Toe touch 12 body weight 34 to full toe touch 14 body weight 12 to 34 body weight full p c p c c c. No loaded knee flexion beyond 450 for 4 weeks no loaded knee flexion beyond 900 for 8 weeks. Read on to find out just how to combine multiple pdf files on macos and windows 10. Acl reconstruction with meniscus repair or microfracture hamstring graft. Aclr protocol with quadriceps tendon autograft and meniscal. Progression is criterionbased and dependent on soft tissue healing, patient demographics, and clinical evaluation. An athlete who returns to sport without functional stability being restored, is at a higher risk of failure and poor outcomes. For this reason, rehabilitation following a meniscal repair is particularly conservative in an effort to protect the repaired meniscus. Knee arthroscopy with meniscus repair rehab protocol. Phase iv advanced acl protocol no significant swellinginflammation, full pain free rom, no evidence of patellofemoral joint irritation, sufficient strength and proprioception to initiate agility, normal.
Download medial meniscus repair post op protocol doc. Specific time frames, restrictions and precautions are given to protect healing tissues and the surgical repair reconstruction. Meniscus repair rehabilitation the following protocol is a guideline for rehabilitation following meniscus repair. Change dressing, keep wound covered, continue ted hose pod 710. Meniscal repair postoperative rehabilitation protocol orthoindy. General time frames are also given for reference to the. Toetouch weight bearing with brace locked in extension. Rehabilitation protocol for meniscus repair this protocol is intended to guide clinicians and patients through the postoperative course for a meniscus repair. A complete radial tear of the meniscus can lead to extrusion, rendering it nonfunctional and resulting in deleterious arthritic changes to the lateral compartment. Repair can be achieved by a transtibial tunnel repair, a suture anchor repair or a side to side repair. Acl with meniscus repair 2 typically, after an anterior cruciate reconstruction surgery acl with meniscal repair there is a protected range of motion and weight bearing period that can last up to 6 weeks. Brace 0 90 for 6 weeks post op 50% weight bearing for 6 weeks post op use of crutches for 6 weeks post op painedema reduction enhance quad recruitment phase 1.
Optimum return to sport does not mean to return as fast as possible. Meniscal repair protocol this will delay the protocol for aclr 1. Meniscus repair rehabilitation protocol the following is a protocol for postoperative patients following meniscus repair. Basic acl protocol but no passive range of motion prom greater than 90 degrees for four. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex. If your scanner saves files as pdf portbale document format files, the potential exists to merge the individual files into one doc. Seated kinetron and multi angle quadriceps isometric can substitute for weightbearing exercises. Aukerman revised 32218 the rehabilitation guidelines are presented in a criterion based progression. Phases and time frames are designed to give the clinician a general sense of progression. Do not do resisted long or short arc quads, to avoid adversely stressing the graft. If completed in conjunction with acl reconstruction, begin with meniscal repair protocol and change to acl reconstruction protocol at four weeks postop. The primary goal of this protocol is to protect the repair while steadily progressing towards and ultimately achieving preinjury level of activity. Acl reconstruction with meniscal repair rehabilitation protocol.
Pdf is a hugely popular format for documents simply because it is independent of the hardware or application used to create that file. Meniscal repair the meniscus is a crescent shaped cartilage that acts as a shock absorber between the femur thigh bone and tibia shin bone. This blood supply is necessary for a tear or a repair to heal. Rehabilitation protocol for meniscus repair massachusetts. Meniscal repairs located in the vascular zones of the periphery or outer third of the meniscus are progressed more rapidly than those repairs that are more complex and located in that avascular. The protocol may be modified depending on the location and extent of the meniscal tear and subsequent repair. Anterior cruciate reconstruction with meniscal repair. How to shrink a pdf file that is too large techwalla. Gallandkirby acl reconstruction with meniscus repair postsurgical rehabilitation protocol postop days 1 14 dressing. A pdf file is a portable document format file, developed by adobe systems.
Increase the intensity of strength a nd func t i ona l t ra i ni ng for gra dua l re t urn t o a c t i vi t i e s. Acl reconstruction with meniscus repair protocol dr bradley bruner 01012009 guidelines. The treatment chosen will depend on the location of the tear, the athletes sport, ligamentous stability of the. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a meniscal repair. Most electronic documents such as software manuals, hardware manuals and ebooks come in the pdf portable document format file format. The inner area white zone lacks a good blood supply and therefore does not heal well. There is an additional type of cartilage in the knee joint called articular cartilage. Achieving the criteria of each phase should be emphasized.
Aclr protocol with quadriceps tendon autograft and. By michelle rae uy 24 january 2020 knowing how to combine pdf files isnt reserved. Figure 6 shows the blood vessels perimeniscular capillary plexus entering the outer portion of the meniscus. Where a meniscus tear occurs is one of the most important things that affects healing. You can use the tools in paint to add something to a different document. Jonathon henry the following document is an evidencebased rehabilitation protocol for knee arthroscopy with meniscus repair. Return to sport meniscal repair protocol general guidelines to consider with return to sport after meniscal repair. Meniscus repair and transplant protocol the noyes knee. Acl with meniscus repair or microfracture rehabilitation. To combine pdf files into a single pdf document is easier than it looks. An oversized pdf file can be hard to send through email and may not upload onto certain file managers. Meniscus repair guidelines meniscus repair guidelines progression is both criteriabased and patient specific. Rehabilitation exercises appendix topic images meniscus tears quad sets straightleg raise to the front straightleg raise to the back hamstring curls heel raises heel dig bridging shallow standing knee bends meniscus tear. Patients must demonstrate specific functional criteria at each physical therapy visit before progressing to more advanced interventions.
Outsidein repair technique for a complete radial tear of. Gentle strengthening protecting the healing meniscus. If the patient has undergone a meniscus repair for a root, radial or horizontal cleavage tear, please refer to the advanced meniscus repair clinical practice guideline. This protocol is intended to provide the treating clinician with a guideline for rehabilitation.
Controlled gains in range of motion early maintenance of strength 2. Searching for a specific type of document on the internet is sometimes like looking for a needle in a haystack. The paint program can help you make new image files, but it cannot open document or pdf file. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and. Weeks 5 through 6 full weight bearing at 6 weeks initiate ckc exercises such as. Rehabilitation exercises a meniscus tear is a common knee joint injury. Tears at the outer edge red zone tend to heal well because there is a good blood supply. Follow pcl protocol as it will be a slower rehab than meniscal repair acl reconstruction. The pdf format allows you to create documents in countless applications and share them with others for viewing. Tears are noted by how they look, as well as where the tear occurs in the meniscus. Wilk, pt, dpt general principles this protocol for rehabilitation after knee meniscus repair surgery is designed to provide the rehabilitation professional with a general guideline for patient care with the alterg antigravity treadmill antigravity treadmill. Dec 27, 2020 sports medicine division physical therapy protocols brad e. It is designed for rehabilitation following arthroscopic meniscal repair.
In addition, if the medial meniscus is involved, active. As tolerated should be understood to include with safety for the reconstruction repair. Small clinical studies support rehabilitation protocols that allow early motion. Luckily, there are lots of free and paid tools that can compress a pdf file in just a few easy steps. Rehabilitation guidelines for meniscal repair of root and. Meniscus repair rehab protocol orthopaedic medical group. Lowe this rehabilitation protocol was developed for patients who have isolated meniscal repairs. This article explains what pdfs are, how to open one, all the different ways. The direct attachment of the hamstring and popliteus tendons to the menisci requires limited knee flexor active contraction during the protection phase of recovery for the meniscus rootradial repair.
Dependent on the meniscus post op protocol depths and not central portion of meniscus repair better take care of the property of meniscus to the entire meniscus. Complex tears 23 strengthening exercise o multiangle quad isometrics o slr all 4 planes o knee extension 900 degrees o ckc weight shifts avoid twisting, deep squatting, and stooping avoid hamstring strengthening stage 3. Postoperative rehabilitation protocol meniscal repair guidelines. Longleg postoperative x x x range of motion minimum goals. This meniscus repair reconstruction protocol is criterion based. Manual stretching for extension with overpressure or recurvatum. Postoperative rehabilitation protocol acl reconstruction with meniscus repair or microfracture phase i. Meniscal repair guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Longleg postoperative c, a, t c, a, t c, t range of motion minimum goals 090 0120 05 x x x weightbearing toe touch to 50% body weight 75% to 100% body weight toe touch to 25% body weight. Download medial meniscus repair post op protocol pdf. Maximum protection weeks 1 to 6 goals control inflammationeffusion allow early healing full passive knee extension gradually increase flexion to 90 degree independent quadriceps control weight bearing non weight bearing for six weeks unless noted by dr.
This protocol is designed to progress the individual through rehabilitation to full sport activity participation. Green time frame treatment goals postop day dressing change instruct in signssymptoms of infection check for dvt cryotherapy hep. Meniscal repair protocol brigham and womens hospital. If your pdf reader is displaying an error instead of opening a pdf file, chances are that the file is c. Meniscus repair protocol center for sports medicine and. Even if an exercise or activity is listed at a particular time frame, some patients may not be ready to perform it. Meniscus repair rehabilitation program gundersen health system. Modifications to the protocol may be necessary dependent on location of repair, concomitant injuries or procedures performed. The decision by the surgeon to repair or remove is based primarily on the location of the meniscal tear. Chief, division of sports medicine associate professor of orthopaedic surgery tel. Acl reconstruction with meniscal repair rehabilitation. The protocol is both chronologically and criterion based for advancement through four postoperative phases. Postoperative physical therapy protocol weeks 1216. The menisci are wedge shaped, being thinner toward the center of the knee and.
Microsoft word arthroscopic meniscal repair protocol. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. Dempsey md, mba rehabilitation guidelines for meniscal root repair the intent of this protocol is to provide the clinician with a general guideline of the postoperative course of the patient that has undergone the above stated procedure. However, the large hematoma produced during the acl surgery is considered beneficial to the healing of the meniscal repair and some. Complete 3 month sports test and i ni t i a t e re t urn t o runni ng progra m. To avoid placing stress on the meniscus repair, do not bend. Meniscal repair postoperative rehabilitation protocol.
Knee osteoarthritis after medial meniscus repair post op protocol sustained. The lateral meniscus is vital in dissipating the force in the lateral compartment of the knee. If you have questions, contact the referring physician. Patients with additional surgery will progress at different rates. Arthroscopic repair of a complete radial tear of the lateral meniscus poses a challenge to orthopaedic surgeons. Pdf file or convert a pdf file to docx, jpg, or other file format. Schaap time frame treatment goals postop day dressing change instructions in signs and symptoms of infection check for dvt issue hep for quad sets, slr, hip abadduction, patellar mobs, hip extension, heel slides and cryotherapy independent in home exercise program fair quad set independent with slr. Depending on the type of scanner you have, you might only be able to scan one page of a document at a time. Anterior cruciate ligament acl and meniscus repair. The orthopedic surgeon may modify the time frames and weight bearing status, as necessary, to allow adequate healing time. To avoid placing stress on the meniscus repair, do not bend your knee beyond 90 degrees bent to a right angle brace and crutches. Hospital has accepted this protocol as our standard protocol for the management of patients sp meniscal repair.
The therapist must modify the program appropriately depending on the individuals goals for activity following meniscal repair. Meniscal root repairs and radial tear repairs should be progressed slowly because the tear involves complete disruption of the circumferential fibers of the meniscus. Arthroscopic meniscal repair rehabilitation protocol i goals 1 manage inflammation iceman, nsaids, etc. Noyes knee institute rehabilitation protocol for meniscus repairs and transplants 12 34 56 78 912 4 5 6 712 brace. Rehabilitation protocol the intent of this protocol is to provide the therapist with a guideline for the postop rehab of a patient who has had a meniscus repair, meniscal root repair, or meniscal transplant. I paid for a pro membership specifically to enable this feature. Meniscus repair rehabilitation protocol general guidelines use the cryotherapy cuff continuously for the first 72 hours, then as needed thereafter ensure that the cuff never contacts the skin directly apply to the knee after performing rehabilitation exercises for the first 6 weeks. The first 6 weeks are a strict protection phase and the patient is nonweight bearing. Accelerated rehabilitation protocols are not associated with higher failure rates following meniscal repair. Common tears include longitudinal, parrotbeak, flap, bucket handle, and mixedcomplex. Adobe designed the portable document format, or pdf, to be a document platform viewable on virtually any modern operating system. One of the fun things about computers is playing with programs like paint. Throughout this protocol, time references in weeks since surgery represent the earliest that a patient may. Acl reconstruction, pcl reconstruction, chondroplasty precautions.
Postoperative rehabilitation protocol meniscal root repair guidelines brace 090 for 6 weeks post op 25% weight bearing for 6 weeks post op use of crutches for 6 weeks post op painedema reduction enhance quad recruitment phase 1. Throughout this protocol, time references in weeks since surgery represent the earliest that a. Anterior cruciate ligament acl and meniscus repair rehabilitation protocol general notes. Dependent upon the location and size of the repair, weight bearing. Meniscus repair physical therapy protocol orthoindy. This means it can be viewed across multiple devices, regardless of the underlying operating system.
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