weight bearing after meniscus repair

Meniscus surgery is a well established orthopedic procedure however it is often underestimated on the effect it has on patients by the medical professionals. Instead the focus on making sure the weight is equal in both legs and work on getting back to a normal squat depth. There is a growing body of evidence that physical therapy and conservative treatment may be as or more beneficial than surgery as soon as a year after the initial injury. 2001;19:384-390. See a surgery video here: Meniscus Repair. 2. For example, medications that thin the blood may have to be avoided for a short period of time. They may also recommend using a knee brace. Goals: 1. Careers. Lift your hips up to the ceiling and roll the ball towards your butt. We typically immobilize people in full extension during weightbearing, locked in a brace for 4-6 weeks after meniscal repair surgery. Our physiotherapy team will develop a personalized program that will address flexibility, endurance, and strength. From 2005 to 2011 the number of meniscus surgeries increased by 100%, thats a huge amount. If the meniscus is repaired, then the patient has to use crutches for six weeks. How long do you expect my recovery process to take after surgery? The knees experience a great deal of pressure and are particularly prone to damage. It really just depends how they repair the meniscus. The increased amount of arthritis makes this type of tears difficult to heal after surgery and may even speed up the degeneration. Gentle stretching is also a good way to maintain flexibility in the knee joint. A wide visual field for posterior root repair can be provided by complete superficial MCL release for OWHTO. Study design: -, Becker R, Brettschneider O, Grobel KH, von Verson R, Starke C. Distraction forces on repaired bucket-handle lesions in the medial meniscus. Start slow and slowy add weight as you feel appropriate as this cause the knee to be sore the first few rounds. Disclaimer: This post is for informational purposes only. How long recovery takes can depend on a variety of factors, which we will delve into below. It is important to note that a torn meniscus will not heal itself. You can use the player below to listen to the podcast or subscribe. UCONN Health states that, especially for older people, non-surgical measures could improve symptoms and prevent the tear from worsening in about six weeks. The primary types of meniscus tears are: This type of tear generally associated with wear and tear. After orthopedic surgery, the surgeon will define the amount of weight that the patient can bear on the leg. 3) Pelvis level. 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. More recent studies using an accelerated rehabilitation protocol with full weightbearing and early range of motion reported 64% to 96% good results. Heel slides should be performed with a stretching strap and done many times during the day to prevent the knee from stiffening up. 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. Surgery on the meniscus is done by an orthopedic surgeon. Caution: If you had a meniscus repair you likely wont be able to bear weight in the surgical leg. What are the risks and benefits of each surgery for my case? There are specific and time-sensitive benchmarks to reach to successfully rehabilitate after a Full Meniscus Repair. It is common with a quick change in direction or a twisting motion while the leg is planted. See video here: Side lying hip abduction. Infection is rare, but always a risk with any surgical procedure. Am J Sports Med. One of the most popular types of tears. If you are enjoying the podcast, PLEASE click here to leave us a review in iTunes, it will really mean a lot to us. (Ankle pumps, quad flexes, squeezing my butt muscles, squeezing pillow between knees, and straight . -, Chiang CW, Chang CH, Cheng CY, et al. Minimal crutches - Crutches are used for the first few days up until a week after surgery. My physio is limited to the meniscus repair plan (more conservative than just ACL) but I was allowed to weight bear right away. Although, many patients can walk without a knee brace and crutches in about 2-3 months. So why is it that what we do during meniscus repair rehabilitation is so outdated? Optimal rehabilitation after meniscal repair remains controversial. 1. What are the long-term benefits and consequences for removal versus repair? . Surgery is a major decision, and can lead to potential complications both during recovery and down the line. Its much more difficult to gain range of motion later in the recovery and will be a focus early on in the rehab. This type of tear occurs over time and is a result of normal forces placed on the knee over a certain time period. As this healing occurs, patients progress towards bearing weight, increasing their range of motion, and leaving the knee brace behind. Staying off your feet during the first few days following the procedure is very important. eCollection 2021 Apr. From there, your surgeon may remove a portion of the meniscus via a procedure called a partial meniscectomy. A repair of the cartilage between the knee bones is a relatively routine procedure to fix a very common injury. 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. This exercise is great to gain rotational control of the leg. This is huge and may aid in the healing process! Objective: Your doctor will likely recommend over-the-counter pain relievers and the RICE method first, especially in mild cases. What speed? 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. 2006;34:1941-1947. Doctors will usually advise against performing certain exercises when you have a meniscus tear. 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. 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. . How long after meniscus surgery can I walk? Activate the quadriceps muscles. A common question of most of the patients to their doctor is how long after meniscus repair can I walk. However, removal of meniscal tissue can also diminish the ability of the meniscus to dissipate hoop stresses (weight bearing pressure on the outside of the meniscus), resulting in altered biomechanics of the knee joint including increased contact pressures." . This will help reduce swelling and pain. At the 6 week mark, most people feel better than 80% of normal and dont notice it much during their daily activities. During weightbearing, compressive forces are loaded across the menisci. Smoak JB, Matthews JR, Vinod AV, Kluczynski MA, Bisson LJ. There is very limited literature on the influences of range of motion on meniscal movement. especially during weight-bearing exercise. All you need is a resistance band. The motion has been shown to help. Before 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. After controlling swelling, increasing range of motion, and progressively increasing your strength it provides a much better picture if surgery is needed. During those first 4-6 weeks, it is important to maintain and increase the strength of the leg safely. . Theres a lot to explore here! Save the armpits! Make sure to keep the leg inline or behind you when performing. Until that time, you are at an increased risk for injury due to the limitations in strength. This is often found on most MRIs especially in older patients and is not considered serious. 2018. Do you recommend that I take over the counter pain relievers? -, Haas AL, Schepsis AA, Hornstein J, Edgar CM. Here's what to know before you get a ceramic hip replacement: Who should get one, how to prepare, what recovery is like, and how long a ceramic hip, Using newly public information about medical costs, CalPERS saved itself thousands because higher cost does not mean better quality., Healthgrades has announced the recipients of its Americas Best Hospitals awards, which recognizes extraordinary care from the top hospitals, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Wall-sit exercises are begun 3 to 4 weeks after meniscus repair and 5 to 6 weeks after meniscal transplantation. The primary finding of the study was that there was no significant difference between the weight-bearing as tolerated and some form of protective weight-bearing following meniscus repair based on these two outcomes that were used, and that our overall failure rates were similar to previous literature, Marc Tompkins, MD, said in his presentation. 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? The site is secure. If the eccentric step down is our favorite exercise then this is a close second one. Control pain and swelling 2. 2015. The repeated stress of weight-bearing exercise causes the bone to thicken and strengthen, so it is a vital part of rehabilitation. Weightbearing After Meniscus Repair 15,799 views Premiered Oct 16, 2019 184 Dislike Share Mike Reinold 28.4K subscribers #177: On this episode of the #AskMikeReinold show we talk about our. Return to the starting position and repeat at least a few sets of 10. . 2022 Aug 5;23(1):753. doi: 10.1186/s12891-022-05662-6. At first, a torn meniscus may be asymptomatic. It allows for bending and twisting. This meant: -No weight bearing/must be on crutches for 6 weeks. Meniscal repair using the fast-fix all-inside meniscal repair device. Further use of the injured menisci can lead to chronic swelling, pain, and clicking noises. government site. Wilderman I, et al. Perkins C, et al. Your stitches will dissolve on their own and any scarring will fade in time. This is a great exercise to do early in rehab tp the strengthen the hip. 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. -, Bray RC, Smith JA, Eng MK, Leonard CA, Sutherland CA, Salo PT. Conclusion: Patients who are unsuitable for repair are generally treated non-surgically, with tablets and perhaps an injection of corticosteroid to minimise pain. Surgery for a meniscus tear - Trimming vs. repair. "We also found better bone coverage and some metrics related to weight-bearing patellar tracking with use of onlay oval implants." . Same situation as the two comments above. Created for people with ongoing healthcare needs but benefits everyone . Casp AJ, Bodkin SG, Gwathmey FW, Werner BC, Miller MD, Diduch DR, Brockmeier SF, Hart JM. Meniscus Surgery is one of the most common knee surgeries in orthopedics today. Weight-bearing to build up bone mass should be done for at least 30 to 45 minutes at least four times a week. The cryocuff is cold, compression device, that consists of a bladder around the knee and a cooler for ice a water. Continue with Recommended Cookies. Let me show you how to get started: 2008-2023 Mike Reinold All Rights Reserved. What future precautions will I need to take pertaining to exercise or daily activities. This is completely normal, and the doctor may prescribe some mild pain medication for you to take when you get home. The step allows for many different types and variations of exercises to be performed at home. Following your prescribed exercises as directed will go a long way towards ensuring a complete return to healthy knee function. Another possible, though rare, procedure is a meniscus reconstruction. We'll discuss how long recovery is and more. After either surgery, you may first notice a significant reduction in knee pain. Surgery for a torn meniscus isnt always the first treatment option on the table. So, the best answer will be, it's completely dependent on their body muscles and their daily routine . pubmed.ncbi.nlm.nih.gov/28815275 . 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. 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. Meniscectomy, or removal of torn meniscus tissue, typically has no post-op restrictions. (2021). We avoid using tertiary references. In terms of location for meniscus tears, 25% tear in the outer layer. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. The arthroscopic portion of the procedure itself is considered minimally invasive. Publicly Available Rehabilitation Protocols Designated for Meniscal Repairs Are Highly Variable. Data sources: What . Patients are usually out of the brace and walking without crutches . You can focus solely on the surgical leg or alternate. 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. Tahami M, Vaziri AS, Tahmasebi MN, Ahmadi MA, Akbarzadeh A, Vosoughi F. BMC Musculoskelet Disord. So, if you're wondering what to expect after meniscus surgery, well, I'm your gal. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. How effective is knee replacement surgery in relieving severe knee pain? While torn cartilage cannot heal itself, it can be made good as new with surgical intervention performed by a skilled orthopedic surgeon. Common Items Needed After Meniscus Surgery Ice machine This one of thest top items on the list for pain control and swelling. How long is non weight bearing after meniscus repair? 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]. Weightbearing versus nonweightbearing after meniscus repair. Recovery time from a partial meniscectomy (partial removal of the meniscus) is quicker than recovery from a meniscus repair. Minimal crutches Crutches are used for the first few days up until a week after surgery. To view the purposes they believe they have legitimate interest for, or to object to this data processing use the vendor list link below. So, if immobilized in extension, why do we limit weightbearing? Advertisement. official website and that any information you provide is encrypted Our favorite is from Cucial Compression since it comes in a two pack and adds just the right amount of compression. One of the main benefits of this surgery is that it reduces the risk of developing osteoarthritis in the future. After a meniscal repair, the knee must be protected to allow the meniscus to heal. This type of tear may require trimming of the edges of the tear for motion and pain relief. Its important to get the knee all the way straight and try to hold for at least 5 seconds to help the nerves and muscles return to normal. Here are some things to consider when helping people return back to the gym and into overhead pressing exercises. All opinions remain our own. 2008;24:1342-1348. This involves trimming away the damaged portion only. The Menisci are more elastic than most of the cartilage in the body and helps absorb force when we are walking, running, and jumping. Usually patient's are non-weight bearing for 4-6 weeks after meniscus repair surgery. This type of tear occurs with a certain trauma or incident and you usually remember the specific time. Memmel C, Krutsch W, Szymski D, Pfeifer C, Henssler L, Frankewycz B, Angele P, Alt V, Koch M. Int J Environ Res Public Health. MeSH Can I work outside US on OPT? The number one recommendation is to properly warm up before intense physical activity. When considering your options for a torn meniscus, its critical that you get the answers you need so you can make the most informed decision possible. Lucky me, I know! Paper #365. Generally, it takes 4 to 8 weeks to increase weight bearing and range of motion. The .gov means its official. Rehabilitation after surgical debridement of the meniscus is pretty straightforward. Symptoms may worsen especially after activity. on isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a more conservative approach. This field is for validation purposes and should be left unchanged. Following a partial meniscectomy, immobilization is not required and full extension with 90 degree flexion is possible approximately 10 days after surgery. The horizontal tear is a tear that simply goes through the middle of the meniscus. Conclusion: 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. The ACL is next to the menisci, running through the center of each knee joint. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. 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. Tompkins M, et al. At this point, they will likely clear you for all activity and you wont have to see them again. 7 (5): 399-402. Click here to learn more about our online and in-person training programs: https://championptandperformance.com/***** FOLLOW ME ONLINE:Instagram: http://instagram.com/mikereinoldFacebook: https://www.facebook.com/mikereinold.ptTwitter: http://twitter.com/mikereinoldBlog: https://mikereinold.com/blog/ Even though it wont like heal in the inner portion that tear may simply scar down and you might simply forget about it in the long run. Giving your body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is advisable. 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. Vascular response of the meniscus to injury: effects of immobilization. Menisci are crescent-shaped pieces of fibrocartilage that are essential to the function and health of the knee joint. Level 4. REHABILITATION AFTER KNEE MENISCUS REPAIR . Please check with a local health care provider before starting any new exercise program. See below for exercises that use an aerobic step and our favorite is the simple yet effective KLB Sport 31 Adjustable Step. 3. Protected weight bearing for 4-6wks with crutches. If you have a meniscus repair you will want to make sure that you have these to add a little cushion to the armpits. 2. See video: Forward Lunges. This deepening of the joint prevents the femur bone from slide too far forward or backward. We also recommend limited motion, and sometimes a knee brace. Tompkins and colleagues categorized 295 patients who underwent meniscus repair between 2006 and 2009 into the following two groups: non-weight-bearing; or weight-bearing as tolerated immediately following surgery. Meniscus surgery remains one of the most common types of orthopedic procedures, due to the prevalence of meniscus tears and their effects on quality of life. For instance I was weight bearing immediately but some are not. Exercise to Improve Knee Range of Movement after Meniscus Repair-The range of motion exercises after knee surgery . . Rehabilitation after knee meniscus repair. Wearing a knee brace can also be helpful. 2021 Jan 30;3(2):e411-e419. This debridement allows the joint to move freely. The audible snap of my tearing meniscus was actually heard by my teammates on the next court. This does most often require surgery to fix the motion block. If you are concerned about knee pain and wish to have an assessment, contact us today at Mattalino Orthopaedic in Phoenix, AZ. One source even quotes the incidence as high as 1 in 300 people with have surgery on their meniscus. Control pain and swelling. 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. We return the patients range of motion, strength and function per their symptoms and let pain and swelling guide the rehab process (a very general guide but one often employed by many rehabilitation specialists). 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. One involves repairing the meniscus, or sewing it back together. 2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. Am J Sports Med. Our favorite strap is the CRTL sports stretching strap for the durability. As biomechanical factors, postoperative range of motion (ROM) and weight-bearing status can impact meniscal healing after repair. 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. Blood Flow Restriction Training is an exciting new adjunct to exercise. Orthop J Sports Med. These exercises can put too much pressure on an already unstable knee. The surgeon may even score or rough up the underlying tissue to help with better healing and blood flow to the area. Once you have regained full strength and mobility in your knee, you will want to make sure you never have to go through this process again! Successful clinical outcomes ranged from 70% to 94% with conservative rehabilitation. Theres a lot to explore here! Then slowly bring yourself back up. When will I be able to resume my normal activities? - If meniscus repair is necessary, recovery is likely to be longer and more involved. . If you only had your ACL reconstructed, weight bearing as tolerated seems to be a good way to go. See video here: Goblet squats. 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. 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. How low are you going to go? For how long? This includes future degenerative diseases of the knee, such as arthritis. Phase Three: Six to twelve weeks after surgery. Drop a note below in the comment section and let me know! and transmitted securely. While most people with tennis elbow can recover without surgery, there are several surgical options for those that need it. Tag: Weight Bearing After Meniscus Repair. Some patients may have other health issues affecting their knees which may complicate treatment. Its easy to use and something that you will undoubtedly use again in the future. Harms were reported, but no serious adverse events were found. Trust me, I respect the healing meniscus and continually monitor patients as I progress their range of motion and weight-bearing activities. 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 is huge and may aid in the healing process! These tensile forces create 'hoop stresses', which expand the menisci in extension. During weightbearing, compressive forces are loaded across the menisci. . Each time you should start increasing the amount of weight put into the surgical leg until you can do a single leg balance with minimal pain. An arthrogram is an imaging test that uses a dye-like fluid called contrast to create detailed images of joints. The same exercise as in phase 2 but now you get to add weight! Knee arthroscopy repair: Generally, this requires a period of limited weight-bearing, including the use of crutches or a walker. Your doctor may recommend a knee replacement. Slowly start moving your knee and leg. As soon as your initial recovery period is over, you will need to start a therapy program that will allow for a steady, gradual return to the activities you enjoyed prior to your meniscus injury. Symptoms of a knee infection may include pain and excess swelling in the joint, and fever or chills. Some of the links in this post are affiliate links. Meniscus (cartilage) Repair patients cannot do twisting, pivoting, squatting, deep knee bends or impact activities for four months. When was the surgery? Meniscus injuries within the knee are a common occurrence. How to choose the best BFR bands, cuffs, and equipment to get started using blood flow restriction training. Initiate knee motion 3. The following are the necessary cues for appropriate form: 1) Lower extremity alignment. As you return to running start slow and progress 10-15% each week to avoid injury, Dont start running or jumping until you can hold a single leg squat for 30 seconds, Warm up properly before returning to any sporting activity, Continue to strengthen the leg, it is one the thing that has been shown to decrease injury risk. Meniscal movement: an in-vivo study . ive kinda been stumbling a little bit but it gets better every day. 4) Trunk vertical (no lateral lean) . 5 Common Mistakes Youre Making After an Ankle Sprain, 6 Great Ways to Reduce Low Back Pain with Driving, Return to Running After an Ankle Sprain: A Helpful Guide, 5 Reasons Why Running on a Treadmill is Better for Back Pain, Hip Replacement: What to Expect in Your First Week, Ankle Exercises for Runners: Strengthening, Stretching, and Loosening Up, How to Strengthen the Tibialis Posterior: A Helpful Guide, https://lifesworkpt.com/2017/05/what-is-a-torn-meniscus-in-the-knee/. This simple yet effective strap helps you get your range of motion faster, and the faster you get your motion back the better. How you squat and how you respond matter! Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. How large is my meniscus tear- could it heal without surgery? Proper self-care is essential to shortening the recovery process and avoiding a recurrence of the injury. However, it is important to note that a complete return of knee strength and full-range mobility may take several months. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. Should you undergo knee replacement surgery now or later? During a knee arthroscopy, your surgeon makes a small incision in the knee joint so they can place a small camera (arthroscope) inside to guide them as they perform surgery on the affected meniscus. Avoid exercises that involve: pivoting. Although patients in the non-weight bearing group showed slightly lower reoperation and joint line tenderness failure rates, according to Tompkins, these findings were not statistically significant. MEDLINE (January 1, 1993 to July 1, 2014) and Embase (January 1, 1993 to July 1, 2014) were queried with use of the terms meniscus OR/AND repair AND rehabilitation. Meniscus tears are a common injury in sports and with activity. Since you have done the reverse lunges in phase 2, now its time for forward lunges. I help people feel better, move better, and perform better. I had a feeling I'd gotten a repair done instead of a removal, and was quickly told that was the case. Should I take these alongside the RICE method? Wear a knee brace as directed by your doctor. Phase One: The first week after surgery . Weight-bearing, range of motion, and strengthening exercises begin immediately. At-home physical therapy exercises are typically recommended, and most patients are approved to resume their normal activities within 4-6 weeks. 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. We and our partners use cookies to Store and/or access information on a device. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold. Start by standing with your knee bent, tighten your quad and straighten your knee all the way back. What will happen if I try and wait for a the tear to heal on its own? The quads, of course, will continue to function during weight bearing exercises. Are any of them still recommending rehab guidelines based on outdated research? 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. FOIA "Meniscus repair is not a small surgery without complication. Visco-Supplementation for Arthritis of the Knee, Arthroscopic Shoulder Impingement Surgery, Platelet Rich Plasma (PRP) Injection Overview, contact us today at Mattalino Orthopaedic in Phoenix, AZ. Thursday, 10 March 2022 / Published in Knee. Total recovery time can vary from 3 to 6 months, depending on the overall health of the patient and their commitment to proper follow-up care. (Updated 2021). 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. Clinical results of all-inside meniscal repair using the fast-fix meniscal repair system. Ask your questions at http://MikeReinold.com/askmikereinold/ and follow us at @mikereinold, @lenmacpt, and @championptp.Was this helpful? See video: Eccentric step down. Phase One: The first week after surgery . 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! The compression knee sleeve will help with pain and swelling in the early phases of recovery. General Considerations Meniscus Repair Considerations: Flexion over 90 degrees loads the back of the meniscus, which is the area where tears occur during ACL injury events. It still can take months for the strength to come back to prior levels before surgery. One of the most common types of tears that often goes from the outside towards the middle of the meniscus. The first weeks you will use this many times a day. Those that are caused by an injury are often the ones that can be. Most patients can walk without a knee brace and crutches in about 2 to 3 . Fast-Fix meniscal repair: mid-term results. You will be advised to rest as soon as you get home following your procedure. Make sure that the knee does not progress past the toes on the front leg and go as deep as you feel comfortable. Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. If you have to go to work, school and need to walk even moderate distances then consider getting a knee scooter. Bookshelf Weight bearing is protected on crutches for two weeks followed by full weight bearing in the brace . It is technically . Context: Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. Knee Surg Sports Traumatol Arthrosc. Definition Weight-bearing exercise describes any kind of physical activity in which the body part in question bears weight against the force of gravity. Shelbourne KD, Patel DV, Adsit WS, Porter DA. You can see out complete review of Eccentric Step Downs here and why we love it. Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. Demographics and clinical and radiographic outcomes of meniscus repair at a minimum of 2 years follow-up were extracted. After the first week, you may then increase weight as tolerated and advance to one crutch for a few days and then a cane if needed. Physical therapy is started immediately to regain motion and strength. I want to help you learn to do the same. They also occur frequently with other knee injuries such as ACL tears. There is a lot of information out there regarding weight bearing status after meniscus repair. This is not a substitute for a medical appointment. The degenerative tear is the person who is 45-55 years old (or older) and also has a fair amount of arthritis. sharing sensitive information, make sure youre on a federal Timeline In general 6-12 weeks and you will be back to normal. 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. Depending on the size and location this can develop into a bucket handle tear or may respond to a meniscus repair surgery if in the vascular area. I started Brazilian Jiu-Jitsu about four years ago. The first weeks you will use this many times a day. Sometimes in these situations a knee brace for a meniscus tear is a better option. 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. An official website of the United States government. Thankfully there are some tried and true habits you can follow to help ensure good knee health well into the future. Modern treatment of meniscal tears. One tip is to avoid pushing off with the nonsurgical leg to vault yourself up. The retrospective review included more than 5 years of follow-up. Our website services, content, and products are for informational purposes only. The Injury: What came first, the Brazilian Jiu Jitsu or my awesome dancing at a wedding? Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries-Differentiation Based on Tendon Graft and Concomitant Injuries. As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well. Use of a knee brace and crutches is advisable for at least two weeks to make sure that the knee is stabilized and there is no unnecessary pressure placed on the joint. Will I need someone to help me around the house with everyday tasks? Preserving and improving muscle mass is important in this state. Using a step or a workout step, try to bring yourself up on to the step using the surgical leg. A torn meniscus can cause pain, swelling . Most patients can walk without a knee brace and crutches in about 2 to 3 months. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. I certainly wouldnt consider these aggressive programs, they simply used immediate weightbearing and range of motion. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla. Disclosure: Tompkins reports no relevant financial disclosures. (2018). However, extensive tears in older adults may require surgery. Data extraction: Its best to perform in front of a mirror to watch for a shift away from the surgical knee. Immediate weight-bearing is allowed and patients are typically back to performing all activities of daily living in three or four days. THANKS! 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. What was the surgery? Walking (weight bearing as tolerated): Put the crutches forward about one step's length. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears or all-inside meniscal repairs. See video: Bulgarian Split Squat. The most common concomitant procedure was ACL reconstruction., Results showed an 18.6% failure rate based on reoperation and a 15.3% failure rate based on joint line tenderness. No active/passive knee flexion past 90deg for 4 weeks. 3. Stand in from of a chair or bench and take a big step with the surgical into a lunge stance. 9. 2005-2023 Healthline Media a Red Ventures Company. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. 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. Once the torn cartilage is repaired and fully healed, patients can expect to return to the physical activities they once loved. Knee Surg Sports Traumatol Arthrosc. Please consult your physician or health care profession before beginning any exercises after surgery. 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. If your doctor recommends a meniscus repair, they will insert sutures or meniscus repair anchors to hold the remaining parts of your meniscus together. The benefits of having a meniscus repair performed by a reputable orthopedic surgeon are numerous. How Long Does It Take Bankart Repair to Heal. 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. Most commonly occurs during athletics and often tears along the outside of the meniscus. The goal of this exercise is to gain knee ROM and quickly. 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. Contact your doctor immediately if you believe you may be experiencing this complication. For a meniscus repair, we expect full recovery to be achieved between 3-6 months after the date of surgery. Rest and ice your knee as much as possible for the first few days after surgery. The first thing to emphasize is that I allow full weight bearing immediately after surgery. 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). To assess the value of postoperative limits to motion, weight bearing, and agility activities, a comparison was made of our previously published "standard" rehabilitation program with an "accelerated" program permitting unlimited weight bearing, full motion, and no restrictions on pivoting sports. Initiate knee motion. 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. 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]. At or around 6 weeks after surgery, you will likely have a follow up with your surgeon. They may also debride or clean up the edges of the tear. This is a great exercise to isolate and strengthen the surgical leg while working on control and balance. Ankle Mobility Drills to Improve Dorsiflexion, Ultimate Guide to Blood Flow Restriction Training, The Best Blood Flow Restriction Bands in 2023. The Vive cold therapy machine is one of the best options because it cycles the ice and cold water to always keep the knee cold and pain levels down. Damaged knee cartilage, left untreated, can progress into severe arthritis and become increasingly debilitating. 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. This involves a combination of physical therapy as well as at-home strengthening exercises recommended by your doctor. Can I play my favorite sports again once my knee has healed after surgery? The trend is to allow weight-bearing sooner than 6 weeks but this is surgeon dependent. Start by standing on of the step with your surgical leg as the stance leg. Unable to load your collection due to an error, Unable to load your delegates due to an error. While a sharp pain in the knee can sometimes indicate a meniscus tear has already occurred, ignoring this pain can turn a minor injury into a much worse one. Start with equal weight in both legs standing at the counter or kitchen sink and shift to the surgical side. Lind M, Nielsen T, Faun P, Lund B, Christiansen SE. How long will I need to take off work? All rights reserved. This is especially true for degenerative meniscus tears which have much less success with surgery. For both cases, I would recommend passive range of motion to tolerance. Find out whether the time is right for you to have knee replacement surgery. What Is the Recovery Time for a Meniscus Tear Without Surgery? How many? 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. See a surgical video here: Partial Meniscectomy. Things like new joint line pain along the site of the repair, new swelling or a change in pain patterns, and even clicking (although most people have this) are all signs that I may want to further assess and modify my progression. Generally, it takes 4 to 8 weeks to increase weight bearing and range of motion. Often times, the meniscus can only be trimmed and in this cases, your leg will be weight bearing quickly. Results: A torn meniscus results from damage or degeneration to the menisci in your knees. Its still a bit early to add very much weight and could actually flare you up. However, having surgery to repair tearsrather than removing themcould also decrease your likelihood of arthritis by improving the meniscus health. Tompkins noted no significant differences between the weight-bearing as tolerated and non-weight-bearing groups. How Long After Meniscus Repair Can I Walk? The menisci are two pieces of articular cartilage between the bones of the lower leg. Joined Aug 27, 2017 Messages 10 Age 29 Gender Male Country United States . The final exercise that you need to do in phase 2 of rehab and its a good one. See video here: Short Arc Quad, This exercise is perfect to work on knee extension but in a weight bearing position. Orthopaedic Surgery, Sports Medicine, Digital Radiography: Phoenix, AZ. Patients are usually out of the brace and walking without crutches around 2-3 months. Level of evidence: Please wait to performing any standing exercises until cleared by your surgeon. 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. 2) Hips down and back. High Glycemic Variability=2x . My first partial meniscectomy occurred almost 30 years ago, after a tennis injury. Any advice pls. This ensures minimal tension on the cartilage as it heals. I'm not allowed weight bearing, or out of the brace, so it's limiting. 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. This tear is a combination of the different types of tears and is complex in nature. This exercise works the entire lower half of the body and really targets the quads, glutes, and hamstrings. HHS Vulnerability Disclosure, Help Our detailed examination process, all our treatment progressions, and detailed information on nonoperative and postoperative treatment of ACL, patellofemoral, meniscus, articular cartilage, osteoarthritis injuries, and so much more. O'Donnell K, Freedman KB, Tjoumakaris FP. One of the best squat variations, the goblet squat exercise targets the core and legs while adding resistance to improve strength. Activate the quadriceps muscles . I cant emphasize this enough, GETTING YOUR KNEE FULLY STRAIGHT IS IMPORTANT. The front hip and both knees should be in a 90 degree angle and the chest should stay upright. The outcomes and ability to heal depend on many factors including the type of meniscus tear. 2021 Oct 6;9(10):23259671211031281. doi: 10.1177/23259671211031281. 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. . See video: Single leg balance, The Hamstring curls on an exercise bike is one of the best ways to strengthen the hamstrings and help with knee flexion range of motion. These measures are taken in order to protect the repair and give it a chance to heal. . Depends: Follow your surgeon's instructions. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold. Other Types of Knee Injuries or Disorders. Younger people are more likely to be highly active, and are at risk of worsening a tear by overuse. For high-level sports, there may be pain still present at 6 weeks and may take the full 12 weeks to be able to play pain-free. 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. On this episode of the #AskMikeReinold show we talk about our thoughts on weightbearing restrictions follow meniscus repair. Meniscus tears. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. For those interested in learning more about how Lenny and I evaluate and treat the knee, we have an amazingly comprehensive course that covers everything you need to know to master the knee. Do not try to do too much too soon. Try to hold for at least 5 seconds per rep. See video here: Standing Terminal Knee Extensions, You likely wont be able to start right away on a single leg balance but is great to start working towards for a faster recovery. 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. Heres an overview of the science behind the safety and efficacy of BFR. While we lean towards allowing weight-bearing, there are some important things you have to consider. After arthroscopic meniscus repair, the patient generally has a cryocuff and a knee brace. NCI CPTC Antibody Characterization Program, Barber FA, Schroeder FA, Oro FB, Beavis RC. Many patients report that their knee mobility following the procedure is at least as good as it was prior to the initial injury. 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. 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