EXERCISE PROGRAM (see phase 2 for descriptions and illustrations). 
Weights can be increased when you can do a particular weight easily, for 3 sets of 10 repetitions, for 3 consecutive workouts. %PDF-1.4 % When they do, the most common surgery is a minimally invasive arthroscopic surgical approach. With the knee bent over a rolled up towel or blanket of a height of 4-5 inches (the knee should be bent only 20-25 degrees), lift the foot so that the knee fully straightens. 0000060112 00000 n g&w?]!%[WN#$,ZdtX$~4Li`iE_;{4YRdqIYME gv-FdFfwOm#_>{69lX v9lO 4_ 0000030627 00000 n
0000046264 00000 n
This exercise is illustrated in phase 2.
How Should You Prepare for Orthopedic Surgery? Successful rehabilitation is different for everyone, but here are some common questions and their answers. endstream endobj 307 0 obj<>stream To avoid placing stress on the meniscus repair, do not bend your knee beyond 90 degrees (bent to a right angle). 0000057545 00000 n Repeat this process of progression from 3 sets of 5, to 3 sets of 10 (about 2 weeks).
If you have any knee discomfort at all, it is important to have it examined as soon as possible. 
Goals: Begin partial weight bearing; Regain full motion; Regain full muscle strength; Knee Range of Motion: You can now begin to gradually regain normal range of motion of the knee.
endobj
Results:
When the meniscus root is repaired there will be a prolonged period of restricted weight bearing and range of motion to protect the WebUsually patient's are non-weight bearing for 4-6 weeks after meniscus repair surgery. A cartilage tear is not like a broken bone you can still move around, which often causes progressive damage and a delay in seeking medical attention. Hold the stretch for 15 to 20 seconds and repeat 3 to 5 times. 
0000049198 00000 n
This ensures minimal tension on the cartilage as it heals. 0000041643 00000 n
0000056408 00000 n
7. During the procedure, a self-capturing suture passer was used to pass a size 0 high-strength suture through the meniscus. Therefore, range of motion, quadriceps strengthening and patellar mobility are of primary concern during the first two weeks following surgery. At all times, be cautious of pain or crunching at the kneecap or patellar tendon while exercising. Accessibility Specifically, the physician will look at and measure: As with any invasive surgical procedure, infection and bleeding are always surgical risks. Webweeks after surgery. Looking at meniscal movement as the knee flexes in weightbearing and non-weightbearing you can see theres less motion, although I really dont think we know how much motion is detrimental. So, if immobilized in extension, National Library of Medicine 0000047486 00000 n
Follow the outline on the first page of phase three where the ankle weight program is described. 0000060864 00000 n
0000053037 00000 n
0000009732 00000 n
Remember to keep your head over your feet and bend at the waist as you descend. Many patients report that their knee mobility following the procedure is at least as good as it was prior to the initial injury. The tightening action of the quadriceps should make your knee straighten and be pushed flat against the bed or floor. Post-operative weight bearing after meniscal repair is a point of debate among physicians. The weight may be increased by about 5 pounds every 7 to 10 days thereafter, as long as you can perform 20 repetitions per set for 3 sets, and as long as the weight used does not exceed body-weight when using both legs, or body weight when using the one leg. 2005 Dec;21(12):1452-6 Retrospective cohort study, Level III. Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. Study selection: Do not sit or rest at the chair, but instead immediately and slowly return to the standing and starting position. If the repair is in an area of sufficient vascularity 0000057070 00000 n
Copyright Emory Healthcare 2022 - All Rights Reserved | Download Adobe Reader. Usually by two weeks after surgery, patients are off crutches and demonstrate adequate muscle function, mobility, and comfort to allow driving. Keeping your knee as still as possible for at least two weeks is recommended. More recent studies using an accelerated rehabilitation protocol with full While there are some initial inconveniences associated with the surgery and healing process, the long-term benefits of addressing this condition at the earliest stages are more than worth it. Purpose and hypothesis: -, Haas AL, Schepsis AA, Hornstein J, Edgar CM. 
2. Data sources: Raise up on tip-toes while maintaining the knees in full extension. ANKLE PUMPS - to stimulate circulation in the leg. 0000053514 00000 n
Let the knee relax into extension (straight). 0000041241 00000 n
0000036246 00000 n
0000032297 00000 n
Do 1 to 2 repetitions of each drill of final workout to warm-up before practice. Recovering from knee surgery requires the patient to take care of themself and be very self-aware of how they feel. To avoid placing stress on the meniscus repair, do not bend your knee beyond 90 degrees (bent to a right angle). Would you like email updates of new search results? 0000015445 00000 n
Weeks 2 - 4 Nurse visit at 14 days for Surgical 0000014936 00000 n
Am J Sports Med. After two to three weeks, you might find that you no longer need the support of crutches, but its important to not rush the process. WebMeniscus Transplant Surgery Rehab Protocol & Recovery Time. 0000043523 00000 n
-, Musculoskelet Surg. 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 weight-bearing and range of motion after a meniscal repair. 0000062531 00000 n
2015 Jan;23(1):83-9 Using gravity to empty and fill the bladder, the knee can be kept cool to minimize swelling and decrease pain. 
My surgeons protocol is to advance ROM as tolerated but nothing over 90 degrees while weight bearing. Similarly, weight-bearing after meniscus repair generally requires several periods. HHS Vulnerability Disclosure, Help In this video, I interview Dr. Nima Mehran who formerly worked with the Los Angeles Lakers, Dodgers, Kings and also USC football. stream 0000057212 00000 n until the knees are flexed about 45 degrees (illustration). 2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. 2005;21:167-175. Start with one pound and add one pound per week until you reach five pounds. The null hypothesis was that there would be no difference in failure between the two groups. Start with a step of 3 inches in height. Please enable it to take advantage of the complete set of features!
Many patients find that they can put their full weight on their knee after a couple of weeks, but know your limits and be sure to not overdo the amount of time you spend on your feet.
0000055072 00000 n Recent studies from VanderHave and Lind on isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a more conservative approach. It commonly takes about 4-8 weeks for patients to increase weight-bearing and range of motion. Remember to keep your head over your feet and bend at the waist as you descend.
0000061643 00000 n These tensile forces create hoop stresses, which expand the menisci in extension. 1994 Apr;10(2):206-10. doi: 10.1016/s0749-8063(05)80095-7. For example, Mayo Clinic research has shown that ultrasound is helpful to diagnose extrusion, where the meniscus dislocates out of its normal shock-absorbing position while weight-bearing.
As soon as your initial recovery period is over, you will need to start a therapy program that will allow for a steady, gradual return to the activities you enjoyed prior to your meniscus injury. 2001;19:384-390. -, Am J Sports Med. In the single leg squat exercise, you stand on the single leg and then lower your buttocks toward the chair. Stand facing a wall, hands on the wall for support and balance. Two weeks after surgery, the goal is for patients to achieve and maintain full knee extension and increase quadriceps muscle function. |x;X 8)~>#Ef 5o9C(]F))[GxN{X]K#~_M@[T'7!;E 0000053987 00000 n 0000045756 00000 n How Many PRP Injections Do People Usually Need to Heal a Joint? PMC 296 0 obj<> endobj
Slowly lower your body by bending the knee and slide down the wall until the knee is flexed about 45 degrees (illustration). Ankle Mobility Drills to Improve Dorsiflexion, Ultimate Guide to Blood Flow Restriction Training, The Best Blood Flow Restriction Bands in 2023. 0000055550 00000 n
The https:// ensures that you are connecting to the During weightbearing, compressive forces are loaded across the menisci. Allow the knee to bend but DO NOT exceed 90 degrees of bendat the knee. Utilize a stationary bicycle to move the knee joint and increase knee flexion. Re-operations were performed in 61 of 157 patients [38.9%]. If the knee will not straighten fully, you can place a weight (2 to 5 pounds) on the thigh, just above the kneecap.
and transmitted securely. Unauthorized use of these marks is strictly prohibited. While you may be able to resume most of your routine daily activities within a few weeks, it will likely take several months before you can resume more intense physical activities such as sports or running. It is important to note that a torn meniscus will not heal itself. Level of evidence: 0000005880 00000 n You may ride the cycle with no resistance for 10 to 20 minutes a day.
0000045064 00000 n
To start the repair, the free ends of the suture were passed from top to bottom on both sides of the tear. Speed and agility running program begins. A Gradual Return to Weight-Bearing Activity After two to three weeks, you might find that you no longer need the support of crutches, but its important to not rush 
Meniscal tears don't always need surgery. Lie on your back with the knee extended fully straight. Doctors on the medical staff practice independently and are not employees or agents of Steward Health Care hospitals. While knee flexion of only 90 degrees is the goal for this stage, obtaining full extension is more of a priority. -, Becker R, Brettschneider O, Grobel KH, von Verson R, Starke C. Distraction forces on repaired bucket-handle lesions in the medial meniscus. Do 20 reps. Repeat 20 times. Conclusion: You will be advised to rest as soon as you get home following your procedure. Add one repetition per set, per workout, until you can do 3 sets of 10 (about 2 weeks minimum). Start with 3 pounds in each hand and add 1 to 2 pounds a week until you reach 10 pounds in each hand. o For meniscus root repairs, crutches will be needed for up to 6 weeks after surgery. 0000035344 00000 n
T/F An athlete who has had a meniscus repair is weight bearing immediately after surgery. 0000040143 00000 n
MeSH Tompkins and colleagues categorized 295 patients who underwent meniscus repair between 2006 and 2009 into the following two groups: non-weight-bearing; or weight-bearing as tolerated immediately following surgery. Once the tear has been repaired, the cyst will usually go away.
After a meniscus root repair, there is a prolonged period of non-weightbearing and restricted range of motion to allow proper healing. 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. Changes include weight bearing as tolerated up to 50%, the inclusion of proprioception exercise, Phase 5 Return to Sports Competition. ORLANDO, Fla. — Patients allowed to weight-bear as tolerated immediately after meniscus repair did not have higher failure rates than patients who HHS Vulnerability Disclosure, Help That is, you can bear as much weight as you can, even full weight, as long as there is no knee pain when you put your weight on the limb. As for bleeding complications, the rates are much less than one percent, and consist mostly of isolated case reports.
Tompkins M, et al. After the Proper aftercare is essential to avoid any complications or setbacks that may lengthen your recovery time. However, to this date, no long-term benefits have been found with regard to knee laxity, range of motion, or function following ACL surgery.
Progressive return to sports, as tolerated, at. This site needs JavaScript to work properly. Patients with a minimum of six weeks following the procedure for meniscus surgery and free ROM starting 9 weeks later should begin limited ROM. 0000004851 00000 n
Protect the knee from overstress and allow healing, Regain knee motion, limiting knee flexion to 90 degrees, Touch the foot of the involved leg to the floor and bear as much weight as you can without pain, If you cannot bear full weight without pain, place some of your weight on the crutches so that there is no pain with weight bearing. Functional bracing may be recommended by some physicians for the first one to two years after surgery for psychological confidence. What Should You Expect From Arthroscopic Rotator Cuff Surgery? You may add 2 to 3 pounds per week until you reach 10 pounds in each hand. 0000050348 00000 n
0000010545 00000 n
0000044707 00000 n
While maintaining this extended position, practice quadriceps setting. What do the surgeons that you work with recommend? Things like new joint line pain along the site of the repair, new swelling or a change in pain patterns, and even clicking (although most people have this) are all signs that I may want to further assess and modify my progression. 
0000037026 00000 n
Lower the operated leg, with the unoperated leg controlling it. I have a peloton and I would love to do some slow and easy cycling ( i definitely go over 90 to get a full revolution) My PT said it was fine, and obviously my surgeon is OK with it but I am just a little cautious if I will do more harm than good? 0000049050 00000 n
Tighten the quadriceps to hold the knee fully straight. If you are concerned about knee pain and wish to have an assessment, contact us today at Mattalino Orthopaedic in Phoenix, AZ. Start with one pound and add one pound per week until you reach five pounds. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. Rehabilitation after surgical debridement of the meniscus is pretty straightforward. Raise the operated limb upward to a 45 degree angle as illustrated. This field is for validation purposes and should be left unchanged. 0000034881 00000 n
by Casey Tingle. 0000034020 00000 n
You may use resistance machines at your gym, DO NOT do lunging or high impact drills or exercises or drills where you pivot on the fixed foot. MeSH The number one recommendation is to properly warm up before intense physical activity. Slowly lower your hips by bending the knees and slide down the wall until the knees are flexed about 45 degrees (illustration). Pull the heel toward the buttock. Use this weight for the first week before raising the weight. The quality of the muscle contraction in this exercise is what counts the most, not just the ability to lift the leg! Avoid squatting or pivoting on the operated knee. Heres an overview of the science behind the safety and efficacy of BFR. If you are too tight to do this, loop a belt or towel around your ankle and grasp that. 2 This is where a surgeon uses instruments passed through small incisions to operate on the joint.
What is the medical term for Knocked knee? When walking with the crutches, follow the instructions below: Walking (Weight bearing as tolerated), brace locked in full extension: The following exercise program should be followed as directed by the doctor or the physical therapist. Add one repetition per set, per workout, until you can do 3 sets of 10 (about 2 weeks minimum). Proper self-care is essential to shortening the recovery process and avoiding a recurrence of the injury. 0000038988 00000 n Bend your knee, grasping your toes, foot or ankle. Alternate the workouts between the single leg wall slide and the single leg squat, e.g.. After working up to the point where you can do 3 sets of ten of all three drills, you can hold dumbbells to add resistance. Use of a knee brace and crutches is advisable for at least two weeks to make sure that the knee is stabilized and there is no unnecessary pressure placed on the joint. 0000009410 00000 n and transmitted securely. Many patients like the comfort of having that extra security around their knee as it heals. Physical exertion will need to be avoided for two to three months, although your doctor or physiotherapist will recommend some appropriate activities that will gradually strengthen the knee and surrounding area. Most people are able to achieve a full cycle revolution backwards first, followed by forward. Federal government websites often end in .gov or .mil. Am J Sports Med. Yes, but only initially and only for comfort. meniscus; rehabilitation; repair; weightbearing. If you continue to have no pain with weight bearing, you can discontinue the crutch and walk with the brace only locked in full extension. 9. Safely recondition the injured area for the demands of sports, Provide a logical sequence of progressive drills for pre-sports conditioning, Provide objective criteria for safe return to sports. Meniscal repair using the fast-fix all-inside meniscal repair device. Are any of them still recommending rehab guidelines based on outdated research? You can use Nordic track, stationary bicycle, elliptical trainer or swimming workouts to build cardiovascular fitness. 736 Cambridge St., Brighton, MA 02135, Continue above Progress to full activity as tolerable, Put the crutches forward about one step's, Put the injured leg forward; level with the crutch, Touch the foot of the involved leg to the floor and bear weight as. 0000042043 00000 n Repeat previous steps can be skipped if the running causes no problems. 0000062386 00000 n Lean forward at the hips with the arms supporting your weight.
This Web site is provided as a courtesy to those interested in Emory Healthcare and does not constitute medical advice and does not create any physician/patient relationship. official website and that any information you provide is encrypted 2018. Please return toyour doctor's office approximately 10-14 days after your surgery. 0000049834 00000 n
Unable to load your collection due to an error, Unable to load your delegates due to an error. 
Unauthorized use of these marks is strictly prohibited. At his point, you can begin to add the single leg squat exercise. After 4 -, Chiang CW, Chang CH, Cheng CY, et al. You should then stretch before beginning the running drills. Tech in Ortho, 8(2): Disclaimer. Study design: 0000048201 00000 n My surgeons protocol is to advance ROM as tolerated but nothing over 90 degrees while weight bearing. The following exercises can be added at this time if there is no pain, swelling or noise under the kneecap: These additional exercises are described in the following pages. After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks.
Patients were categorized by post-surgical weight-bearing status, either NWB or WBAT, and then analysed for failure of repair. Context: SITTING HEEL SLIDES - to regain the bend (flexion of the knee). 0000040281 00000 n
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). What is hoffas syndrome? Despite this high occurrence, many inconsistencies continue to exist in the rehabilitation of a patient following meniscus repair surgery, particularly involving the rate of weightbearing and range of motion. Hold for one second, then lower slowly to the starting position. You should continue muscle-strengthening exercises from phase 2 and 3 on a three times a week basis. NCI CPTC Antibody Characterization Program, Am J Sports Med. Some physicians will recommend non-weight bearing activities for a period of time (depending on the surgery performed) and others may want you to start trying weight-bearing activities sooner in your recovery. Did you surgeon limit ROM after meniscus repair? 0000065521 00000 n Speed and agility running program for Return to Sports, Pain free all stretching and strengthening exercises. In the chair squat exercise, you lower your buttocks toward the chair until your buttocks touch the chair. For assistance, ask a Nurse at Emory HealthConnection (404) 778-7777 or Find a Physician. Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. The study controlled for variables including age at surgery, sex, height, weight, and BMI, classification of tear type, acuity of the tear, repair location (medial or lateral), repair location within the meniscus, repair technique, and concomitant procedures.