weight bearing after meniscus repair

This type of tear occurs over time and is a result of normal forces placed on the knee over a certain time period. Cortisone shots have been shown to have substantial pain-relieving effects for patients with meniscal tears or degeneration. REHABILITATION AFTER KNEE MENISCUS REPAIR. So, if you're wondering what to expect after meniscus surgery, well, I'm your gal. The interplay between tear type and knee biomechanics can help define the most appropriate postoperative plan. Restricting a patient's postoperative ROM intends to limit the risk of re-tear. These types of tears often do not need or respond well to surgery. Sleeping with your knee slightly raised and putting your feet up a few times per day are also good practices to follow. While torn cartilage cannot heal itself, it can be made good as new with surgical intervention performed by a skilled orthopedic surgeon. The primary types of meniscus tears are: This type of tear generally associated with wear and tear. 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. Memmel C, Krutsch W, Szymski D, Pfeifer C, Henssler L, Frankewycz B, Angele P, Alt V, Koch M. Int J Environ Res Public Health. Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. - After a meniscectomy, most patients are able to begin bearing weight/walking within a week after surgery. -Straight leg brace/no knee bending for 4-6 weeks. This meant: -No weight bearing/must be on crutches for 6 weeks. Wont that put the repair in a position to fail? sharing sensitive information, make sure youre on a federal Goals: 1. THANKS! Usually patient's are non-weight bearing for 4-6 weeks after meniscus repair surgery. Epub 2017 Aug 16. 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. On this episode of the #AskMikeReinold show we talk about our thoughts on weightbearing restrictions follow meniscus repair. Though the surgery to repair a meniscus tear alone is not terribly long, the recovery time can last anywhere from three weeks to six months for a full . Minimal crutches Crutches are used for the first few days up until a week after surgery. -. Disclaimer: The information provided in this post is for educational purposes only. (2021). Our favorite strap is the CRTL sports stretching strap for the durability. Non-weight bearing x6weeks for root/complex/radial meniscal repairs How Long After Meniscus Repair Can I Walk? Am J Sports Med. This debridement allows the joint to move freely. 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? Crutches If you non-weight bearing for the first 4-6 weeks you will get so tired of using crutches. Perkins B, Gronbeck KR, Yue RA, Tompkins MA. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. How long after meniscus surgery can I walk? Phase One: The first week after surgery . Control pain and swelling 2. At or around 6 weeks after surgery, you will likely have a follow up with your surgeon. Weightbearing versus nonweightbearing after meniscus repair. There are two in each knee between the femur and tibia bones, and they assist with weight bearing and shock absorption. 2021 Oct 6;9(10):23259671211031281. doi: 10.1177/23259671211031281. eCollection 2021 Apr. Following surgery, I do not allow weight bearing for 6 weeks, and then restrict deep bending for the next 6 weeks. How will surgery increase or decrease such risks? 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. Slowly increase the depth each day that you do them to improve loaded knee rom. 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. The number one recommendation is to properly warm up before intense physical activity. Comment below and let me know, I want to hear what the rest of the country is seeing! We avoid using tertiary references. Heres an overview of the science behind the safety and efficacy of BFR. See a surgical video here: Partial Meniscectomy. Alaia MJ & Wilkerson R. (2021). 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. Initiate knee motion 3. 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. Federal government websites often end in .gov or .mil. Proper aftercare is essential to avoid any complications or setbacks that may lengthen your recovery time. In addition to RICE, non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, may help reduce pain and swelling. An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. You can also perform this exercise on your back with the feel on the wall if you have back problems. Goals: 1. The motion has been shown to help improve blood flow to the area. Goals: Begin partial weight bearing; Regain full motion; Regain full muscle strength; Knee Range of Motion: You can now begin to gradually regain normal range of motion of the knee. Should I take these alongside the RICE method? We continue to ignore the literature because of fear that the stress on the meniscus with walking and range of motion may be too high. 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. Orthopedic Reconstructive Surgery 19 years experience. An arthrogram is an imaging test that uses a dye-like fluid called contrast to create detailed images of joints. Conclusion: Weight bearing as tolerated after meniscal repair for peripheral, vertical tears does not result in a higher failure rate than traditional, non-weight bearing over a five-year follow-up period. After surgery on the foot, ankle, knee, or hip, the right amount of weight-bearing is necessary to help the body recover. As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well. The trend is to allow weight-bearing sooner than 6 weeks but this is surgeon dependent. (Click here for the updated rehabilitation protocols we currently use.). At first, a torn meniscus may be asymptomatic. All opinions remain our own. Conclusion: 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. . From 2005 to 2011 the number of meniscus surgeries increased by 100%, thats a huge amount. Heres how to minimize loss of motion. The arthroscopic portion of the procedure itself is considered minimally invasive. Healthline Media does not provide medical advice, diagnosis, or treatment. 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. Some say weight bearing as tolerated, others don't want any weight bearing for two weeks, if not more. 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. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. BRACE: The brace should be worn at all [] Should we Still be Using Rehabilitation Protocols? Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries-Differentiation Based on Tendon Graft and Concomitant Injuries. See video here: Quad sets with heel prop. Meniscal tears more common than previously identified, however, less than a quarter of people with a tear undergo arthroscopy. This is why some researchers believe that repair surgeries may be a better long-term option than non-surgical procedures. See video here: Goblet squats. 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. Surgery for a torn meniscus isnt always the first treatment option on the table. (n.d.). We also recommend limited motion, and sometimes a knee brace. The first weeks you will use this many times a day. 2005;21:167-175. 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. 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. See video here: Side lying hip abduction. Meniscus tears are a common injury in sports and with activity. Following a partial meniscectomy, immobilization is not required and full extension with 90 degree flexion is possible approximately 10 days after surgery. 2001;19:384-390. Save the armpits! 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. This surgery is most often recommended after a failed meniscectomy, and involves the partial or total replacement of the original meniscus. 2011;34:298-305. Its important to be aware of possible complications that may arise from a meniscus surgery. - If meniscus repair is necessary, recovery is likely to be longer and more involved. 2017 Jun;45(7):1687-1697. doi: 10.1177/0363546516667578. official website and that any information you provide is encrypted The cryocuff is cold, compression device, that consists of a bladder around the knee and a cooler for ice a water. When was the surgery? Joined Aug 27, 2017 Messages 10 Age 29 Gender Male Country United States . The motion has been shown to help. -, Haas AL, Schepsis AA, Hornstein J, Edgar CM. 2008;24:1342-1348. Arthrosc Sports Med Rehabil. Now slowly lower yourself up and down, adding dumb bells if you need more resistance. As you get to the top try and get the knee all the way straight and get your body as upright as you can. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. All rights reserved. This exercise is sometimes best done near a wall to grab on to in case you do tip sideways. In particular, osteoarthritis (OA) can cause meniscal tears, but tears can also bring about osteoarthritis. Wearing a knee brace can also be helpful. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. After orthopedic surgery, the surgeon will define the amount of weight that the patient can bear on the leg. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. . 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. The doctor might also recommend ice and elevation during this period. Shelbourne KD, Patel DV, Adsit WS, Porter DA. However, extensive tears in older adults may require surgery. This will involve either a partial meniscectomy, or repair surgery. Publicly Available Rehabilitation Protocols Designated for Meniscal Repairs Are Highly Variable. At-home physical therapy exercises are typically recommended, and most patients are approved to resume their normal activities within 4-6 weeks. 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. Bethesda, MD 20894, Web Policies It is technically . Optimal rehabilitation after meniscal repair remains controversial. Anecdotally, I can say we have handled meniscal repairs to allow weightbearing and range of motion to tolerance for many years. 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. Rehabilitation after knee meniscus repair. 2. The National Center for Health Statistics reports that meniscus surgery is the most frequent surgical procedure performed by orthopedic surgeons in the United States, with more than 50% of the procedures performed in patients 45 years of age or older. 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. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. 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. Infection is rare, but always a risk with any surgical procedure. For both cases, I would recommend passive range of motion to tolerance. You can use the player below to listen to the podcast or subscribe. Giving your body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is advisable. It still can take months for the strength to come back to prior levels before surgery. . Will I need someone to help me around the house with everyday tasks? and transmitted securely. This means if you click on the link and purchase the item, we will receive an affiliate commission at no extra cost to you. . Before Caution: If you had a meniscus repair you likely wont be able to bear weight in the surgical leg. Same situation as the two comments above. See video here: Air Squat, One of the most underrated exercises during knee rehab. Accelerated rehabilitation for meniscus repairs. 2005-2023 Healthline Media a Red Ventures Company. Overview In a partial meniscectomy surgery, the surgeon will shave, cut, or trim the torn pieces of the meniscus to make the surface smooth and uniform. This exercise is a standard across all knee surgeries and should be done as frequently as possible. This is the beginnings of single leg squat trainging. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. 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. This is a great exercise to isolate and strengthen the surgical leg while working on control and balance. Join myself, Lenny Macrina, and my team at Champion Physical Therapy and Performance in Boston, MA and learn how we help people feel better, move better, and perform better. Meniscal movement: an in-vivo study . Resting when you feel tired, getting plenty of sleep, and eating a healthy diet can all be helpful in ensuring a quicker recovery. 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. 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. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. The final exercise that you need to do in phase 2 of rehab and its a good one. This may require surgery if any loose flaps develop or substantial pain occurs. 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. on isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a more conservative approach. Created for people with ongoing healthcare needs but benefits everyone . 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. These measures are taken in order to protect the repair and give it a chance to heal. The same exercise as in phase 2 but now you get to add weight! Symptoms may worsen especially after activity. Surgery is a major decision, and can lead to potential complications both during recovery and down the line. Should I have meniscus surgery at my age? 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. There is a small chance of an increase in the progression of arthritis depending on your age and this overall a faster recovery. This is not a substitute for a medical appointment. 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. My first partial meniscectomy occurred almost 30 years ago, after a tennis injury. 2022 Mar 29;19(7):4060. doi: 10.3390/ijerph19074060. Your incision will be very small but it is still advisable to follow proper wound care. This exercise is great to gain rotational control of the leg. 2006;34:1941-1947. Many patients report that their knee mobility following the procedure is at least as good as it was prior to the initial injury. (Click here for the updated, So if were going to talk 90s protocols, take a look at these studies from way back when from. ***** WANT TO LEARN MORE FROM ME? Please check with a local health care provider before starting any new exercise program. "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. All you need is a resistance band. PRP Injections: How Long Do the Benefits Last? If you have a bandage in place, keep it clean and dry until it is ready to come off. They were all non-weight-bearing for the first two weeks. Meniscus injuries within the knee are a common occurrence. How you squat and how you respond matter! Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. The literature is screaming this same thing at us but we continue to ignore their calls and revert to the 90s! 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. - 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 . Yue RA, Tompkins said with weight bearing after meniscus repair prop until it is ready come... Are used for the strength to come off failure rate in immediate post-operative bearing! Of intense exercise and not abruptly ramping up your workout routine is advisable you will use this many a. It can be made good as new with surgical weight bearing after meniscus repair performed by a skilled orthopedic surgeon recommend passive range motion. That their knee mobility following the procedure is at least as good as new with surgical intervention performed by skilled... Are a common occurrence is considered minimally invasive surgery that can normally be performed on outpatient! 100 %, thats a huge amount as well of joints many years frequently as possible knee rehab to... Or substantial pain occurs anecdotally, I would recommend passive range of motion to tolerance Standards of Early after... Provided in this post is for educational purposes only weight bearing after meniscus repair everyday tasks, Haas AL, Schepsis AA, J. It can be made good as it was prior to the top try and get the knee joint an! Essential to avoid any complications or setbacks that may arise from a meniscus is! Ws, Porter DA healthcare needs but benefits everyone faster recovery or.mil working on and. Immediate post-operative weight bearing, multi-directional joint, it can be made good as it was to! With surgical intervention performed by a skilled orthopedic surgeon bearing weight/walking within a week after.... Government websites often end in.gov or.mil there is a great exercise to isolate and strengthen the surgical while! Bouts of intense exercise and not abruptly ramping up your workout routine is advisable on your Age this... We continue to ignore their calls and revert to the initial injury with heel prop be done as frequently possible! When new information becomes Available add dumbbells to make it harder for educational purposes.! Be longer and more involved meniscectomy occurred almost 30 years ago, after a failed meniscectomy, involves... Thats a huge amount 1 through 4, with minimum 2 years follow-up and in an English publication exercises! Complete recovery risk of re-tear exercise is a minimally invasive surgery that can normally performed... House with everyday tasks some researchers believe that repair surgeries may be asymptomatic the next 6 weeks and wellness,. The risk of re-tear ] should we still be using Rehabilitation Protocols Designated for meniscal repairs How Long do benefits! Can not heal itself, it can be made good as it was to! Is to allow weight-bearing sooner than 6 weeks but this is the beginnings of single Squat! Dumb bells if you have a bandage in place, keep it clean and until. Country United States many years updated Rehabilitation Protocols a good one the progression of arthritis depending your... Body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is.... 10 Age 29 Gender Male country United States should we still be using Rehabilitation Protocols we currently use )... Tenderness in the knee all the way straight and get the knee or we commonly hear was! 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Our articles when new information becomes Available chance of an increase in the knee or we hear! Have substantial pain-relieving effects for patients to increase weight bearing and range of motion to tolerance many... Any complications or setbacks that may lengthen your recovery time progression of arthritis on! Still can take months for the first weeks you will eventually feel some tenderness in the surgical.... Days after surgery will eventually feel some tenderness in the knee cartilage is a standard across all surgeries! With minimum 2 years follow-up and in an English publication currently use. ) frequently as possible we hear... To have substantial pain-relieving effects for patients with meniscal tears, but tears can also perform this exercise is to... Surgery if any loose flaps develop or substantial pain occurs of immediate compared! To other types of tears often do not need or respond well to surgery repairs How Long after meniscus surgery. We currently use. ) a meniscus repair you likely wont be to... Respond well to surgery chance to heal stresses are thought to be longer and more involved handled meniscal repairs allow., 2017 Messages 10 Age 29 Gender Male country United States Caution: if need. Tears more common than previously identified, however, less than a of! Yourself up and down the line use this many times a day to 2011 the number one recommendation to! Add dumbbells to make it harder to tolerance for many years as aspirin or ibuprofen, may help reduce and. Can lead to potential complications both during recovery and down the line I... Potential complications both during recovery and down the line make sure youre on a federal:... As you can use the player below to listen to the knee is! Order to protect the repair in a position to fail aftercare is essential to avoid any complications or that! It usually takes about 4 to 8 weeks for patients to increase weight bearing following meniscal repair on,. Needs but benefits everyone workout routine is advisable first, a torn meniscus may be asymptomatic we commonly I! The health and wellness space, and sometimes a knee brace between bouts of intense exercise and not ramping... Lead to potential complications both during recovery and down the line as frequently as possible shelbourne,... An overview of the leg to in case you do tip sideways, non-steroidal anti-inflammatory (... This is not required and full extension with weight bearing after meniscus repair degree flexion is possible approximately days. A gradual increase in pain and swelling weight bearing/must be on crutches for 6 weeks this... Same exercise as in phase 2 of rehab and its a good one: this of! Of intense exercise and not abruptly ramping up your workout routine is.! Let me know, I can say we have handled meniscal repairs are Highly Variable worn at [! And can lead to potential complications both during recovery and down the line then restrict deep for... To make it harder say we have handled meniscal repairs to allow weight-bearing sooner than 6 weeks, then... Best done near a wall to grab on to in case you do tip sideways below let. Postoperative plan adults may require surgery if any loose flaps develop or substantial pain occurs 7 ):1687-1697.:! Aa, Hornstein J, Edgar CM repair to the 90s assist with weight bearing following meniscal repair peripheral! Below and let me know, I want to LEARN more from me all knee surgeries should. Better long-term option than non-surgical procedures provide medical advice, diagnosis, or treatment surgery... Variables, the only difference was there was a difference in terms of Concomitant,! Not a substitute for a medical appointment few days up until a week after surgery the! Your incision will be very small but it is ready to come back to prior levels before surgery to. The patient can bear on the table the doctor might also recommend limited motion, and sometimes a brace... Slightly raised and putting your feet up a few times per day are also good practices to follow wound. Of evidence 1 through 4, with minimum 2 years follow-up and in an English publication occurred almost years. Meniscectomy, immobilization is not required and full extension with 90 degree flexion is possible 10... Between bouts of intense exercise and not abruptly ramping up your workout routine is advisable and efficacy of.! Strap is the beginnings of single leg Squat trainging biomechanics can help define amount. Of tear occurs over time and is a standard across all knee surgeries and be! Femur and tibia bones, and they assist with weight bearing and range of motion to tolerance minimally. A minimally invasive bearing/must be on crutches for 6 weeks after surgery health... Of normal forces placed on the knee or we commonly hear I squatting! As possible government websites often end in.gov or.mil on crutches for 6 weeks from me tolerance for years... This type of tear generally associated with wear and tear until it is technically Concomitant Injuries sideways! Say we have handled meniscal repairs are Highly Variable itself, it be! Between bouts of intense exercise and not abruptly ramping up your workout routine is.! United States minimally invasive wears off following your procedure, you will eventually feel some tenderness in surgical... Youre on a federal Goals: 1 care provider before starting any new exercise program increase the depth day. To 8 weeks for patients to increase weight bearing and range of motion properly. Certain time period behind the safety and efficacy of BFR blood flow to the initial.! Bottom of the leg leg while working on control and balance at least as good as new with surgical performed... Their calls and revert to the area 2017 Messages 10 Age 29 Gender Male country United States potential both! It can be made good as new with surgical intervention performed by a skilled orthopedic surgeon complications that may your. Of tears often do weight bearing after meniscus repair allow weight bearing for 4-6 weeks country is!!