Dependent upon the location and size of the repair, weight bearing. It is no means intended to be a substitute for ones clinical decision making regarding the. Begin light jogging program if pain freeno swelling begin on treadmill or soft track. Acl reconstruction w meniscus repair mizzou sports doc. Throughout this protocol, time references in weeks since surgery represent the. Rehabilitation protocol for meniscus repair massachusetts. This evidencebased meniscal repair rehabilitation protocol is criterionbased. Returntosport after acl with meniscal repair reconstruction protocol weightbearing in full extension with a locking brace with crutches is allowed, no weightbearing in flexion. 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. Meniscus rehab exercises the physical therapy advisor. The primary goal of this protocol is to protect the reconstruction 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. Pdf the outcome of meniscal repair has been good to excellent with regard to. Weight bearing should be limited after meniscal repair, and progressed slowly. Factors affecting success include tear age, location and pattern, age of the patient, as well as any associated injuries. 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. 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.
Ambulate without crutches or brace at end of 6 weeks. The meniscus is a circular piece of cartilage with its blood supply coming from the outer rim. Meniscal repair protocol1 northwestern medical center. One report showed that less than 10% of meniscal tears occurring in patients greater than forty years of age were repairable.
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. Meniscus repair physical therapy protocol orthoindy. Tears in the peripheral third of the meniscus are more likely to heal due its vascular nature. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes.
Rehabilitation exercises a meniscus tear is a common knee joint injury. Acl reconstruction wmeniscal repair protocol missouri orthopaedic institute weeks 612. 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. The primary function of the articular cartilage is to provide. A meniscal repair is a surgical procedure to repair a torn meniscus via keyhole surgery. 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. The intent is to provide the therapist with a general framework. 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. This meniscus repair reconstruction protocol is criterion based. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. This protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. The primary goal of this protocol is to protect the reconstruction and while steadily progressing towards and ultimately achieving pre. 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.
The decision to repair a tear in the meniscus is based largely on the location of the tear. As tolerated should be understood to include with safety for the reconstructionrepair. 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. It is not intended to serve as a substitute for clinical decision making. Meniscal repair protocol this will delay the protocol for aclr 1. Phase 1 maximum protection phase 06 weeks goals for phase 1 protect anatomic repair. The meniscus cartilage in the knee includes a medial inside meniscus and a lateral outside meniscus. Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years followup were. Chief, division of sports medicine associate professor of orthopaedic surgery tel. Longleg postoperative x x x range of motion minimum goals. 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. Discontinue crutches and brace when gait in nonantalgic about 6 weeks post op and patient has adequate quad control.
Rehabilitation guidelines for meniscal repair uw health. Even if an exercise or activity is listed at a particular time frame, some patients may not be ready to perform it. Meniscal repair rehabilitation protocol rom brace, wbat in extension only, limit rom 090 x 6 wks phase 1 02wks. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. Acl reconstruction with patellar tendon autograft and. Symptoms of a degenerative meniscus tear include swelling, pain along the joint line, catching and locking. Isolated meniscus repair postop rehab protocol paragon. If you have questions, contact the referring physician. In general, knee is protected with a brace, rom limited to meniscus repair rehabilitation dr. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Specific changes in the program will be made by the. Patients must demonstrate specific functional criteria at each physical therapy visit before progressing to more advanced interventions.
Rehabilitation guidelines for meniscal repair of root and. Articular cartilage is made up of collagen, proteoglycans and water which lines the end of the bones that meet to form a joint. Knee arthroscopy with meniscus repair rehab 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. 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. Physical therapy rehabilitation protocols and rtp decisionmaking remains controversial in the setting of meniscal repair. Treatment will follow the defined protocol below and be carried. The gundersen sports medicine meniscus repair rehabilitation program is an evidencebased and soft tissue. 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. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making.
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. 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. Pdf rehabilitation and return to play following meniscal repair. 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. This protocol is a criterionbased protocol, with a goal of maximizing healing and strength recovery, while. 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. Considerations for the postoperative meniscal repair program. Throughout this protocol, time references in weeks since surgery represent the earliest that a patient may. Do not do resisted long or short arc quads, to avoid adversely stressing the graft. Meniscal repair protocol brigham and womens hospital.
Rehabilitation guidelines for meniscal repair there are two types of cartilage in the knee, articular cartilage and meniscus cartilage. Regular manual mobilizations to surgical wounds and associated soft tissue to. Articular cartilage is made up of collagen, proteoglycans and water and lines the end of the bones that meet to form a joint. Acl reconstruction with meniscus repair protocol dr bradley bruner 01012009 guidelines.
These tears will typically be repaired in younger, active patients. Each phase is adaptable based on the individual patient. 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. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Gallandkirby acl reconstruction with meniscus repair postsurgical rehabilitation protocol postop days 1 14 dressing. Be sure to rotate your leg outward laterally slightly to gain a better activation of the medial inner side of the. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Click here to download pdf rehabilitation after knee meniscus repair. The primary function of the articular cartilage is to. Daily edge of bed dangle for passive knee flexion allow knee to hang in pain free range with light stretch. Rehabilitation guidelines for meniscal repair of root and complex tears there are two types of cartilage in the knee. It is normal to experience some sharp pain in the front of the knee when working on moving your knee.
Manual stretching for extension with overpressure or recurvatum. In patients with concomitant acl reconstruction and meniscus repair, acl reconstruction protocol is followed. Anterior cruciate ligament acl and meniscus repair. It is a minimally invasive procedure often undergone as an outpatient. Right left knee medial lateral meniscal repair phase i 08 wks. Change dressing, keep wound covered, continue ted hose pod 710. Define the protocol to be followed for all patients referred from northwestern orthopedics after the above procedure has been performed. Post operatively these patients will need to avoid combined. Key factors in determining progression of rehabilitation after meniscal repair include. 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. This protocol is intended to guide clinicians and patients through the post operative course for a meniscus repair. 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.