Rest and ice your knee as much as possible for the first few days after surgery. . Conservative measures dont work in all cases of torn menisci, especially for younger patients. Arthroscopy. There is so much "Just DO It". Return to the starting position and repeat at least a few sets of 10. (2021). eCollection 2021 Apr. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. Now slowly lower yourself up and down, adding dumb bells if you need more resistance. Many patients like the comfort of having that extra security around their knee as it heals. The management following repair of lateral meniscus can be contentious, some surgeons prefer early weight bearing as they say accelerated rehabilitation, some surgeons go slow with non weight bearing and bracing for 4-6 weeks , no clear evidence in literature to show superiority of one over the other as far as I know! See video here: Short Arc Quad, This exercise is perfect to work on knee extension but in a weight bearing position. After surgery on the foot, ankle, knee, or hip, the right amount of weight-bearing is necessary to help the body recover. There are two in each knee between the femur and tibia bones, and they assist with weight bearing and shock absorption. Meniscus Surgery is one of the most common knee surgeries in orthopedics today. Infection is rare, but always a risk with any surgical procedure. It will save your armpits, protect your other knee from wearing out, and get you places much faster during your 6 weeks of nonweight bearing. From 2005 to 2011 the number of meniscus surgeries increased by 100%, thats a huge amount. (Ankle pumps, quad flexes, squeezing my butt muscles, squeezing pillow between knees, and straight . 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. After a meniscal repair, the knee must be protected to allow the meniscus to heal. - 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 . 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. REHABILITATION AFTER KNEE MENISCUS REPAIR . Goals: 1. This may have the ability to heal if located in the vascular portion of the meniscus. Protected weight bearing for 4-6wks with crutches. You can learn more about how we ensure our content is accurate and current by reading our. However, it is important to note that a complete return of knee strength and full-range mobility may take several months. Using a step or a workout step, try to bring yourself up on to the step using the surgical leg. Perkins B, Gronbeck KR, Yue RA, Tompkins MA. Usually patient's are non-weight bearing for 4-6 weeks after meniscus repair surgery. Understand the clinical outcomes, statistics, and success rates. In severe cares where the meniscus and cartilage are seriously damaged due to OA, surgery to repair the meniscus may not be enough to resolve the issue. -, Bray RC, Smith JA, Eng MK, Leonard CA, Sutherland CA, Salo PT. 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. While you may be able to resume most of your routine daily activities within a few weeks, it will likely take several months before you can resume more intense physical activities such as sports or running. Meniscal repair using the fast-fix all-inside meniscal repair device. Many patients report that their knee mobility following the procedure is at least as good as it was prior to the initial injury. Bone fracture (Patella, Femur . The Injury: What came first, the Brazilian Jiu Jitsu or my awesome dancing at a wedding? 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. The surgeon may even score or rough up the underlying tissue to help with better healing and blood flow to the area. ***** WANT TO LEARN MORE FROM ME? RANGE OF KNEE MOTION AND FLEXIBILITY Most patients can walk without a knee brace and crutches in about 2 to 3 . A torn meniscus can cause pain, swelling . This exercise is to get your quads firing. Healthline Media does not provide medical advice, diagnosis, or treatment. What Is the Recovery Time for a Meniscus Tear Without Surgery? Depending on the extent of your meniscus tear, your surgeon may recommend removing or repairing part of the meniscus via a knee arthroscopy. In terms of location for meniscus tears, 25% tear in the outer layer. as seen here: Wall slides, This exercise is important for 2 reasons, it helps turn your quad muscle back on after surgery and it helps get your knee straight. Rest, healing, and recovery time: Immediately after the injury, patients will be put into RICE (rest, ice, compression, elevation) protocol alongside pain and inflammation medication as needed. Theres a lot to explore here! While we lean towards allowing weightbearing, there are some important things you have to consider. Once the torn cartilage is repaired and fully healed, patients can expect to return to the physical activities they once loved. Beaufils P, et al. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears or all-inside meniscal repairs. They were all non-weight-bearing for the first two weeks. Vedi V, Williams A, et al. Results: The Menisci are more elastic than most of the cartilage in the body and helps absorb force when we are walking, running, and jumping. Although, many patients can walk without a knee brace and crutches in about 2-3 months. Thankfully, the surgery required to fix torn knee cartilage (also known as meniscus) can be done through a very small incision that leaves minimal scarring that will fade over time. sharing sensitive information, make sure youre on a federal -, Chiang CW, Chang CH, Cheng CY, et al. - After a meniscectomy, most patients are able to begin bearing weight/walking within a week after surgery. Most patients can walk without a knee brace and crutches in about 2 to 3 months. Meniscectomy, or removal of torn meniscus tissue, typically has no post-op restrictions. These tensile forces create hoop stresses, which expand the menisci in extension. 9. How many? 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. Some of the top orthopedic surgeons in the world that I have worked with currently handle a meniscal repair the same as an ACL reconstruction with a meniscal repair . Depending on how large the tear is, as well as other contributing health factors, your doctor may recommend surgery. With a meniscus repair you may be allowed to bear some weight on your repaired knee with the assistance of crutches and a brace immediately following surgery. You can focus solely on the surgical leg or alternate. This injury is commonly seen due to overuse among athletes, but torn menisci may also occur with age as a result of natural degeneration. This is a horizontal tear that the torn flap has flipped over like a bucket handle. When the tear flips this can cause locking of the knee and difficulty with movement. Your doctor will give you very specific instructions for what medication you can and cannot take during the meniscus repair recovery process. Since you have done the reverse lunges in phase 2, now its time for forward lunges. Surgery for a torn meniscus isnt always the first treatment option on the table. 2005-2023 Healthline Media a Red Ventures Company. Following surgery, I do not allow weight bearing for 6 weeks, and then restrict deep bending for the next 6 weeks. Doral MN, et al. Ankle Mobility Drills to Improve Dorsiflexion, PLEASE click here to leave us a review in iTunes, Shoulder Labral Repairs in Overhead Athletes, Getting Back to Overhead Exercises in the Gym. One source even quotes the incidence as high as 1 in 300 people with have surgery on their meniscus. This one of thest top items on the list for pain control and swelling. 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. The meniscus acts to provide shock absorption and stability at the knee joint. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. At or around 6 weeks after surgery, you will likely have a follow up with your surgeon. Let me show you how to get started: 2008-2023 Mike Reinold All Rights Reserved. If you have a bandage in place, keep it clean and dry until it is ready to come off. The https:// ensures that you are connecting to the -total recovery time of approximately 6 months (full return to running) Squat down as deep as the knee will tolerate and hold for 2-3 seconds. Should we Still be Using Rehabilitation Protocols? What was the surgery? Knee Surg Sports Traumatol Arthrosc. 3. 2001;19:384-390. Common Items Needed After Meniscus Surgery Ice machine This one of thest top items on the list for pain control and swelling. You may need to use crutches for a little while. 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. 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. Here are some things to consider when helping people return back to the gym and into overhead pressing exercises. Get ready to feel the burn. A relatively early weight-bearing protocol for meniscal repair can be applied because the repaired meniscus can be spared from weight-bearing by the load-shifting effect of the OWHTO. Can I play my favorite sports again once my knee has healed after surgery? Well break down the different surgical options available for torn menisci, including what to expect during recovery, possible complications, and overall prognosis for each type of surgery. Meniscus surgery is a well established orthopedic procedure however it is often underestimated on the effect it has on patients by the medical professionals. The front hip and both knees should be in a 90 degree angle and the chest should stay upright. Thompson showed that during flexion, the posterior excursion of the medial meniscus was 5.1 mm, while that of the lateral meniscus was 11.2 mm. Find a bolster or a foam roller and place it underneath the knee. Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. This might make all the difference in the degree of treatment and recovery time that will be required. After meniscus tear surgery, a knee brace can be worn to limit knee flexion and rotation, protecting the meniscus while allowing weight-bearing and movement [9]. Any advice pls. This involves a combination of physical therapy as well as at-home strengthening exercises recommended by your doctor. 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. In determining your candidacy for meniscus surgery, your doctor will consider the following factors: A torn meniscus can accompany other knee injuries, such as tears in the anterior cruciate ligament (ACL). During weightbearing, compressive forces are loaded across the menisci. . Physical Therapy Product Reviews is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com, Pain with twisting or running along the joint line. Put your back foot on top of the bench or chair. I help people feel better, move better, and perform better. Manage Settings See video here: Air Squat, One of the most underrated exercises during knee rehab. Slowly increase the depth each day that you do them to improve loaded knee rom. BFR-LLST added to usual care exercise initiated early after cartilage or meniscus repair seems feasible and may prevent disuse thigh muscle atrophy during a period of weight bearing restrictions. What do the surgeons that you work with recommend? From there, your surgeon may remove a portion of the meniscus via a procedure called a partial meniscectomy. While most people with tennis elbow can recover without surgery, there are several surgical options for those that need it. I started Brazilian Jiu-Jitsu about four years ago. Trust me, I respect the healing meniscus and continually monitor patients as I progress their range of motion and weight-bearing activities. (Click here for the updated rehabilitation protocols we currently use.). Wilderman I, et al. More recent studies using an accelerated rehabilitation protocol with full weightbearing and early range of motion reported 64% to 96% good results. We also recommend limited motion, and sometimes a knee brace. How you squat and how you respond matter! Exercise to Improve Knee Range of Movement after Meniscus Repair-The range of motion exercises after knee 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. However, extensive tears in older adults may require surgery. Avoid exercises that involve: pivoting. 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. In this surgery, the torn part of the meniscus is repaired with sutures. Partial / toe-touch weight bearing for 3-5 days post-op, increasing to full weight bearing-important to watch for lower leg rotation or "heel whip" with ambulation to avoid stress onto the meniscus. This ensures minimal tension on the cartilage as it heals. Unfortunately, many of these commonly used protocols are from the 1990s. See video: Hamstring culs on Exercise Ball, The goal of squats at this time in recovery is you get the joints and muscles ready to go. 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. An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses. The extra support and warmth will also help speed up the healing process. Some patients may have other health issues affecting their knees which may complicate treatment. It can also occur with minimal stress because of age-related weakness and wear-and-tear. "ACL and meniscus repair together require a longer recovery," says Dr. Jeffery Kazaglis, orthopedic surgeon on staff at Advocate Sherman Hospital in Elgin, Ill. "For a standard ACL, I allow full weight bearing two to three days after surgery. Sometimes in these situations a knee brace for a meniscus tear is a better option. The audible snap of my tearing meniscus was actually heard by my teammates on the next court. Start slow and slowy add weight as you feel appropriate as this cause the knee to be sore the first few rounds. Start by lying on your back with your feet on top of the exercise ball. J Orthop Res. Epub 2017 Aug 16. FOIA We can set up a consultation and determine the best course of treatment for you to return to a full range of physical activity and a better quality of life. 2015. ncbi.nlm.nih.gov/pmc/articles/PMC8514344/, orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/, ncbi.nlm.nih.gov/pmc/articles/PMC5994634/, health.uconn.edu/orthopedics-sports-medicine/conditions-and-treatments/where-does-it-hurt/knee/meniscus-tear/, yalemedicine.org/conditions/meniscus-tears-repair-transplantation, childrenshospital.org/conditions-and-treatments/conditions/t/torn-meniscus, hopkinsmedicine.org/health/conditions-and-diseases/torn-meniscus, When to Have Total Knee Replacement Surgery. Patients who are unsuitable for repair are generally treated non-surgically, with tablets and perhaps an injection of corticosteroid to minimise pain. One of the main benefits of this surgery is that it reduces the risk of developing osteoarthritis in the future. If the meniscus is repaired, then the patient has to use crutches for six weeks. Meniscus tears, repair, and transplantation. Let me show you how to get started: 2008-2023 Mike Reinold All Rights Reserved, 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. Meniscus injuries within the knee are a common occurrence. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. Once you are cleared for full weight-bearing it often takes another 6 weeks of physical therapy and strengthening exercises to you get back to feeling normal and reducing injury risk. Am J Sports Med. 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. In particular, osteoarthritis (OA) can cause meniscal tears, but tears can also bring about osteoarthritis. Another possible, though rare, procedure is a meniscus reconstruction. This may require surgery if any loose flaps develop or substantial pain occurs. Last medically reviewed on December 21, 2021. How to choose the best BFR bands, cuffs, and equipment to get started using blood flow restriction training. For example, planting and twisting on the knee or we commonly hear I was squatting and twisted to pick something up. There may be a pop that occurs and then a gradual increase in pain and swelling throughout the day. 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. However, in some cases, they can stitch the meniscus back together. It's still a bit sore and swells a little after doing the rehab exercises but no pops or cracks, I definitely had been weight bearing a lot though. Wont that put the repair in a position to fail? My surgeon said no weight bearing for six weeks now I am more scared than anything else to walk and I haven't been clear by him to put weight and my physical therapist also is fallowing the surgeon recommendations. How quickly this progress occurs varies by surgeon, but a typical range is 4-8 weeks. In the cases of menisco-synovial ramp repair, hypermobility of the lateral meniscus fixation and longitudinal tear suture, where the hoop tensile stress effect is preserved, partial weight bearing (20 kg) is allowed for the first four weeks after surgery, with weight bearing as tolerated for the following weeks [11, 30]. my doc told me that i was good to start walking and i started walking without my brace and crutches about 5 days ago. Can you squat with proper form and control? We typically immobilize people in full extension during weightbearing, locked in a brace for 4-6 weeks after meniscal repair surgery. Initiate knee motion. They may also recommend using a knee brace. Instead the focus on making sure the weight is equal in both legs and work on getting back to a normal squat depth. See video: Eccentric step down. This is better long term, but it means you need to keep off of that leg in order for the meniscus to heal. Use of Crutches Following Meniscal Repair-Crutches for partial weight bearing should be used by this stage and progression to full weight bearing should be achieved by the 10th week following meniscal repair knee surgery. Thursday, 10 March 2022 / Published in Knee. The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair. Can I work outside US on OPT? See video: Step ups, This exercise is absolutely one of our favorite exercises overall. Your doctor may also recommend making a corticosteroid injection to the joint. It can help identify joint pain. We will determine during your consultation whether general or regional anesthesia would be appropriate either way, no pain will be experienced during the procedure itself. While we lean towards allowing weight-bearing, there are some important things you have to consider. We also recommend limited motion, and sometimes a knee brace. According to the American Academy of Orthopaedic Surgeons (AAOS), the estimated recovery time is three to six weeks for a partial meniscectomy, and three to six months for a meniscus repair.. This is why some researchers believe that repair surgeries may be a better long-term option than non-surgical procedures. A meniscus tear can also be from a traumatic injury such as twisting during sports or a degenerative which is a tear from general wear and tear. Heres an overview of the science behind the safety and efficacy of BFR. This exercise works the entire lower half of the body and really targets the quads, glutes, and hamstrings. Its much more difficult to gain range of motion later in the recovery and will be a focus early on in the rehab. Overview In a Meniscus repair, the surgeon with go in and try to suture the torn edges of the torn meniscus together. This will help reduce swelling and pain. BRACE: The brace should be worn at all [] Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. Same situation as the two comments above. Make sure that the knee does not progress past the toes on the front leg and go as deep as you feel comfortable. 0; . The same exercise as in phase 2 but now you get to add weight! Damaged knee cartilage, left untreated, can progress into severe arthritis and become increasingly debilitating. I'm not allowed weight bearing, or out of the brace, so it's limiting. It still can take months for the strength to come back to prior levels before surgery. Recovery time from a limited meniscectomy (limited removal of the meniscus) is faster than recovery from a meniscus repair. Epub 2013 Oct 10. . Despite this high occurrence, many inconsistencies continue to exist in the rehabilitation of a patient following meniscus repair surgery, particularly involving the rate of weightbearing and range of motion. Successful clinical outcomes ranged from 70% to 94% with conservative rehabilitation. Get the latest news and education delivered to your inbox, Receive an email when new articles are posted on, Please provide your email address to receive an email when new articles are posted on, American Academy of Orthopaedic Surgeons Annual Meeting. This is dependent on the surgeon and a great question to ask. There are specific and time-sensitive benchmarks to reach to successfully rehabilitate after a Full Meniscus Repair. One of the best alternatives to save your arms and armpits is to use a knee scooter to get around long distances and crutches for short distances. These measures are taken in order to protect the repair and give it a chance to heal. Continue with Recommended Cookies. Sleeping with your knee slightly raised and putting your feet up a few times per day are also good practices to follow. Lind M, Nielsen T, Faun P, Lund B, Christiansen SE. All rights reserved. The benefits of having a meniscus repair performed by a reputable orthopedic surgeon are numerous. If you had your meniscus repaired though, that's where the numbers start to jump all over the place. Disclaimer: This post is for informational purposes only. This timeline can vary depending on the patients age, fitness level, and commitment to appropriate physiotherapy following the procedure. However, when the meniscus is actually repaired and not just debrided, there are other factors to consider. On February 6, 2012, I underwent my sixth (count them) knee surgery. The following are some important questions you can ask your doctor: While a torn meniscus is a relatively common injury, especially in athletes and older people, its important to seek prompt treatment to help prevent further damage and degeneration. As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well.
weight bearing after meniscus repair
Rest and ice your knee as much as possible for the first few days after surgery. . Conservative measures dont work in all cases of torn menisci, especially for younger patients. Arthroscopy. There is so much "Just DO It". Return to the starting position and repeat at least a few sets of 10. (2021). eCollection 2021 Apr. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. Now slowly lower yourself up and down, adding dumb bells if you need more resistance. Many patients like the comfort of having that extra security around their knee as it heals. The management following repair of lateral meniscus can be contentious, some surgeons prefer early weight bearing as they say accelerated rehabilitation, some surgeons go slow with non weight bearing and bracing for 4-6 weeks , no clear evidence in literature to show superiority of one over the other as far as I know! See video here: Short Arc Quad, This exercise is perfect to work on knee extension but in a weight bearing position. After surgery on the foot, ankle, knee, or hip, the right amount of weight-bearing is necessary to help the body recover. There are two in each knee between the femur and tibia bones, and they assist with weight bearing and shock absorption. Meniscus Surgery is one of the most common knee surgeries in orthopedics today. Infection is rare, but always a risk with any surgical procedure. It will save your armpits, protect your other knee from wearing out, and get you places much faster during your 6 weeks of nonweight bearing. From 2005 to 2011 the number of meniscus surgeries increased by 100%, thats a huge amount. (Ankle pumps, quad flexes, squeezing my butt muscles, squeezing pillow between knees, and straight . 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. After a meniscal repair, the knee must be protected to allow the meniscus to heal. - 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 . 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. REHABILITATION AFTER KNEE MENISCUS REPAIR . Goals: 1. This may have the ability to heal if located in the vascular portion of the meniscus. Protected weight bearing for 4-6wks with crutches. You can learn more about how we ensure our content is accurate and current by reading our. However, it is important to note that a complete return of knee strength and full-range mobility may take several months. Using a step or a workout step, try to bring yourself up on to the step using the surgical leg. Perkins B, Gronbeck KR, Yue RA, Tompkins MA. Usually patient's are non-weight bearing for 4-6 weeks after meniscus repair surgery. Understand the clinical outcomes, statistics, and success rates. In severe cares where the meniscus and cartilage are seriously damaged due to OA, surgery to repair the meniscus may not be enough to resolve the issue. -, Bray RC, Smith JA, Eng MK, Leonard CA, Sutherland CA, Salo PT. 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. While you may be able to resume most of your routine daily activities within a few weeks, it will likely take several months before you can resume more intense physical activities such as sports or running. Meniscal repair using the fast-fix all-inside meniscal repair device. Many patients report that their knee mobility following the procedure is at least as good as it was prior to the initial injury. Bone fracture (Patella, Femur . The Injury: What came first, the Brazilian Jiu Jitsu or my awesome dancing at a wedding? 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. The surgeon may even score or rough up the underlying tissue to help with better healing and blood flow to the area. ***** WANT TO LEARN MORE FROM ME? RANGE OF KNEE MOTION AND FLEXIBILITY Most patients can walk without a knee brace and crutches in about 2 to 3 . A torn meniscus can cause pain, swelling . This exercise is to get your quads firing. Healthline Media does not provide medical advice, diagnosis, or treatment. What Is the Recovery Time for a Meniscus Tear Without Surgery? Depending on the extent of your meniscus tear, your surgeon may recommend removing or repairing part of the meniscus via a knee arthroscopy. In terms of location for meniscus tears, 25% tear in the outer layer. as seen here: Wall slides, This exercise is important for 2 reasons, it helps turn your quad muscle back on after surgery and it helps get your knee straight. Rest, healing, and recovery time: Immediately after the injury, patients will be put into RICE (rest, ice, compression, elevation) protocol alongside pain and inflammation medication as needed. Theres a lot to explore here! While we lean towards allowing weightbearing, there are some important things you have to consider. Once the torn cartilage is repaired and fully healed, patients can expect to return to the physical activities they once loved. Beaufils P, et al. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears or all-inside meniscal repairs. They were all non-weight-bearing for the first two weeks. Vedi V, Williams A, et al. Results: The Menisci are more elastic than most of the cartilage in the body and helps absorb force when we are walking, running, and jumping. Although, many patients can walk without a knee brace and crutches in about 2-3 months. Thankfully, the surgery required to fix torn knee cartilage (also known as meniscus) can be done through a very small incision that leaves minimal scarring that will fade over time. sharing sensitive information, make sure youre on a federal -, Chiang CW, Chang CH, Cheng CY, et al. - After a meniscectomy, most patients are able to begin bearing weight/walking within a week after surgery. Most patients can walk without a knee brace and crutches in about 2 to 3 months. Meniscectomy, or removal of torn meniscus tissue, typically has no post-op restrictions. These tensile forces create hoop stresses, which expand the menisci in extension. 9. How many? 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. Some of the top orthopedic surgeons in the world that I have worked with currently handle a meniscal repair the same as an ACL reconstruction with a meniscal repair . Depending on how large the tear is, as well as other contributing health factors, your doctor may recommend surgery. With a meniscus repair you may be allowed to bear some weight on your repaired knee with the assistance of crutches and a brace immediately following surgery. You can focus solely on the surgical leg or alternate. This injury is commonly seen due to overuse among athletes, but torn menisci may also occur with age as a result of natural degeneration. This is a horizontal tear that the torn flap has flipped over like a bucket handle. When the tear flips this can cause locking of the knee and difficulty with movement. Your doctor will give you very specific instructions for what medication you can and cannot take during the meniscus repair recovery process. Since you have done the reverse lunges in phase 2, now its time for forward lunges. Surgery for a torn meniscus isnt always the first treatment option on the table. 2005-2023 Healthline Media a Red Ventures Company. Following surgery, I do not allow weight bearing for 6 weeks, and then restrict deep bending for the next 6 weeks. Doral MN, et al. Ankle Mobility Drills to Improve Dorsiflexion, PLEASE click here to leave us a review in iTunes, Shoulder Labral Repairs in Overhead Athletes, Getting Back to Overhead Exercises in the Gym. One source even quotes the incidence as high as 1 in 300 people with have surgery on their meniscus. This one of thest top items on the list for pain control and swelling. 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. The meniscus acts to provide shock absorption and stability at the knee joint. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. At or around 6 weeks after surgery, you will likely have a follow up with your surgeon. Let me show you how to get started: 2008-2023 Mike Reinold All Rights Reserved. If you have a bandage in place, keep it clean and dry until it is ready to come off. The https:// ensures that you are connecting to the -total recovery time of approximately 6 months (full return to running) Squat down as deep as the knee will tolerate and hold for 2-3 seconds. Should we Still be Using Rehabilitation Protocols? What was the surgery? Knee Surg Sports Traumatol Arthrosc. 3. 2001;19:384-390. Common Items Needed After Meniscus Surgery Ice machine This one of thest top items on the list for pain control and swelling. You may need to use crutches for a little while. 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. 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. Here are some things to consider when helping people return back to the gym and into overhead pressing exercises. Get ready to feel the burn. A relatively early weight-bearing protocol for meniscal repair can be applied because the repaired meniscus can be spared from weight-bearing by the load-shifting effect of the OWHTO. Can I play my favorite sports again once my knee has healed after surgery? Well break down the different surgical options available for torn menisci, including what to expect during recovery, possible complications, and overall prognosis for each type of surgery. Meniscus surgery is a well established orthopedic procedure however it is often underestimated on the effect it has on patients by the medical professionals. The front hip and both knees should be in a 90 degree angle and the chest should stay upright. Thompson showed that during flexion, the posterior excursion of the medial meniscus was 5.1 mm, while that of the lateral meniscus was 11.2 mm. Find a bolster or a foam roller and place it underneath the knee. Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. This might make all the difference in the degree of treatment and recovery time that will be required. After meniscus tear surgery, a knee brace can be worn to limit knee flexion and rotation, protecting the meniscus while allowing weight-bearing and movement [9]. Any advice pls. This involves a combination of physical therapy as well as at-home strengthening exercises recommended by your doctor. 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. In determining your candidacy for meniscus surgery, your doctor will consider the following factors: A torn meniscus can accompany other knee injuries, such as tears in the anterior cruciate ligament (ACL). During weightbearing, compressive forces are loaded across the menisci. . Physical Therapy Product Reviews is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com, Pain with twisting or running along the joint line. Put your back foot on top of the bench or chair. I help people feel better, move better, and perform better. Manage Settings See video here: Air Squat, One of the most underrated exercises during knee rehab. Slowly increase the depth each day that you do them to improve loaded knee rom. BFR-LLST added to usual care exercise initiated early after cartilage or meniscus repair seems feasible and may prevent disuse thigh muscle atrophy during a period of weight bearing restrictions. What do the surgeons that you work with recommend? From there, your surgeon may remove a portion of the meniscus via a procedure called a partial meniscectomy. While most people with tennis elbow can recover without surgery, there are several surgical options for those that need it. I started Brazilian Jiu-Jitsu about four years ago. Trust me, I respect the healing meniscus and continually monitor patients as I progress their range of motion and weight-bearing activities. (Click here for the updated rehabilitation protocols we currently use.). Wilderman I, et al. More recent studies using an accelerated rehabilitation protocol with full weightbearing and early range of motion reported 64% to 96% good results. We also recommend limited motion, and sometimes a knee brace. How you squat and how you respond matter! Exercise to Improve Knee Range of Movement after Meniscus Repair-The range of motion exercises after knee 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. However, extensive tears in older adults may require surgery. Avoid exercises that involve: pivoting. 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. In this surgery, the torn part of the meniscus is repaired with sutures. Partial / toe-touch weight bearing for 3-5 days post-op, increasing to full weight bearing-important to watch for lower leg rotation or "heel whip" with ambulation to avoid stress onto the meniscus. This ensures minimal tension on the cartilage as it heals. Unfortunately, many of these commonly used protocols are from the 1990s. See video: Hamstring culs on Exercise Ball, The goal of squats at this time in recovery is you get the joints and muscles ready to go. 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. An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses. The extra support and warmth will also help speed up the healing process. Some patients may have other health issues affecting their knees which may complicate treatment. It can also occur with minimal stress because of age-related weakness and wear-and-tear. "ACL and meniscus repair together require a longer recovery," says Dr. Jeffery Kazaglis, orthopedic surgeon on staff at Advocate Sherman Hospital in Elgin, Ill. "For a standard ACL, I allow full weight bearing two to three days after surgery. Sometimes in these situations a knee brace for a meniscus tear is a better option. The audible snap of my tearing meniscus was actually heard by my teammates on the next court. Start slow and slowy add weight as you feel appropriate as this cause the knee to be sore the first few rounds. Start by lying on your back with your feet on top of the exercise ball. J Orthop Res. Epub 2017 Aug 16. FOIA We can set up a consultation and determine the best course of treatment for you to return to a full range of physical activity and a better quality of life. 2015. ncbi.nlm.nih.gov/pmc/articles/PMC8514344/, orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/, ncbi.nlm.nih.gov/pmc/articles/PMC5994634/, health.uconn.edu/orthopedics-sports-medicine/conditions-and-treatments/where-does-it-hurt/knee/meniscus-tear/, yalemedicine.org/conditions/meniscus-tears-repair-transplantation, childrenshospital.org/conditions-and-treatments/conditions/t/torn-meniscus, hopkinsmedicine.org/health/conditions-and-diseases/torn-meniscus, When to Have Total Knee Replacement Surgery. Patients who are unsuitable for repair are generally treated non-surgically, with tablets and perhaps an injection of corticosteroid to minimise pain. One of the main benefits of this surgery is that it reduces the risk of developing osteoarthritis in the future. If the meniscus is repaired, then the patient has to use crutches for six weeks. Meniscus tears, repair, and transplantation. Let me show you how to get started: 2008-2023 Mike Reinold All Rights Reserved, 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. Meniscus injuries within the knee are a common occurrence. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. Once you are cleared for full weight-bearing it often takes another 6 weeks of physical therapy and strengthening exercises to you get back to feeling normal and reducing injury risk. Am J Sports Med. 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. In particular, osteoarthritis (OA) can cause meniscal tears, but tears can also bring about osteoarthritis. Another possible, though rare, procedure is a meniscus reconstruction. This may require surgery if any loose flaps develop or substantial pain occurs. Last medically reviewed on December 21, 2021. How to choose the best BFR bands, cuffs, and equipment to get started using blood flow restriction training. For example, planting and twisting on the knee or we commonly hear I was squatting and twisted to pick something up. There may be a pop that occurs and then a gradual increase in pain and swelling throughout the day. 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. However, in some cases, they can stitch the meniscus back together. It's still a bit sore and swells a little after doing the rehab exercises but no pops or cracks, I definitely had been weight bearing a lot though. Wont that put the repair in a position to fail? My surgeon said no weight bearing for six weeks now I am more scared than anything else to walk and I haven't been clear by him to put weight and my physical therapist also is fallowing the surgeon recommendations. How quickly this progress occurs varies by surgeon, but a typical range is 4-8 weeks. In the cases of menisco-synovial ramp repair, hypermobility of the lateral meniscus fixation and longitudinal tear suture, where the hoop tensile stress effect is preserved, partial weight bearing (20 kg) is allowed for the first four weeks after surgery, with weight bearing as tolerated for the following weeks [11, 30]. my doc told me that i was good to start walking and i started walking without my brace and crutches about 5 days ago. Can you squat with proper form and control? We typically immobilize people in full extension during weightbearing, locked in a brace for 4-6 weeks after meniscal repair surgery. Initiate knee motion. They may also recommend using a knee brace. Instead the focus on making sure the weight is equal in both legs and work on getting back to a normal squat depth. See video: Eccentric step down. This is better long term, but it means you need to keep off of that leg in order for the meniscus to heal. Use of Crutches Following Meniscal Repair-Crutches for partial weight bearing should be used by this stage and progression to full weight bearing should be achieved by the 10th week following meniscal repair knee surgery. Thursday, 10 March 2022 / Published in Knee. The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair. Can I work outside US on OPT? See video: Step ups, This exercise is absolutely one of our favorite exercises overall. Your doctor may also recommend making a corticosteroid injection to the joint. It can help identify joint pain. We will determine during your consultation whether general or regional anesthesia would be appropriate either way, no pain will be experienced during the procedure itself. While we lean towards allowing weight-bearing, there are some important things you have to consider. We also recommend limited motion, and sometimes a knee brace. According to the American Academy of Orthopaedic Surgeons (AAOS), the estimated recovery time is three to six weeks for a partial meniscectomy, and three to six months for a meniscus repair.. This is why some researchers believe that repair surgeries may be a better long-term option than non-surgical procedures. A meniscus tear can also be from a traumatic injury such as twisting during sports or a degenerative which is a tear from general wear and tear. Heres an overview of the science behind the safety and efficacy of BFR. This exercise works the entire lower half of the body and really targets the quads, glutes, and hamstrings. Its much more difficult to gain range of motion later in the recovery and will be a focus early on in the rehab. Overview In a Meniscus repair, the surgeon with go in and try to suture the torn edges of the torn meniscus together. This will help reduce swelling and pain. BRACE: The brace should be worn at all [] Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. Same situation as the two comments above. Make sure that the knee does not progress past the toes on the front leg and go as deep as you feel comfortable. 0; . The same exercise as in phase 2 but now you get to add weight! Damaged knee cartilage, left untreated, can progress into severe arthritis and become increasingly debilitating. I'm not allowed weight bearing, or out of the brace, so it's limiting. It still can take months for the strength to come back to prior levels before surgery. Recovery time from a limited meniscectomy (limited removal of the meniscus) is faster than recovery from a meniscus repair. Epub 2013 Oct 10. . Despite this high occurrence, many inconsistencies continue to exist in the rehabilitation of a patient following meniscus repair surgery, particularly involving the rate of weightbearing and range of motion. Successful clinical outcomes ranged from 70% to 94% with conservative rehabilitation. Get the latest news and education delivered to your inbox, Receive an email when new articles are posted on, Please provide your email address to receive an email when new articles are posted on, American Academy of Orthopaedic Surgeons Annual Meeting. This is dependent on the surgeon and a great question to ask. There are specific and time-sensitive benchmarks to reach to successfully rehabilitate after a Full Meniscus Repair. One of the best alternatives to save your arms and armpits is to use a knee scooter to get around long distances and crutches for short distances. These measures are taken in order to protect the repair and give it a chance to heal. Continue with Recommended Cookies. Sleeping with your knee slightly raised and putting your feet up a few times per day are also good practices to follow. Lind M, Nielsen T, Faun P, Lund B, Christiansen SE. All rights reserved. The benefits of having a meniscus repair performed by a reputable orthopedic surgeon are numerous. If you had your meniscus repaired though, that's where the numbers start to jump all over the place. Disclaimer: This post is for informational purposes only. This timeline can vary depending on the patients age, fitness level, and commitment to appropriate physiotherapy following the procedure. However, when the meniscus is actually repaired and not just debrided, there are other factors to consider. On February 6, 2012, I underwent my sixth (count them) knee surgery. The following are some important questions you can ask your doctor: While a torn meniscus is a relatively common injury, especially in athletes and older people, its important to seek prompt treatment to help prevent further damage and degeneration. As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well.
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