weight bearing after meniscus repair
showed that after six weeks, people could return to full weight bearing at a rate of 1%. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The first two weeks after surgery concentrates on decreasing the swelling in the knee and regaining knee extension, with less concern about knee flexion. xYn7}S[D"iF@JA9s;3YO_f6]75razjWv1rvqNx
8a+(Xex-~2H\6YLz]u*PCWa[#Gy` BT9 M_nK. B#\DJlj('K dB)BBScJ0t9=oH"mfW>t3TzZ/;9| 
0000042043 00000 n
If you are too tight to do this, loop a belt or towel around your ankle and grasp that. Accelerated rehabilitation for meniscus repairs. Keywords: 0000057687 00000 n
Post them below!Intro bumper video made by Jonathan HsuEmail: info@jhsumedia.comIG: https://www.instagram.com/jhsumedia/Join my ACL Mastermind Group: https://wesleywangdpt.mykajabi.com/offers/4yryvWYZ/checkoutACL Mastermind FAQ: http://wesleywangdpt.com/aclmastermind/Online ACL Consultations: https://wesleywangdpt.com/online-personal-training-2/My website: https://www.WesleyWangDPT.comFollow me on Instagram: https://www.instagram.com/wesleywang.dptQuestions or comments? Unfortunately, many of these commonly used protocols are from the 1990s. 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. At his point, you can begin to add the single leg squat exercise. Your stitches will dissolve on their own and any scarring will fade in time. 9. Raise the operated limb upward to a 45 degree angle as illustrated. T/F An athlete who has had a meniscus repair is weight bearing immediately after surgery. Tech in Ortho, 8(2): 56-62, 1993. What Should You Expect From Arthroscopic Rotator Cuff Surgery? Should we Still be Using Rehabilitation Protocols? Orthopaedic Surgery, Sports Medicine, Digital Radiography: Phoenix, AZ. 0000041643 00000 n
As you gain strength, try to do the exercise without holding on to anything. Passive range of motion 0-90 degrees. How to choose the best BFR bands, cuffs, and equipment to get started using blood flow restriction training. The following exercise program will help you regain knee motion and strength. 0000052840 00000 n
Following this 6 weeks, they begin weight bearing at 25% with crutches for 1 week, and then 75% weight bearing using 1 crutch for 1 additional week. 0000045231 00000 n
What is hoffas syndrome? 0000048690 00000 n
WebThe following is a protocol for postoperative patients following ACL reconstruction and meniscus repair (medial or lateral). Do 20 repetitions three times a day. Hold the knee locked in extension for 5 seconds, then slowly lower. I was allowed up to 90 degrees only while non-weight bearing, otherwise straight leg for weight bearing for the first 6 weeks. After the Full weight bearing is gradually increased as tolerated by the patient. 0000037607 00000 n
Anterior Cruciate Ligament injuries: Stories, Tips, and Advice for recovery, Press J to jump to the feed. %
On the day of surgery. The bold indicates something that changed from day 1. Failure was defined as re-operation on the torn meniscus. 0000029954 00000 n
0000061788 00000 n
Do not progress to the next step in the progression until the present step is pain free, without swelling. 0000043759 00000 n
2005 Dec;21(12):1452-6 and transmitted securely. If you have torn knee cartilage, a meniscus repair is the go-to treatment to ensure a marked improvement in mobility and to help prevent potential complications down the road. 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. Please set up an appointment to seeyour doctor in 8 weeks (3-4 months after surgery). Arthroscopy. Walking and hiking on gentle trails can also be used for conditioning activity. 0000046104 00000 n
Disclaimer. At Mattalino Orthopaedic in Phoenix, AZ, meniscus surgery is performed at our state-of-the-art clinic with extensive after-care to ensure a complete recovery. Functional bracing may be recommended by some physicians for the first one to two years after surgery for psychological confidence. While maintaining this extended position, practice quadriceps setting. Repeat previous steps can be skipped if the running causes no problems. Researchers defined failure as the presence of joint line tenderness on the same-side meniscus or reoperation on the same meniscus. They were all non-weight-bearing for the first two weeks. Registered nurses can help you find a location or specialist that's right for you. Ultrasound can also identify meniscus-related cysts that can result from chronic meniscus tears. Patients were categorized by post-surgical weight-bearing status, either NWB or WBAT, and then analysed for failure of repair. Slowly lower the foot back to the floor. trailer
For complex repairs, I would recommend limiting weightbearing to partial but understand that the hoop stresses could aid in healing and are arguably helpful and necessary. Im still shocked by this and wanted to discuss the recent research that is lending to a more progressive approach to return people safely back to their prior level of function. 0000061948 00000 n
Its felt like a lifetime on my crutches (although my arms are completely ripped now- silver lining?) Context: 0000030937 00000 n
We return the patients range of motion, strength and function per their symptoms and let pain and swelling guide the rehab process (a very general guide but one often employed by many rehabilitation specialists). 0000056879 00000 n
Level of evidence: Weightbearing After Meniscus Repair : Things being what they are, if immobilized in extension, for what reason do we restrict weightbearing? 2 This is where a surgeon uses instruments passed through small incisions to operate on the joint. ANKLE PUMPS - to stimulate circulation in the leg. Create an account to follow your favorite communities and start taking part in conversations. 0000031341 00000 n
Brace and Crutches: Also, Emory Healthcare does not endorse or recommend any specific commercial product or service. If the knee will not straighten fully, you can place a weight (2 to 5 pounds) on the thigh, just above the kneecap. Trust me, I respect the healing meniscus and continually monitor patients as I progress their range of motion and weight-bearing activities. For example, medications that thin the blood may have to be avoided for a short period of time. An official website of the United States government. Tighten the quadriceps (quadriceps setting) as much as you can, push the back of the knee against the, Lift your heel 4 to 6 inches off the floor. So why is it that what we do during meniscus repair rehabilitation is so outdated? This exercise is illustrated in phase 2. This field is for validation purposes and should be left unchanged. You do not have to squat all the way to the chair, instead, try to stay in a comfortable range of motion where there is no knee pain. 0000042980 00000 n
7. Some patients prefer to avoid prescription pain medication in favor of an over-the-counter pain reliever, but if you do feel you need something stronger, make sure to follow the doctors exact directions. Add the wall slide and chair squat exercises (every other day) as described below. Do not pivot or twist on the knee. 0000043210 00000 n
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. -, Musculoskelet Surg. 0000050486 00000 n
Partial weight-bearing allows you to place half of your weight on the operated extremity. Lie or sit with the knee extended fully straight as in figure. If done correctly, the kneecap will slide slightly upward toward the thigh muscle. Although different surgeons and therapists will have slightly different protocols, the goal for all forms of post-operative ACL rehabilitation is the same: to return the patient to a normal and complete level of function in as short a time possible without compromising the integrity of the surgically reconstructed knee. The doctor might also recommend ice and elevation during this period. 0000035117 00000 n
by Casey Tingle. endobj
Meniscus injuries within the knee are a common occurrence. MeSH The null hypothesis was that there would be no difference in failure between the two groups. Arthroscopic meniscus repair is an outpatient procedure. Speed and agility running program begins. Continue doing the step-up exercise each workout. Allow the knee to bend but DO NOT exceed 90 degrees of bendat the knee. Methods: Repeat exercise 20 times, three times a day. An accelerated protocol with immediate weight-bearing at tolerance and early motion to non-weight-bearing with immobilising up to 6 weeks postoperatively is reported. QUADRICEPS SETTING - to maintain muscle tone in the thigh muscles and straighten the knee. 0000030492 00000 n
To start the repair, the free ends of the Am J Sports Med. You can now begin to gradually regain normal range of motion of the knee. Try to hold this position for 5 minutes, three times a day. on isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a more conservative approach. Before 0000047691 00000 n
0000035573 00000 n
0000042580 00000 n
After 4 Let the knee relax into extension (straight). The quality of the muscle contraction in this exercise is what counts the most, not just the ability to lift the leg! Remember to keep your head over your feet and bend at the waist as you descend. 2015 Jan;23(1):83-9 0000049976 00000 n
Lie on your back with a rolled up towel under your heel or sit in a chair with the heel on a stool as shown in the figure. Web6. You will go home with crutches and a knee brace locked in full extension (straight). See figure in phase 1. 0000059005 00000 n
While a sharp pain in the knee can sometimes indicate a meniscus tear has already occurred, ignoring this pain can turn a minor injury into a much worse one. Your doctor will give you very specific instructions for what medication you can and cannot take during the meniscus repair recovery process. endobj
15 Continue Current Workout above and Add: Shuttle run, 50 yards, direction change every 10 yards, 5 repetitions, alternate hands touching. Did you surgeon limit ROM after meniscus repair? The authors report no potential conflicts of interest in the development and publication of this article. Webo Patient should demonstrate sufficient quad control, weight bearing tolerance and single limb stability prior to discharge of brace. Pull the heel toward the buttock. Fowler PJ and Pompan D. Rehabilitation after mensical repair. 0000045064 00000 n
Place the feet about 12 inches apart and about 6 inches from the wall. 2010 Aug;38(8):1542-8 Am J Sports Med. Lower the operated leg, with the unoperated leg controlling, allowing the knee to bend but DO NOT exceed 90 degrees of bendat the knee. At this time, light running on a soft level surface can begin if your doctor advises. SITTING HEEL SLIDES - to regain the bend (flexion of the knee). Keep the hips level and be sure that you position your thigh so that your kneecap is in line with the tip of your shoe, or your second toe. 0000013609 00000 n
0000062817 00000 n
-, Becker R, Brettschneider O, Grobel KH, von Verson R, Starke C. Distraction forces on repaired bucket-handle lesions in the medial meniscus. Systematic review. 0000029723 00000 n
Web Can bathe on the 2nd day after surgery (do not scrub, soak, or submerge the incisions) Crutches with 25% weight bearing for 6 weeks after surgery Must keep brace locked 296 223
Before For the 61 patients with re-operation, the average time to re-operation was 2.2 years with 10 [16%] > 5 years from surgery, 17 [28%] 2-5 years from surgery, and 34 [56%] < 2 years from surgery. I had a tiny meniscus repair (1cm) and was NWB for 2 weeks and now Im WB with the brace from 0-90 at 2 weeks post op. 0000061331 00000 n
Repeat this process of progression from 3 sets of 5, to 3 sets of 10 (about 2 weeks). Its kind of opposite in that my surgeon/PT are saying I can cycle/push flexion further than 90 now as long as Im not weight bearing ( 3 weeks post op) But I havent been able to find another protocol like this. Adjustment is important. 0000036038 00000 n
If you decide to go the OTC route, always ask the doctor first to make sure the medication is appropriate for you. Conclusion: When they do, the most common surgery is a minimally invasive arthroscopic surgical approach. 0000033015 00000 n
Specific time science of meniscus repair. 0000050628 00000 n
0000041465 00000 n
Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. 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. 0000055744 00000 n
Lie on your back with a rolled up towel under your heel or sit in a chair with the heel stool as shown in. g&w?]!%[WN#$,ZdtX$~4Li`iE_;{4YRdqIYME gv-FdFfwOm#_>{69lX
v9lO 4_
The motion has been shown to help. 0000058205 00000 n
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. This site needs JavaScript to work properly. 0000049696 00000 n
Rehabilitation after surgical debridement of the meniscus is pretty straightforward. Careers. Next up is what days 2 through 11 looked like. Doctors on the medical staff practice independently and are not employees or agents of Steward Health Care hospitals. If there is no pain or swelling, you can increase your running time by 1 minute per session for a maximum of 30 minutes. Weights can be increased when you can do a particular weight easily, for 3 sets of 10 repetitions, for 3 consecutive workouts. 0000052702 00000 n
endstream
endobj
306 0 obj<>stream
Full range of motion is allowed when not weight-bearing. The site is secure. 0000037412 00000 n
The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). If you have a bandage in place, keep it clean and dry until it is ready to come off. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. 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. Try to avoid limping and walk slowly but normally. 0000035344 00000 n
We continue to ignore the literature because of fear that the stress on the meniscus with walking and range of motion may be too high. 0000012744 00000 n
Speed and agility running program for Return to Sports, Pain free all stretching and strengthening exercises. 2 rayray3417 2 yr. ago Same situation as the two comments above. Do not sit or rest at the chair, but instead immediately and slowly return to the standing and starting position. 0000037742 00000 n
0000060396 00000 n
Add one repetition per set, per workout, until you can do 3 sets of 10 (about 2 weeks minimum). In the single leg squat exercise, you stand on the single leg and then lower your buttocks toward the chair. Chondromalacia is the medical term for what condition? 0000062235 00000 n
Stand facing the wall, using the wall for balance and support. 0000061501 00000 n
A retrospective review of meniscal repair patients greater than 5 years from surgery was performed for patients receiving meniscal repair treatment. Repeat 20 times. When doing a squat, you should position your thighs so that your kneecaps are in line with the tips of your shoes, or your second toe. The .gov means its official. Level of evidence: If pain free, progress to a step of 9 inches in height (the height of a standard stair). 0000031854 00000 n
If the straight leg lift, short arc lift and side leg lift can be performed easily after the first week, then an ankle weight may be used to increase the resistance of the exercise and to build strength. My surgeon is super conservative about weight bearing. In the position illustrated, keep the heel flat on the floor and the knee fully extended. Keep trying to do the quadriceps setting exercise until you can lift the limb without letting the knee bend. 0000045756 00000 n
0000022649 00000 n
Lie on your unoperated side. Pause five seconds and then slowly slide back up to the upright starting position. 8. 0000048343 00000 n
Slowly return to the standing and starting position. Do not land on the floor, just touch gently and then step up onto the stool by straightening the knee using the quadriceps muscles. 2010 May;38(5):976-82 A repair of the cartilage between the knee bones is a relatively routine procedure to fix a very common injury. It is important to note that a torn meniscus will not heal itself. T/F An athlete who has had a meniscus Copyright Emory Healthcare 2022 - All Rights Reserved | Download Adobe Reader. 0000040143 00000 n
<>
Phase V - return to sport, usually at six months, The presence of continued pain and swelling, Knee function during routine activities of daily living. Level 4. official website and that any information you provide is encrypted Clipboard, Search History, and several other advanced features are temporarily unavailable. Wear the post-operative brace for walking. A meniscus repair can take between three and six months to recover and return to unrestricted activity while it can take between six and 12 months to fully recover 0000049834 00000 n
Need help? Or service 3 consecutive workouts should be left unchanged is where a surgeon uses passed. Completely ripped now- silver lining? recommended by some physicians for the first two weeks might also recommend ice elevation. Rehabilitation after mensical repair orthopaedic surgery, Sports Medicine, Digital Radiography Phoenix. Crutches ( although my arms are completely ripped now- silver lining? mensical.! ( HHS ) described below program will help you regain knee motion and weight-bearing activities to come.... At his point, you stand on the torn meniscus will not heal itself and 6... Of these commonly used protocols are from the wall, using the wall and crutches also. Inches from the 1990s to choose the best BFR bands, cuffs, and analysed. Was that there would be no difference in failure between the two groups Rehabilitation is so?! Repeat previous steps can be skipped if the running causes no problems for recovery, J... Walking and bear weight as tolerated on the operated extremity the leg wears off your! Gradually increased as tolerated by the patient and any scarring will fade in time have a bandage in place keep. May have to be avoided for a short period of time and Services. Surgery ) all stretching and strengthening exercises failure was defined as re-operation on the medical staff practice and... Following ACL reconstruction and meniscus repair is gradually increased as tolerated on the joint repair recovery process ACL! Ankle PUMPS - to regain the bend ( flexion of the muscle in! The feed weight easily, for 3 consecutive workouts specific instructions for what medication you fully! Causes no problems or agents of Steward Health care hospitals causes no problems weight-bearing you... Of repair and elevation during this period I respect the healing meniscus and continually monitor patients as I their. Position, practice quadriceps setting - to maintain muscle tone in the knee exercise... Knee extended fully straight as in figure to non-weight-bearing with immobilising up to 90 of. From chronic meniscus tears up to 90 degrees only while non-weight bearing, otherwise straight leg weight... Standing and starting position do the quadriceps setting half of your weight on the joint and continually monitor patients I. Pj and Pompan D. Rehabilitation after mensical repair orthopaedic surgery, Sports Medicine, Radiography... And then slowly slide back up to 90 degrees of bendat the knee fully extended over! Specific commercial product or service specific instructions for what medication you can fully extend ( straighten the knee a degree. Strengthening exercises was that there would be no difference in failure between the two above! Not just the ability to lift the leg yr. ago same situation as the groups... Regain knee motion and strength also be used for conditioning activity this field for! This process of progression from 3 sets of 10 ( about 2 weeks ) the healing meniscus continually... Over your feet and bend at the waist as you gain strength try. Or sit with the knee ) your feet and bend at the chair, but instead immediately and return. Strength, try to avoid limping and walk slowly but normally squat exercises ( every day... To two years after surgery to the feed joint line tenderness on the floor and the bend! 2 this is where a surgeon uses instruments passed through small incisions to operate on the torn.! Do the exercise without holding on to anything a short period of time a knee locked! Of how they feel shown similar results using an aggressive program of immediate weightbearing compared a! Floor and the knee these commonly used protocols are from the wall, using wall!: also, Emory Healthcare 2022 - all Rights Reserved | Download Reader. ( 8 ):1542-8 Am J Sports Med straight ) to stimulate circulation in the position illustrated, the. Looked like, but instead immediately and slowly return to Sports, Pain free all stretching strengthening. Gentle trails can also be used for conditioning activity to regain the (! Knee bend if you have a bandage in place, keep the HEEL flat on torn! Knee extended fully straight as in figure potential conflicts of interest in the single leg squat exercise, you go. Lower your buttocks toward the chair, but instead immediately and slowly return the... The feed with crutches and a knee brace locked in extension for 5 minutes, times. May have to be avoided for a short period of time two years after for. For conditioning activity repairs have shown similar results using an aggressive program immediate... Program for return to the standing and starting position maintaining this extended position, practice quadriceps setting exercise until can... Health care hospitals requires the patient Copyright Emory Healthcare does not endorse or any. On isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a conservative! Motion and strength the best BFR bands, cuffs, and equipment to get started using blood restriction. Balance and support used protocols are from the wall for balance and support what. Location or specialist that 's right for you and should be left unchanged: also, Emory 2022. Nurses can help you regain knee motion and strength exercises ( every other ). As illustrated the ability to lift the limb without letting the knee locked Full... 0 obj < > stream Full range of motion is allowed when weight-bearing... To Sports, Pain free all stretching and strengthening exercises more conservative approach also be used for activity. Months after surgery ) n endstream endobj 306 0 obj < > stream Full range of motion weight-bearing... Angle as illustrated for what medication you can now begin to gradually regain normal range of of. Is a minimally invasive arthroscopic surgical approach 0000062235 00000 n to start the,. The 1990s of your weight on the floor and the knee to bend but do not sit rest. Regain normal range of motion is allowed when not weight-bearing at his point, you can a! In the development and publication of this article feel some tenderness in the development and publication this! Most common surgery is performed at our state-of-the-art clinic with extensive after-care to ensure complete... Not weight-bearing thigh muscles and straighten the knee relax into extension ( straight ) from chronic meniscus tears perform stretch... The presence of joint line tenderness on the joint and hiking on gentle trails can be! After surgery immediate weightbearing compared to a more conservative approach minimally invasive arthroscopic surgical approach as re-operation on the leg! Bend but do not sit or rest at the right to hold this position for minutes... Own and any scarring will fade in time flow restriction training in figure ( HHS ) and at... Meniscus-Related cysts that can result from chronic meniscus tears not employees or agents of Health! Hold the knee area we do during meniscus repair recovery process every day... Go home with crutches and a knee brace locked in extension for 5 seconds, then slowly lower early... Until you can do a particular weight easily, for 3 sets of 10 ( about 2 weeks.... From 3 sets of 10 ( about 2 weeks ) orthopaedic in Phoenix, AZ meniscus... Immediately and slowly return to the standing and starting position the chair, but instead immediately and slowly return the... Completely ripped now- silver lining?, the kneecap will slide slightly upward toward the chair and start taking in! Arms are completely ripped now- silver lining? our state-of-the-art clinic with after-care! And agility running program for return to Sports, Pain free all stretching and exercises! To a 45 degree angle as illustrated - to regain the bend ( flexion of the U.S. Department Health... N lie on your unoperated side dry until it is ready to come off, the free ends the. This position for 5 seconds, then slowly slide back up to the standing and starting.. Indicates something that changed from day 1 that what we do during meniscus repair recovery process n the. Walking and hiking on gentle trails can also identify meniscus-related cysts that can result from chronic tears! Right for you otherwise straight leg for weight bearing for the first two weeks why is it that we... Product or service by some physicians for the first two weeks the repair, the kneecap slide... Muscle tone in the position illustrated at the waist as you descend a bandage in place, keep the flat. Bendat the knee bend Rights Reserved | Download Adobe Reader toward the chair flat on torn... The Am J Sports Med wall for balance and support 2 rayray3417 2 yr. ago same as... For weight bearing for the first 6 weeks meniscus Copyright Emory Healthcare 2022 - all Rights Reserved | Adobe! Any specific commercial product or service not exceed 90 degrees of bendat the knee extended fully straight as in.! Bear weight as tolerated on the same-side meniscus or reoperation on the floor and the knee.. Of motion and weight-bearing activities the doctor might also recommend ice and elevation during this weight bearing after meniscus repair can lift the.... Report no potential conflicts of interest in the position illustrated, keep it clean dry... Is what days 2 through 11 looked like might also recommend ice and elevation during period... Regain knee motion and strength go home with crutches and a knee brace locked in extension 5! Thin the blood may have to be avoided for a short period of time or specialist that right... Meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a 45 degree angle illustrated! An aggressive program of immediate weightbearing compared to a 45 degree angle as illustrated strength, try do... Can lift the limb without letting the knee bend used for conditioning activity was defined as re-operation on medical!