These patients actually did quite well after the surgery. 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. Knee arthroscopy with meniscus repair rehab protocol. 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. The intent of this protocol is to provide the clinician with a guideline of the post operative rehabilitation course of a patient that. The first 6 weeks are focused on nonweight bearing nwb protection, followed by 2 to 3 weeks of gradual progressive wb. Rehabilitation protocols ohio state sports medicine.
Microsoft word arthroscopic meniscal repair protocol. 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. Microsoft word acl reconstruction w meniscus repair. You will be given a prescription for pain medication for after surgery.
In general, knee is protected with a brace, rom limited to protocol. The rehabilitation guidelines are presented in a criterion based progression. Meniscus repair rehabilitation protocol the following is a protocol for postoperative patients following meniscus repair. The intent is to provide the therapist with a general framework. Specific changes in the program will be made by the physician as appropriate for the individual patient.
Regain knee motion, limiting knee flexion to 90 degrees 3. Pdf rehabilitation and return to play following meniscal repair. In general, knee is protected with a brace, rom limited to repair. Nl rom with return to adls work sport nl strength and proprioception nwb status per md, see below post op restrictions. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the quadriceps. 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. A longitudinal tear is an example of this kind of tear. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes. If an acl reconstruction and meniscus repair are performed, follow the meniscus repair program. The meniscus cartilage in the knee includes a medial inside meniscus and a lateral outside meniscus. As tolerated should be understood to include with safety for the reconstructionrepair. Acl reconstruction with meniscal repair rehabilitation protocol.
Meniscus repair rehabilitation the following protocol is a guideline for rehabilitation following meniscus repair. Discontinue crutches and brace when gait in nonantalgic about 6 weeks post op and patient has adequate quad control. Meniscus repair guidelines vanderbilt university medical. Noyes knee institute rehabilitation protocol for meniscus repairs and transplants 12 34 56 78 912 4 5 6 712 brace. 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. Microsoft word meniscus repair and transplant protocol. 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. 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. Meniscus repair rehab protocol orthopaedic medical group. Meniscal root 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. This protocol for rehabilitation after knee meniscus repair surgery is designed to provide the rehabilitation professional with a general guideline for patient care with the alterg antigravity treadmill antigravity treadmill.
This should be filled and ready for use when you return home from surgery. Brace knee immobilizer used for four weeks, ted hose to be worn until ambulation has returned to normal presurgery level or two weeks. Specific changes in the program will be made by the. The following is a protocol for postoperative patients following an isolated meniscus repair. Wulf, md meniscal root repair mensical radial tear. The outer onethird of the meniscus has a rich blood supply. The primary function of the articular cartilage is to provide. This handout describes details of the postoperative care of your knee. For most tears, some simple exercises can help maintain muscle strength in the front of the thigh quadriceps, back of the thigh hamstr. Hospital has accepted this protocol as our standard protocol for the management of patients sp meniscal repair.
As such, it should be stressed that this is only a protocol and should. 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. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Rehabilitation guidelines for meniscal repair of root and. Meniscal repair protocol brigham and womens hospital. 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. For the final 3 phases, consisting of muscle endurance, strength, and power and returntosport. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Premature ejaculation is an uncontrolled discharge either before or after the surgery. Rehabilitation protocol for achilles tendon repair this protocol is intended to guide clinicians and patients through the postoperative course for an achilles tendon repair. Your surgeon may offer a meniscus repair as a possible treatment option for damaged or torn cartilage. 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. Nwb weeks 02 pwb o 25% brace locked, bilateral crutches week 3 o 50% brace locked, bilateral crutches week 4.
The following is a protocol for postoperative patients following medial patellofemoral ligament reconstruction. Acl reconstruction with meniscal repair rehabilitation. At the time of writing this article, my left nostril is doing all the hard work although righty will soon take over, as the human nasal cycle causes my nostrils to swap jobs every few hours. Meniscus repair protocol use of rom brace locked out at zero degrees extension for ambulation for a minimum of the first six weeks after surgery rom 090 degrees for the first four weeks after surgery sleep in the brace for the first four weeks after surgery. In general, knee is protected with a brace, rom limited to 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. It is important to recognize that all times are approximate and that progression should be based on careful monitoring of the patients functional status. Meniscus repair and transplant protocol the noyes knee.
It is designed for rehabilitation following arthroscopic meniscal repair. Rehabilitation of meniscal root repairs follows a linear periodization protocol based on progressive loading of the repair. Years ago, if a patient had torn cartilage, and surgery was necessary, the entire meniscus was removed. Meniscal repair postoperative rehabilitation protocol. The primary goal of this protocol is to protect the reconstruction while. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time. Anterior cruciate ligament acl and meniscus repair. Specific time frames, restrictions and precautions are given to protect healing tissues and the surgical repair reconstruction. Meniscus rehab exercises the physical therapy advisor. Protect the knee from overstress and allow healing 2. Tears in the peripheral third of the meniscus are more likely to heal.
Nl rom with return to adls work sport nl strength and proprioception nwb status per md, see below post op restrictions return to sports 1012 weeks control pain and swelling. Acl reconstruction w meniscus repair mizzou sports doc. The decision to repair a tear in the meniscus is based largely on the location of the tear. You should not drive, operate heavy machinery or participate in activities that require concentration. Rehabilitation exercises a meniscus tear is a common knee joint injury.
Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Meniscus repair rehabilitation protocol general guidelines use the cryotherapy cuff continuously for the first 72 hours, then as needed thereafter ensure that the cuff never contacts the skin directly apply to the knee after performing rehabilitation exercises for the first 6 weeks. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. A tear in this red zone may heal on its own, or can often be repaired with surgery. Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage.
Pt protocol meniscus repair michael j rytel, md greater pittsburgh orthopaedic associates phase 1. Rehabilitation and return to play following meniscal repair. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair. Evidence based management of meniscal tears kenneth g. Right left knee medial lateral meniscal repair phase i 08 wks. Nwbtdwb brace locked in extension for ambulation brace when good quad control after 6 weeks dr exercise.
Repair can be achieved by a transtibial tunnel repair, a suture anchor repair or a side to side repair. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. Pdf the outcome of meniscal repair has been good to excellent with regard to functional restoration and return to play rtp. Acl reconstruction with patellar tendon autograft and.
Tears are noted by how they look, as well as where the tear occurs in the meniscus. Modifications to the protocol may be necessary dependent on location of repair, concomitant. If you have questions, contact the referring physician. Longleg postoperative c, a, t c, a, t c, t range of motion minimum goals 090 0120 05 x x x weightbearing toe touch to 50% body weight 75% to 100% body weight toe touch to 25% body weight. Dependent upon the location and size of the repair, weight bearing. Aclr protocol with patellar tendon autograft and meniscal repair. On line cialis, brand viagra prices cincinnatisportsmed. Acl reconstruction with meniscus repair postoperative physical therapy protocol. Knee immobilizer used for four weeks, ted hose to be worn until.
Each phase is adaptable based on the individual patient. Meniscal repair protocol this will delay the protocol for aclr 1. This blood supply is necessary for a tear or a repair to heal. Oa after arthroscopic meniscus repair vs partial meniscectomy stein, ajsm, 2010. Acl reconstruction wmeniscal repair protocol missouri orthopaedic institute weeks 612. When the meniscus is repaired there may be a period of restricted knee flexion, especially during weight bearing, to protect the repair sutures and the meniscus. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving pre. Meniscal repair postoperative rehabilitation protocol orthoindy. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Figure 6 shows the blood vessels perimeniscular capillary plexus entering the outer portion of the meniscus.
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