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 partial meniscectomy, loose body removal or debridement. The arrow in figure 3 shows a normal meniscus on an mri, but the arrows in figure 5 show a torn meniscus. Rehabilitation guidelines for arthroscopic knee meniscectomy. Brace knee immobilizer used for four weeks, ted hose to be worn until ambulation has returned to normal presurgery level or two weeks. Once the dressing is removed on the first or second day, ice is applied for 20minute periods 34 times per day. The knee is also cushioned during weight bearing by two cartilaginous discs, called the medial inside and lateral outside menisci. Meniscus repair rehabilitation the following protocol is a guideline for rehabilitation following meniscus repair. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Soft tissue treatment to quads, posterior musculature, suprapatellar pouch, popliteal fossa, iliotibial band and hoffas fat pad. 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. 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. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair. Department of exercise, health, and sports science.
Bledsoe style brace for concomitant gr iii mcl injury if present. Meniscal repair postoperative rehabilitation protocol. The outer onethird of the meniscus has a rich blood supply. There was wide variation in rehabilitation protocols among clinical studies. Meniscectomy rehabilitation protocol this protocol is a general outline. 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. It is not intended to be a substitute for ones clinical decision making. While the postop dressing is in place, icing should be done continuously. Postoperative arthroscopic partial meniscectomy physical therapy rehabilitation protocol each phase should include.
Repair postsurgical rehabilitation protocol postop days 1 14 dressing. Knee arthroscopy meniscectomy anatomy and biomechanics. The sports physical therapy service is an integral part of the sports medicine center and the department of physical and occupational therapy. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the quadriceps. Postoperative instructions knee arthroscopy and partial. Knee arthroscopy and partial meniscectomy day of surgery a. Madison, wi 53718 rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Sports medicine physical therapy 6176439999 we use cookies and other tools to enhance your experience on our website and to analyze our web traffic. After partial meniscectomy rehabilitation protocol can be aggressive, because in the knee joint anatomical structure should not be protected during the healing phase. Jan 21, 20 rehabilitation after partial meniscectomy. It is held together by several important ligaments.
Work with your doctor to plan a rehabilitation rehab program that helps you regain as much strength and flexibility in your knee as possible. Our rehab protocols outline timing, precautions and progression criteria for returning to activity. Postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. 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. Specific changes in the program will be made by the. General guidelines the local anesthetic similar to novacaine in your knee lasts 612 hours start taking the pain medication as soon as you start to feel any pain stay ahead of the pain with your pain medication. 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. Surgical knee will be in a hinged rehab brace locked in full extension for 4 weeks postop. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. The meniscus is a crescentshaped piece of cartilage that is located between the femur and the tibia. Middle of road rehab guidelines for meniscus repair rehabilitation 1st question. 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. Brace knee immobilizer ted hose to be worn until ambulation has returned to normal presurgery level or two weeks crutches. The knee is a hinge joint at the connection point between the femur and tibia bones. This technique allows the surgeon to have a clear view of the inside of. We want the blood to drain out of the knee on to the dressings rather than.
Articular cartilage is made up of collagen, proteoglycans and water and lines. The intensity allowed and the time frame required for the rehabilitation process is dependent upon the. Sports medicine physical therapy rehabilitation protocols. Knee partial meniscectomy post operative rehabilitation. The sports physical therapy service is an integral part of the sports medicine center and the department of. Throughout this protocol, time references in weeks since surgery represent the earliest that a patient may begin an exerciseactivity following meniscus repair reconstruction. Postoperative arthroscopic partial meniscectomy physical.
Knee arthroscopy with meniscus repair rehab protocol. Madison, wi 53718 rehabilitation guidelines for knee arthroscopy arthroscopy is a common surgical procedure in which a joint is viewed using a small camera. Here is some info from ohio state improving lives through excellence in research, education and patient care. Protocol utilization each time reference in the protocol is. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Meniscus repair rehab protocol orthopaedic medical group. The gundersen health system rehabilitation programs are evidencebased and soft tissue healing dependent programs designed to allow patients to progress to vocational and sportrelated activities as quickly and safely as possible. If any of these occur, decrease activity level and ice. Lock the brace when walking to protect the knee in case of a fall.
Knee arthroscopy rehab protocol meniscus repair rehab protocol meniscus transplant rehab protocol pcl reconstruction rehab protocol pcl repair rehab protocol partial knee replacement rehab protocol patellofemoral ligament reconstruction rehabilitation. As tolerated with crutches for balance x 2448 hours progress to wbat range of motion aarom arom as tolerated o goal. Arthroscopic partial medial or lateral meniscectomy, loose body removal or debridement protocol. Ohio states rehabilitation guidelines are instrumental to patient recovery. Meniscus repair rehabilitation protocol the following is a protocol for postoperative patients following meniscus repair. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. We summarised rehabilitation protocols and patients outcome among original studies. Exercises that might be prescribed for rehab are listed here. 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.
Meniscus rehab exercises the physical therapy advisor. Your rehab program probably will include physical therapy and home exercises. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Arthroscopic meniscectomychondral debridement name. 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. Home exercise program hep as indicated 1215 repetitions with 12 sets of each exercise.
Physical therapy pt intervention as indicated by treating physical therapists plan of care within guidelines of this study protocol. Regular assessment of gait to avoid compensatory patterns. Knee rehabilitation following meniscectomy, meniscal. 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 exercises a meniscus tear is a common knee joint injury. Rehabilitation protocols ohio state sports medicine. Lowe this rehabilitation protocol is designed for patients who have undergone knee arthroscopy or arthroscopic lateral release. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. A tear in this red zone may heal on its own, or can often be repaired with surgery. Apply to the knee after performing rehabilitation exercises for the first 6 weeks if no cryotherapy cuff is provided, use a bag of ice for 20 minutes each hour while awake, separating the bag of ice from skin with a cloth or tshirt.
If an athlete suffers a meniscal tear the three options for treatment include. 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 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. Iceelevation every 2 hours for 15 minute to minimize edema and promote healing please refer to icing recommendations handout.
Knee arthroscopy meniscectomychondroplasty rehabilitation. There are two types of cartilage in the knee, articular cartilage and meniscus cartilage. As tolerated refers to no increased sharp pain, swelling, or other undesirable factors. Jan 09, 2016 postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Knee braces a compressive knee brace or knee support should be worn for protection and reduction in the swelling around knee joint following partial or. Op r ehabilitation protocol the following is a protocol for postoperative patients following an isolated meniscus repair.
The aim of phase 3 of a meniscus tear rehabilitation program is to ensure full range of movement in the knee, regain normal strength with the ability to perform a full squat and start to return to running and normal training. Knee arthroscopy meniscectomychondroplasty missouri orthopaedic institute knee arthroscopy meniscectomychondroplasty. Early rehab, pt and exercises following knee surgerypartial or complete meniscectomy following to be done in phasei 010 days after partial or complete menisectomy for early recovery. Nov 16, 2016 below is an example of a rehabilitation program suitable for both conservative treatment and following surgery for partial removal of torn knee cartilage meniscus. 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. Conservative treatment for meniscus rehabilitation. If you have questions, contact the referring physician. Regular manual mobilizations to surgical wounds and associated soft tissue to decrease the incidence of fibrosis. We recommend seeking professional advice before beginning rehabilitation. Md physical therapy section kenneth kirby, pt, dpt william beaumont army medical center. You can unlock the brace to sit or move the knee when not walking.
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