Specific changes in the program will be made by the. Knee arthroscopy meniscectomy anatomy and biomechanics. Patients in 1973 and 1978, all residents of the lund district who. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Fritz in a case study described the rehabilitation protocol used in the recovery phase of a young man after meniscus transplantation. Chief, division of sports medicine associate professor of orthopaedic surgery tel.
In one case report by muche 10, a patient who had been in a coma for a month and a half complained of knee pain upon waking up which was diagnosed as a posterior horn meniscus tear. 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, loose body removal or debridement. Knee arthroscopy meniscectomychondroplasty rehabilitation. Postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Treatment for knee injuries depends on the severity of the injury. Knee arthroscopy meniscectomychondroplasty missouri orthopaedic institute knee arthroscopy meniscectomychondroplasty. Muscle and tissue are dilated rather than being cut when accessing the disc. When injuries occur in the relatively avascular inner zones of the meniscus, partial meniscectomy is usually the treatment of choice. Arthroscopic meniscectomychondral debridement name. Discectomy postop protocol penrose physical therapy. Oct 19, 2012 the athlete with a meniscal injury can be returned to activity quickly and safely with appropriate treatment and rehabilitation. Surgeons who perform meniscectomies orthopedic surgeons will make surgical decisions based on the meniscuss ability to heal as well as your age, health, and activity level. Knee arthroscopy with meniscal debridement rehabilitation. Data generated from this investigation is clinically relevant, as it can help determine if more focused rehabilitation protocols need to be developed.
Treatment of these defects presents a clinical challenge for physicians and physiotherapists for two reasons. The patients activity level and overall health are also important factors to consider before treatment begins. May be weight bearing as tolerated wbat as soon as possible may use crutches for assistance initially, but wean as tolerated week 1 wall slidesheel slides. Openurl1crossref2pubmed3web of science4 arthroscopic partial meniscectomy apm is arguably the most frequent knee surgery procedure undertaken in the usa.
Knee partial meniscectomy post operative rehabilitation. Jan 09, 2016 postoperative knee partial meniscectomy rehabilitation protocol from san francisco orthopaedic sports medicine surgeon dr. Partial meniscectomy changes contact stress distribution in. Meniscectomy for a meniscus tear uw health madison, wi. Treatment of meniscal lesions has evolved considerably over the past 20 years and partial meniscectomies, or menisci repairs, are now the treatment of choice for the majority of lesions. Conservative treatment for meniscus rehabilitation. Manske claimed that meniscus transplants are under more stress in a joint with early degenerative processes, consequently a conservative rehabilitation protocol results more appropriate49. It is held together by several important ligaments. Rehabilitation following arthroscopic meniscectomy springerlink. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Arthroscopic partial medial or lateral meniscectomy, loose body removal or debridement protocol. Brace knee immobilizer ted hose to be worn until ambulation has returned to normal presurgery level or two weeks crutches. Partial menisectomy of the knee rehabilitation protocol daniel redziniak, md the orthopedic and sports medicine center office. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear.
Arthroscopic partial medial or lateral meniscectomy, loose. Should achieve full extension and ability to slr with no extensor lag. Rehabilitation exercises a meniscus tear is a common knee joint injury. Generally a patient can recover and return to work and sports after 34 weeks following a knee scope for synovectomy. Reduce painswelling ice 3xs daily for 1520 minutes directly on knee full knee rom as soon as possible full weight bearing as tolerated. The knee is a hinge joint at the connection point between the femur and tibia bones. Home exercise program hep as indicated 1215 repetitions with 12 sets of each exercise. Recently a friend of mine underwent a meniscectomy and postoperatively inquired what the meniscus actually did, how it typically was injured and what she should expect during the rehabilitation process. It is not intended to be a substitute for ones clinical decision making.
The problem damage to the articular cartilage of the knee in athletes presents one of the most difficult challenges in the care of elite and recreational athletes. If any of these occur, decrease activity level and ice. Meniscectomy is the surgical removal of all or part of a torn meniscus. Intraarticular injection of hyaluronic acid following. Mediallateral partial meniscectomy postoperative rehabilitation protocol. This may vary from a minor trimming of a frayed edge to anything short of.
Cryotherapy and nonsteroidal antiinflammatory drugs nsaids play a very important role in the management of nonoperative meniscal injury. Partial meniscectomy protocol general may progress range of motion rom as quickly as tolerated initial emphasis on full extension weight bearing status. This leads to less tissue destruction, less postoperative pain, quicker recovery times, earlier. Meniscal injuries are reported to be the most common injury sustained by athletes, with sports injuries being responsible for over 30% of the total number of lesions. Answers from doctors on meniscectomy recovery timeline. Return to play after articular cartilage repair of the knee written by scott d. As tolerated refers to no increased sharp pain, swelling, or other undesirable factors. The knee is also cushioned during weight bearing by two cartilaginous discs, called the medial inside and lateral outside menisci.
The endoscope allows the surgeon to use a keyhole incision to access the herniated disc. Overall, knee osteoarthritis may affect more than 250 million people and is a leading contributor to disability worldwide. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Meniscectomy rehabilitation protocol this protocol is a general outline. Mediallateral meniscectomy and rehabilitation anatomical considerations. Jan 21, 20 manske claimed that meniscus transplants are under more stress in a joint with early degenerative processes, consequently a conservative rehabilitation protocol results more appropriate49.
A modification of the standard meniscectomy procedure has been described to simplify the detachment of the posterior horn of the medial cartilage of the kneejoint. All patients followed a rehabilitation protocol for meniscectomy and were asked to return for assessment at weeks 1, 4, and 12. As tolerated with crutches for balance x 2448 hours progress to wbat range of motion aarom arom as tolerated o goal. Below is an indepth look at the information i provided for her. Questions if you have any concerns or questions after your surgery. Protocol s5 conservative physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for a large to massive.
Partial weightbearing status rehabilitation arthroscopic meniscectomy loose body removaldebridement division of orthopaedic surgery suite 800, 55 queen street east toronto, on, m5c 1r6 tel. The meniscus is a crescentshaped piece of cartilage that is located between the femur and the tibia. To our knowledge, this is the first investigation to examine the potential additive effect of concomitant meniscectomy or meniscal repair on neural alterations and strength postreconstruction. Knee arthroscopy with meniscus repair rehab protocol. This is a protocol that provides you with general information and guidelines for the initial stage and progression of rehabilitation according to the listed timeframes. A tear in this red zone may heal on its own, or can often be repaired with surgery. 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. The procedure can be a complete meniscectomy where the meniscus and the meniscal rim is removed or partial where only a section of the meniscus is removed. The program for nonoperative rehabilitation is similar in principle to the program that follows meniscectomy. The outer onethird of the meniscus has a rich blood supply. Medial andor lateral menisectomy protocol 2 days postop remove dressings, clean wounds, dress with bandaids rom exercise hip isotonics quad sets ham sets slr crutch training modalities for swelling and pain 2 days 1 week continue modalities for swelling and pain stationary bike progress to full weight bearing, start with one crutch. 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. Arthroscopic partial meniscectomy provides no benefit over. There is little evidence suggesting that ultrasound treatment is effective in treating the impairments following meniscus tears.
Return to play after articular cartilage repair of. Focal articular cartilage defects in the knee joint are highly prevalent and are a common cause of functional restrictions and pain during daily life and sport activities1,2,3. A simplification of the kneejoint meniscectomy operation. It is also an important secondary stabilizer of the. The meniscus is an important loadbearing structure that supports 70% of the load transmitted. Knee arthroscopy with meniscal debridement rehabilitation protocol for physical therapy.
Physical therapy pt intervention as indicated by treating physical therapists plan of care within guidelines of this study protocol. Pain management and rehabilitation discectomy postop protocol penrose physical therapy penrose physical therapy this is a sample surgical protocol that we typically use. Rehabilitation programmes following arthroscopic meniscectomy. Acute traumatic tears occur most frequently in the athletic population as a result of a twisting injury to lateral meniscus medial meniscus figure 1 meniscus cartilage shown here from above the knee, without the femur image property of primal pictures, ltd. An arthroscopic meniscectomy is a procedure to remove some or all of a meniscus from the tibiofemoral joint of the knee using arthroscopic keyhole surgery. The meniscus is an important loadbearing structure that supports 70% of the load transmitted through the lateral compartment and 50% medially, thus decreasing contact pressures on the articular cartilage. In order to identify the relevant literature, we performed a pubmed search for the years ranging from. In one case report by muche 10, a patient who had been in a coma for a month and a half complained of knee pain upon waking up which was diagnosed as. The rehabilitation programme should emphasise decreasing inflammation, restoring motion, increasing strength, and safe return to. Protocol s5 conservative physical therapy protocol for. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Meniscectomy recovery timeline answers on healthtap.
Postoperative arthroscopic partial meniscectomy physical. Meniscectomy in patients with knee osteoarthritis and a. Rehabilitation guidelines for arthroscopic knee meniscectomy. Nonsurgical treatment and recovery joint implant surgeons. Gallandkirby isolated meniscal repair postsurgical rehabilitation protocol postop days 1 14 dressing.
Department of exercise, health, and sports science. Material and methods the study was approved by the ethics committee at the medical faculty of lund university. 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. Partial meniscectomy changes contact stress dist ribution in knee joint under combined loading shirazi, r. Mediallateral meniscectomy and rehabilitation aspire. Postoperative arthroscopic partial meniscectomy physical therapy rehabilitation protocol each phase should include. Physical therapy management of meniscus tears morphopedics. Knee arthroscopy partial meniscectomy, plica excision. Change dressing, keep wound covered, continue ted hose pod 710. Knee arthroscopy meniscectomy south shore orthopedics. The athlete with a meniscal injury can be returned to activity quickly and safely with appropriate treatment and rehabilitation.
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