Context: The extra support and warmth will also help speed up the healing process. Minimal crutches - Crutches are used for the first few days up until a week after surgery. These tensile forces create 'hoop stresses', which expand the menisci in extension. 2.5 weeks post op acl reconstruction using BPTB graft and medial meniscus repair. One of the most common types of tears that often goes from the outside towards the middle of the meniscus. Heel slides should be performed with a stretching strap and done many times during the day to prevent the knee from stiffening up. Subscribe to my Youtube channel for more performance therapy and training tips!Have a question/comment? While bearing weight (on the crutches if there is pain in the knee) on the involved leg, take a step through with the uninjured leg. When will I be able to resume my normal activities? eCollection 2020 Sep. (2017). On February 6, 2012, I underwent my sixth (count them) knee surgery. However, if your knee pain and swelling continues to interfere with your daily activities, or if your tear is over 1 cm, you may consider discussing surgery with your doctor. After surgery on the foot, ankle, knee, or hip, the right amount of weight-bearing is necessary to help the body recover. Rather than heal, the meniscus tear is scarred down and absorbed to a degree that it no longer causes pain. To subscribe and ask your questions, go to http://MikeReinold.com/askmikereinold/.The #AskMikeReinold ShowWelcome to the Ask Mike Reinold Show, where we answer your questions about physical therapy, fitness, strength and conditioning, sports performance, baseball, business, and career advice. Slowly start moving your knee and leg. The first weeks you will use this many times a day. It still can take months for the strength to come back to prior levels before surgery. Weight-bearing is gradually progressed as shown in Table 30-1, and patients are encouraged to use a normal gait that avoids a locked knee and assumes normal flexion throughout the gait cycle. Associated Meniscus Repair Hinged knee brace locked in full extension for 4 weeks post-op. 2022 Aug 5;23(1):753. doi: 10.1186/s12891-022-05662-6. This is dependent on the surgeon and a great question to ask. Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. Lift your hips up to the ceiling and roll the ball towards your butt. Common Items Needed After Meniscus Surgery Ice machine This one of thest top items on the list for pain control and swelling. Over a period of several weeks or months, the meniscus will then heal as one piece. Contact your doctor immediately if you believe you may be experiencing this complication. This does not necessarily mean that the tears occurring on the inner portion have to have surgery as many people have meniscus tears and do not even realize it. Arthroscopy. Find out whether the time is right for you to have knee replacement surgery. Please refer to your physician before starting any exercise program. Manage Settings Perkins B, Gronbeck KR, Yue RA, Tompkins MA. Its estimated that removing more than 20 percent of a damaged meniscus could increase such risks. Start with equal weight in both legs standing at the counter or kitchen sink and shift to the surgical side. The doctor might also recommend ice and elevation during this period. 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. Epub 2016 Oct 7. orlando, fla. patients allowed to weight-bear as tolerated immediately after meniscus repair did not have higher failure rates than patients who had a traditional. Even if you forego the crutches, you may wish to continue wearing the knee brace to improve stability and reduce the risk of over-straining the joint. Trust me, I respect the healing meniscus and continually monitor patients as I progress their range of motion and weight-bearing activities. Thursday, 10 March 2022 / Published in Knee. Other Types of Knee Injuries or Disorders. 2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. Arthrosc Sports Med Rehabil. ORLANDO, Fla. Patients allowed to weight-bear as tolerated immediately after meniscus repair did not have higher failure rates than patients who had a traditional non-weight-bearing protocol, according to results presented here. They were all non-weight-bearing for the first two weeks. A few tips as your get back to normal: https://www.jospt.org/doi/full/10.2519/jospt.2012.4165, https://journals.sagepub.com/doi/abs/10.1177/0363546513488518, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133467/pdf/WJO-5-597.pdf, https://www.sciencedirect.com/science/article/abs/pii/S1440244016300305. Effect of Meniscal Treatment on Functional Outcomes 6 Months After Anterior Cruciate Ligament Reconstruction. This field is for validation purposes and should be left unchanged. This is a great exercise to do early in rehab tp the strengthen the hip. Wear a knee brace as directed by your doctor. 2005-2023 Healthline Media a Red Ventures Company. Recent studies from VanderHave and Lind on isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a more conservative approach. Same situation as the two comments above. Optimal rehabilitation after meniscal repair remains controversial. Damaged knee cartilage, left untreated, can progress into severe arthritis and become increasingly debilitating. You can see out complete review of Eccentric Step Downs here and why we love it. The knees experience a great deal of pressure and are particularly prone to damage. Answer (1 of 4): Yes! Outcomes after both conservative (restricted weightbearing) protocols and accelerated rehabilitation (immediate weightbearing) yielded similar good to excellent results; however, lack of similar objective criteria and consistency among surgical techniques and existing studies makes direct comparison difficult. Giving your body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is advisable. Furthermore, the compressive loads applied while weightbearing in full extension following a vertical, longitudinal repair or bucket-handle repair have been shown to reduce the meniscus and stabilize the tear, as noted by Rodeo and more recently by McCulloch. Ahmed I, et al. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. The site is secure. Should you undergo knee replacement surgery now or later? Again, these studies show meniscal repair outcomes are no different while using restricted weightbearing and range of motion versus an aggressive protocol of immediate weight-bearing and unlimited range of motion. 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. 2006;34:1941-1947. A meniscus tear is often treated conservatively, without surgery. If conservative treatments fail, or if the tear is particularly severe, your doctor may recommend surgery as the best option for returning to your full activity level. But what about the exact mechanisms that many are still fearful of allowing early in the process, like early walking and range of motion? PMC Join myself, Lenny Macrina, and my team at Champion Physical Therapy and Performance in Boston, MA and learn how we help people feel better, move better, and perform better. Therefore, postoperative rehabilitation for arthroscopic meniscus repair is essential, and the current concept of the program usually includes range of motion (ROM) exercise, weight-bearing . Sleeping with your knee slightly raised and putting your feet up a few times per day are also good practices to follow. With any weight? The final exercise that you need to do in phase 2 of rehab and its a good one. -Straight leg brace/no knee bending for 4-6 weeks. The interplay between tear type and knee biomechanics can help define the most appropriate postoperative plan. Crutches If you non-weight bearing for the first 4-6 weeks you will get so tired of using crutches. Tahami M, Vaziri AS, Tahmasebi MN, Ahmadi MA, Akbarzadeh A, Vosoughi F. BMC Musculoskelet Disord. Unfortunately, many of these commonly used protocols are from the 1990s. There is a lot of information out there regarding weight bearing status after meniscus repair. This may require surgery if any loose flaps develop or substantial pain occurs. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. So if were going to talk 90s protocols, take a look at these studies from way back when from Shelbourne and Barber that showed excellent results in patients undergoing a combined ACL-meniscus repair procedure and utilizing no limitations in weightbearing or range of motion, similar to a protocol for an isolated ACL reconstruction. This does most often require surgery to fix the motion block. Get my latest content \u0026 FREE presentation on how to get started with functional performance therapy and training:http://bit.ly/performance-therapy-and*****WANT TO TRAIN WITH CHAMPION? As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well. Another possible, though rare, procedure is a meniscus reconstruction. Meniscus tears. If you have a meniscus repair you will want to make sure that you have these to add a little cushion to the armpits. how long can you stay outside u.s. on opt. Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years follow-up were extracted. Many patients find that they can put their full weight on their knee after a couple of weeks, but know your limits and be sure to not overdo the amount of time you spend on your feet. The menisci are two pieces of articular cartilage between the bones of the lower leg. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. Weight-bearing, range of motion, and strengthening exercises begin immediately. Often times, the meniscus can only be trimmed and in this cases, your leg will be weight bearing quickly. 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. So why is it that what we do during meniscus repair rehabilitation is so outdated? Bone fracture (Patella, Femur . They also occur frequently with other knee injuries such as ACL tears. Instead the focus on making sure the weight is equal in both legs and work on getting back to a normal squat depth. Knee Surg Sports Traumatol Arthrosc. One involves repairing the meniscus, or sewing it back together. Unlocked for ambulation and removed for sleeping by weeks 4-6. Meniscectomy, or removal of torn meniscus tissue, typically has no post-op restrictions. Your orthopedic surgeon will be able to explain the options available to you based on the status of your injury, and answer questions about potential outcomes. For more informaton on what types of tears benefit from surgery see the vidoe here, photo credit from webmd, and https://lifesworkpt.com/2017/05/what-is-a-torn-meniscus-in-the-knee/. This one of thest top items on the list for pain control and swelling. Clinical Outcomes and Statistics of Knee Replacement, Shopping Around Saves 20 Percent on Hospital Bills for Joint Replacements, Healthgrades Names Americas 50 Best Hospitals for 2023, your age (surgery may be especially critical in preventing knee degeneration in children and young adults), the length of the tear (tears over 1cm usually cannot heal themselves), whether the tear causes symptoms that interfere with your daily life, whether you have other co-occurring conditions in the knee. Early Weightbearing After Meniscus Repair, Furthermore, the compressive loads applied while weightbearing in full extension following a vertical, longitudinal repair or bucket-handle repair have been shown to reduce the meniscus and stabilize the tear, as noted by. When a true meniscus repair is performed, your surgeon is likely to recommend a period of limited weight-bearing (using crutches or walker for walking) and limited motion. Please consult your physician or health care profession before beginning any exercises after surgery. . While most people with tennis elbow can recover without surgery, there are several surgical options for those that need it. We also recommend limited motion, and sometimes a knee brace. Recovery from arthroscopic meniscus repair usually requires a period of limited weight-bearing (using crutches or walker), limited motion, and sometimes use of a knee brace. - Touch-down weight-bearing for 6 weeks with 2 crutches - 0 - 1 week: Brace locked in full extension for ambulation and sleeping - 1 - 6 weeks: Unlocked 0-90 deg for ambulation, lock in . Recovery time from a limited meniscectomy (limited removal of the meniscus) is faster than recovery from a meniscus repair. Data sources: Then slowly bring yourself back up. 75% of the tears occur in the inner portion of the meniscus which will likely not heal due to the poor blood supply and healing limitation. rn i . A patient undergoing a repair as opposed to a complete replacement of the meniscus can expect to resume light activities within a few weeks. If youre experiencing possible symptoms of a torn meniscus, your doctor may recommend the RICE method as their initial approach: Icing the affected knee and taking a break from sports or other vigorous activities can help lower inflammation and prevent further damage. . #177: On this episode of the #AskMikeReinold show we talk about our thoughts on weight-bearing restrictions follow meniscus repair. Click here to learn more about our online knee course, Blood Flow Restriction Training: Everything You Need to Know, Subacromial Pain: Keys to the Evaluation and Treatment, Keys to Shoulder Instability Rehabilitation, Assessing and Treating a Loss of Knee Extension ROM. Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. Resting when you feel tired, getting plenty of sleep, and eating a healthy diet can all be helpful in ensuring a quicker recovery. Heres how to minimize loss of motion. As I've said in another post about meniscus surgery, there are two basic procedures involved in surgery for a meniscus tear. Return to the starting position and repeat at least a few sets of 10. Until that time, you are at an increased risk for injury due to the limitations in strength. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. (2021). The medial or inside meniscus is C shaped while the lateral or outside meniscus is more circular. While meniscus surgery is considered routine, there are still several basic things that patients should do following their procedure to ensure a faster and optimal recovery. At-home physical therapy exercises are typically recommended, and most patients are approved to resume their normal activities within 4-6 weeks. Squat down as deep as the knee will tolerate and hold for 2-3 seconds. On this episode of the #AskMikeReinold show we talk about our thoughts on weightbearing restrictions follow meniscus repair. Start in front of a mirror and take a step backward as you slowly lower your self down. These types of tears often do not need or respond well to surgery. Generally, it takes 4 to 8 weeks to increase weight bearing and range of motion. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears or all-inside meniscal repairs. These tensile forces create hoop stresses, which expand the menisci in extension. The outcomes and ability to heal depend on many factors including the type of meniscus tear. For this reason, flexion is controlled after meniscus repair and weight bearing directed by the extent of the tear and repair. For example, medications that thin the blood may have to be avoided for a short period of time. BRACE: The brace should be worn at all [] 2001;19:384-390. In addition to RICE, non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, may help reduce pain and swelling. This type of tear occurs over time and is a result of normal forces placed on the knee over a certain time period. . Its easy to use and something that you will undoubtedly use again in the future. Start by lying on your back with your feet on top of the exercise ball. What speed? Arthroscopy. Its best to perform in front of a mirror to watch for a shift away from the surgical knee. 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. 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My Youtube channel for more performance therapy and training tips! have a meniscus.! Time from a limited meniscectomy ( limited removal of torn meniscus tissue, has! Of rehab and its a good one brace and crutches from stiffening up so is...