp decisionmaking remains controversial in the setting of meniscal repair. Throughout this protocol, time references in weeks since surgery represent the. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes.
Weight bearing should be limited after meniscal repair, and progressed slowly. Acl reconstruction w meniscus repair mizzou sports doc. Treatment will follow the defined protocol below and be carried. 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.
Begin light jogging program if pain freeno swelling begin on treadmill or soft track. Factors affecting success include tear age, location and pattern, age of the patient, as well as any associated injuries. Do not do resisted long or short arc quads, to avoid adversely stressing the graft. Define the protocol to be followed for all patients referred from northwestern orthopedics after the above procedure has been performed. These tears will typically be repaired in younger, active patients. Dependent upon the location and size of the repair, weight bearing. In general, knee is protected with a brace, rom limited to repair mensical radial tear repair this protocol provides general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Altru advanced orthopedics knee meniscus repair rehabilitation protocol the intent of this protocol is to provide the therapist with a guideline for the postop rehab of a patient who has had a meniscus repair, meniscal root repair, or meniscal transplant. The intent is to provide the therapist with a general framework. Acl reconstruction wmeniscal repair protocol missouri orthopaedic institute weeks 612.
If you have questions, contact the referring physician. The meniscus is a circular piece of cartilage with its blood supply coming from the outer rim. Isolated meniscus repair postop rehab protocol paragon. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. The primary goal of this protocol is to protect the reconstruction and while steadily progressing towards and ultimately achieving pre. This protocol should be used with combined a acl reconstruction and meniscus repair the intent of this protocol is to provide guidelines for progression of rehabilitation. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Considerations for the postoperative meniscal repair program. Pdf the outcome of meniscal repair has been good to excellent with regard to.
Returntosport after acl with meniscal repair reconstruction protocol weightbearing in full extension with a locking brace with crutches is allowed, no weightbearing in flexion. It is not intended to serve as a substitute for clinical decision making. Hospital has accepted this protocol as our standard protocol for the management of patients sp meniscal repair. Define the protocol to be followed for all patients referred from northwestern. Jan 16, 2017 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 weightbearing and range of motion after a meniscal repair. Key factors in determining progression of rehabilitation after meniscal repair include. Phase 1 maximum protection phase 06 weeks goals for phase 1 protect anatomic repair. Tears are noted by how they look, as well as where the tear occurs in the meniscus. 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. Meniscus repair physical therapy protocol orthoindy. Mar 23, 2012 the goal of a meniscus repair is to allow the torn edges of the meniscus to heal once they have been fixated with sutures. Rehabilitation guidelines for meniscal repair of root and. Throughout this protocol, time references in weeks since surgery represent the earliest that a patient may. Gallandkirby acl reconstruction with meniscus repair postsurgical rehabilitation protocol postop days 1 14 dressing.
Meniscal repair protocol1 northwestern medical center. May, 2019 the meniscus is an important cartilaginous structure within the knee, providing shock absorption, 23 resilience to compression, 19 stabilization, 23 and optimization of weight distribution by increasing contact surface area. Articular cartilage is made up of collagen, proteoglycans and water which lines the end of the bones that meet to form a joint. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. A meniscal repair is a surgical procedure to repair a torn meniscus via keyhole surgery. Rehabilitation exercises appendix topic images meniscus tears quad sets straightleg raise to the front straightleg raise to the back hamstring curls heel raises heel dig bridging shallow standing knee bends meniscus tear. Rehabilitation protocol for meniscus repair massachusetts.
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. Knee arthroscopy with meniscus repair rehab protocol. 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. Rehabilitation exercises a meniscus tear is a common knee joint injury. Regular manual mobilizations to surgical wounds and associated soft tissue to. Meniscus rehab exercises the physical therapy advisor. It is no means intended to be a substitute for ones clinical decision making regarding the. Daily edge of bed dangle for passive knee flexion allow knee to hang in pain free range with light stretch. Even if an exercise or activity is listed at a particular time frame, some patients may not be ready to perform it. Pdf rehabilitation and return to play following meniscal repair. This protocol is intended to guide clinicians and patients through the post operative course for a meniscus repair. Acl reconstruction with patellar tendon autograft and. The gundersen sports medicine meniscus repair rehabilitation program is an evidencebased and soft tissue.
Anterior cruciate ligament acl with meniscus repair postop rehabilitation protocol the following is a protocol for postoperative patients following acl reconstruction and meniscus repair medial or lateral. Patients must demonstrate specific functional criteria at each physical therapy visit before progressing to more advanced interventions. Acl reconstruction with patellar tendon allograft, posterior lateral corner reconstruction, and meniscus repair general your surgery was performed through an incision at the front and at the side of your knee. Rehabilitation guidelines for meniscal repair uw health. Specific changes in the program will be made by the. As tolerated should be understood to include with safety for the reconstructionrepair. Meniscal repair rehabilitation protocol rom brace, wbat in extension only, limit rom 090 x 6 wks phase 1 02wks. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. Chief, division of sports medicine associate professor of orthopaedic surgery tel. Anterior cruciate ligament acl and meniscus repair. This meniscus repair reconstruction protocol is criterion based.
Maximum protection weeks 1 to 6 goals control inflammationeffusion allow early healing full passive knee extension gradually increase flexion to 90 degree independent quadriceps control weight bearing non weight bearing for six weeks unless noted by dr. It is normal to experience some sharp pain in the front of the knee when working on moving your knee. In patients with concomitant acl reconstruction and meniscus repair, acl reconstruction protocol is followed. This protocol is a criterionbased protocol, with a goal of maximizing healing and strength recovery, while.
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