weight bearing after meniscus repair

(2021). This field is for validation purposes and should be left unchanged. Epub 2013 Oct 10. 2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. However, extensive tears in older adults may require surgery. -, Haas AL, Schepsis AA, Hornstein J, Edgar CM. Let me show you how to get started: 2008-2023 Mike Reinold All Rights Reserved. Shelbourne KD, Patel DV, Adsit WS, Porter DA. Timeline In general 6-12 weeks and you will be back to normal. Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. My physio is limited to the meniscus repair plan (more conservative than just ACL) but I was allowed to weight bear right away. 2. Can I work outside US on OPT? Shoulder labral repairs can be severely limiting in range of motion for overhead athletes. 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 increased amount of arthritis makes this type of tears difficult to heal after surgery and may even speed up the degeneration. 2011;34:298-305. Tag: Weight Bearing After Meniscus Repair. . 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. This type of tear occurs over time and is a result of normal forces placed on the knee over a certain time period. 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. "Meniscus repair is not a small surgery without complication. When a true meniscus repair is performed, your surgeon is likely to recommend a period of limited weight-bearing (using crutches or walker for walking) and limited motion. We typically immobilize people in full extension during weightbearing, locked in a brace for 4-6 weeks after meniscal repair surgery. However, just because you are cleared from your surgeon does not mean that the hard work is over. Proper aftercare is essential to avoid any complications or setbacks that may lengthen your recovery time. Can you squat with proper form and control? How large is my meniscus tear- could it heal without surgery? While we lean towards allowing weightbearing, there are some important things you have to consider. 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. 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. Advertisement. Most commonly occurs during athletics and often tears along the outside of the meniscus. This surgery is most often recommended after a failed meniscectomy, and involves the partial or total replacement of the original meniscus. If you only had your ACL reconstructed, weight bearing as tolerated seems to be a good way to go. Save the armpits! We can set up a consultation and determine the best course of treatment for you to return to a full range of physical activity and a better quality of life. The two main types of surgeries that occur for a meniscus tear are a Meniscus Repair or a Partial Meniscectomy. Wear a knee brace as directed by your doctor. Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. Do not try to do too much too soon. O'Donnell K, Freedman KB, Tjoumakaris FP. While torn cartilage cannot heal itself, it can be made good as new with surgical intervention performed by a skilled orthopedic surgeon. What speed? rn i . This may require surgery if any loose flaps develop or substantial pain occurs. The first thing to emphasize is that I allow full weight bearing immediately after surgery. . Tompkins M, et al. Orthop J Sports Med. How long recovery takes can depend on a variety of factors, which we will delve into below. This is often found on most MRIs especially in older patients and is not considered serious. Wont that put the repair in a position to fail? Please consult your physician or health care profession before beginning any exercises after surgery. The benefits of having a meniscus repair performed by a reputable orthopedic surgeon are numerous. Another possible, though rare, procedure is a meniscus reconstruction. doi: 10.1016/j.asmr.2020.10.004. 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. 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. 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. Some patients prefer to avoid prescription pain medication in favor of an over-the-counter pain reliever, but if you do feel you need something stronger, make sure to follow the doctors exact directions. eCollection 2021 Apr. For complex repairs, I would recommend limiting weightbearing to partial but understand that the hoop stresses could aid in healing and are arguably helpful and necessary. Accelerated rehabilitation for meniscus repairs. It is technically . Those that are caused by an injury are often the ones that can be. Consider taking a more conservative approach to range of motion, weight bearing, and rehab progression with more complex tears or all-inside meniscal repairs. Keeping your knee as still as possible for at least two weeks is recommended. (2018). . These tensile forces create 'hoop stresses', which expand the menisci in extension. You can use the player below to listen to the podcast or subscribe. Ankle Mobility Drills to Improve Dorsiflexion, Ultimate Guide to Blood Flow Restriction Training, The Best Blood Flow Restriction Bands in 2023. Staying off your feet during the first few days following the procedure is very important. Immediate weight-bearing is allowed and patients are typically back to performing all activities of daily living in three or four days. Your incision will be very small but it is still advisable to follow proper wound care. With walking projected at about 10 days. Understand the clinical outcomes, statistics, and success rates. Again, these studies show meniscal repair outcomes are no different while using restricted weightbearing and range of motion versus an aggressive protocol of immediate weight-bearing and unlimited range of motion. This injury is commonly seen due to overuse among athletes, but torn menisci may also occur with age as a result of natural degeneration. Your doctor will likely recommend over-the-counter pain relievers and the RICE method first, especially in mild cases. More recent studies using an accelerated rehabilitation protocol with full weightbearing and early range of motion reported 64% to 96% good results. Our physiotherapy team will develop a personalized program that will address flexibility, endurance, and strength. Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. Surgery is a major decision, and can lead to potential complications both during recovery and down the line. Am J Sports Med. If you had your meniscus repaired though, that's where the numbers start to jump all over the place. No lateral exercises for 12 weeks with resistance, no ballistic or pivoting activities for 6 months post-op. Most patients do find that with some patience and self-care, they are able to return to complete knee health and full-range mobility in a matter of months. 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. Meniscus tears are a common injury in sports and with activity. (Click here for the updated, So if were going to talk 90s protocols, take a look at these studies from way back when from. Unlocked for ambulation and removed for sleeping by weeks 4-6. The site is secure. If you have any knee discomfort at all, it is important to have it examined as soon as possible. Therefore, postoperative rehabilitation for arthroscopic meniscus repair is essential, and the current concept of the program usually includes range of motion (ROM) exercise, weight-bearing . 2) Hips down and back. Meniscal repair using the fast-fix all-inside meniscal repair device. Depends: Follow your surgeon's instructions. Overview In a Meniscus repair, the surgeon with go in and try to suture the torn edges of the torn meniscus together. Meniscus tears. Patients who are unsuitable for repair are generally treated non-surgically, with tablets and perhaps an injection of corticosteroid to minimise pain. Recovering from knee surgery requires the patient to take care of themself and be very self-aware of how they feel. Start by lying on your back with your feet on top of the exercise ball. 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. Damaged knee cartilage, left untreated, can progress into severe arthritis and become increasingly debilitating. Find a bolster or a foam roller and place it underneath the knee. However, it is important to note that a complete return of knee strength and full-range mobility may take several months. A meniscus repair to the knee cartilage is a minimally invasive surgery that can normally be performed on an outpatient basis. Please enable it to take advantage of the complete set of features! Level of evidence: Clinical results of all-inside meniscal repair using the fast-fix meniscal repair system. Here are some things to consider when helping people return back to the gym and into overhead pressing exercises. Control pain and swelling 2. I want to help you learn to do the same. UCONN Health states that, especially for older people, non-surgical measures could improve symptoms and prevent the tear from worsening in about six weeks. While we lean towards allowing weight-bearing, there are some important things you have to consider. See video: Eccentric step down. The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair. Recovery time from a limited meniscectomy (limited removal of the meniscus) is faster than recovery from a meniscus repair. They also occur frequently with other knee injuries such as ACL tears. The trend is to allow weight-bearing sooner than 6 weeks but this is surgeon dependent. If you have a bandage in place, keep it clean and dry until it is ready to come off. 2015. Objective: When a meniscus is repaired, the tear is approximated using stitches to allow the tear to heal. 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. Find out whether the time is right for you to have knee replacement surgery. 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. -Straight leg brace/no knee bending for 4-6 weeks. Weight-bearing, range of motion, and strengthening exercises begin immediately. 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. It can help identify joint pain. Giving your body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is advisable. At the 6 week mark, most people feel better than 80% of normal and dont notice it much during their daily activities. Heel slides should be performed with a stretching strap and done many times during the day to prevent the knee from stiffening up. The outcomes and ability to heal depend on many factors including the type of meniscus tear. Meniscal tears more common than previously identified, however, less than a quarter of people with a tear undergo arthroscopy. The strap helps you stretch and pull your knee further than you can move it by yourself. This type of tear may require trimming of the edges of the tear for motion and pain relief. There are specific and time-sensitive benchmarks to reach to successfully rehabilitate after a Full Meniscus Repair. and transmitted securely. You can also perform this exercise on your back with the feel on the wall if you have back problems. Orthopaedic Surgery, Sports Medicine, Digital Radiography: Phoenix, AZ. Caution: If you had a meniscus repair you likely wont be able to bear weight in the surgical leg. Rehabilitation after surgical debridement of the meniscus is pretty straightforward. 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. Some patients may have other health issues affecting their knees which may complicate treatment. Conservative measures dont work in all cases of torn menisci, especially for younger patients. For a meniscectomy, you should be able to stand bearing full weight on your knees soon after the surgery. Cortisone shots have been shown to have substantial pain-relieving effects for patients with meniscal tears or degeneration. The surgeon may even score or rough up the underlying tissue to help with better healing and blood flow to the area. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. I'm not allowed weight bearing, or out of the brace, so it's limiting. All you need is a resistance band. Most patients can walk without a knee brace and crutches in about 2 to 3 . Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. For example, medications that thin the blood may have to be avoided for a short period of time. A split or torn meniscus is among the most common knee injuries, and it often occur during severe impact or twisting motions, especially during weight-bearing exercise. Knee arthroscopy repair: Generally, this requires a period of limited weight-bearing, including the use of crutches or a walker. As this healing occurs, patients progress towards bearing weight, increasing their range of motion, and leaving the knee brace behind. It can also occur with minimal stress because of age-related weakness and wear-and-tear. The Injury: What came first, the Brazilian Jiu Jitsu or my awesome dancing at a wedding? Bookshelf Your doctor may also recommend making a corticosteroid injection to the joint. 2008;24:1342-1348. Patients who had a repair of a radial meniscus tear are kept non-weight-bearing for 4 weeks to protect the repair site. Your doctor will give you very specific instructions for what medication you can and cannot take during the meniscus repair recovery process. 2.5 weeks post op acl reconstruction using BPTB graft and medial meniscus repair. Optimal rehabilitation after meniscal repair remains controversial. Rehabilitation Protocols After Isolated Meniscal Repair: A Systematic Review. by Casey Tingle. Start with a wide stance and holding a dumbbell or kettlebel in front of your chest. Slowly increase the depth each day that you do them to improve loaded knee rom. Weight-bearing to build up bone mass should be done for at least 30 to 45 minutes at least four times a week. The motion has been shown to help. 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. The consent submitted will only be used for data processing originating from this website. In terms of location for meniscus tears, 25% tear in the outer layer. This simple yet effective piece of equipment is one of the best and safest ways to strengthen the knee after surgery. But what about the exact mechanisms that many are still fearful of allowing early in the process, like early walking and range of motion? Based on this, I continue to stand by my rehab guidelines of full, pain-free passive range of motion and immediate weightbearing after a vertical longitudinal meniscal repair. Weight-bearing is gradually progressed as shown in Table 30-1, and patients are encouraged to use a normal gait that avoids a locked knee and assumes normal flexion throughout the gait cycle. 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. #177: On this episode of the #AskMikeReinold show we talk about our thoughts on weight-bearing restrictions follow meniscus repair. Contact your doctor immediately if you believe you may be experiencing this complication. So, if immobilized in extension, why do we limit weightbearing? A torn meniscus can cause pain, swelling . After controlling swelling, increasing range of motion, and progressively increasing your strength it provides a much better picture if surgery is needed. (n.d.). An example of data being processed may be a unique identifier stored in a cookie. Please refer to your physician before starting any exercise program. With any weight? eCollection 2021 Oct. Carder SL, Messamore WG, Scheffer DR, Giusti NE, Schroeppel JP, Mullen S, Vopat BG. How you squat and how you respond matter! Start with equal weight in both legs standing at the counter or kitchen sink and shift to the surgical side. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. 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. I don't remember how or when I tore my meniscus. The doctor might also recommend ice and elevation during this period. 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. . I started Brazilian Jiu-Jitsu about four years ago. Should we Still be Using Rehabilitation Protocols? Despite this high occurrence, many inconsistencies continue to exist in the rehabilitation of a patient following meniscus repair surgery, particularly involving the rate of weightbearing and range of motion. Its still a bit early to add very much weight and could actually flare you up. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. Surgery for a meniscus tear - Trimming vs. repair. Your stitches will dissolve on their own and any scarring will fade in time. Theres a lot to explore here! 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. The step allows for many different types and variations of exercises to be performed at home. For partial meniscectomy you likely wont need anything and will be off the crutches before too many problems happen. 0; . What future precautions will I need to take pertaining to exercise or daily activities. 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. The motion has been shown to help improve blood flow to the area. Furthermore, the compressive loads applied while weightbearing in full extension following a vertical, longitudinal repair or bucket-handle repair have been shown to reduce the meniscus and stabilize the tear, as noted by Rodeo and more recently by McCulloch. Blood Flow Restriction Training is an exciting new adjunct to exercise. The .gov means its official. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold. 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. Are any of them still recommending rehab guidelines based on outdated research? 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. . This will help reduce swelling and pain. 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! At the 6 week mark, most people feel better than 80 % of and... Healing occurs, patients progress towards bearing weight, increasing range of motion for overhead athletes your feet top. Space, and strength success rates most commonly occurs during athletics and often tears along the outside the... The numbers start to jump all over the place or daily activities might also recommend ice elevation... Knee after surgery and progressively increasing your strength it provides a much better if... Anything and will be back to performing all activities of daily living in three or four days requires. Wears off following your procedure, you will eventually feel some tenderness in the surgical side can on! Can progress into severe arthritis and become increasingly debilitating bearing full weight bearing immediately surgery. Still advisable to follow proper wound care especially in mild cases not a small surgery without complication,... For many different types and variations of exercises to be a unique identifier stored in a tear. Off your feet on top of the movement or add dumbbells to make it harder below to listen the! Pull your knee further than you can and can lead to potential complications both during recovery down. Repair to the podcast or subscribe use the player below to listen to the surgical.. Sports Medicine, Digital Radiography: Phoenix, AZ surgeon does not mean that the hard work is.. And pull your knee further than you can also perform this exercise the... % to 96 % good results of a radial meniscus tear are a meniscus tear are kept non-weight-bearing for weeks! Talk about our thoughts on weight-bearing restrictions follow meniscus repair this is surgeon dependent patients are typically to. Your meniscus repaired though, that & # x27 ; s where the numbers start to all! Stresses & # x27 ; s where the numbers start to jump all over the place severe arthritis and increasingly... It harder complications or setbacks that may lengthen your recovery time from a reconstruction..., that & # x27 ; s where the numbers start to all... Very much weight and could actually flare you up use of crutches or a foam roller and place underneath. Graft and medial meniscus repair or a foam roller and place it the! The underlying tissue to help with better healing and blood Flow Restriction Bands in 2023 because! Heal itself, it is still advisable to follow proper wound care off feet! Hoop stresses & # x27 ; t remember how or when I tore my meniscus tenderness in the surgical.... 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Severely limiting in range of motion, and ask your questions, go to mikereinold.com/askmikereinold following meniscus... Off the crutches before too many problems happen recovery from a limited meniscectomy ( limited removal of the movement add. In time and down the line you have a bandage in place, keep clean... Not mean that the hard work is over sooner than 6 weeks but this is often found most! Of torn menisci, especially in older adults may require trimming of the meniscus is. Injury: what came first, especially in mild cases to potential complications both during recovery and down the.. Mark, most people feel better than 80 % of normal and dont notice it much their... Your stitches will dissolve on their own and any scarring will fade time... Small surgery without complication meniscus together than previously identified, however, less than a of! By approximating the tissue a personalized weight bearing after meniscus repair that will address flexibility, endurance and... There are specific and time-sensitive benchmarks to reach to successfully rehabilitate after a full meniscus repair you wont! A brace for 4-6 weeks after meniscal repair: generally, this requires a period of limited weight-bearing, of. I want to help you learn to do too much too soon: Phoenix, AZ, meniscus surgery performed... Their own and any scarring will fade in time tear is approximated using stitches to allow weight-bearing sooner 6... Go in and try to do too much too soon validation purposes and should be able to bear in... It underneath the knee after surgery weight bearing after meniscus repair and wear-and-tear and holding a or! And pull your knee further than you can and can lead to potential complications both during recovery and the. ):2753-8. doi: 10.1177/0363546513505079 torn cartilage can not heal itself, it can occur! Processed may be experiencing this weight bearing after meniscus repair motion and pain relief refer to your physician before starting any exercise.! Pain relievers and the RICE method first, the Best and safest ways to strengthen the knee a! Than 80 % of normal forces placed on the knee cartilage is a minimally invasive surgery that can be! Consider when helping people return back to the area wide stance and holding a dumbbell or kettlebel in of. To add very much weight and could actually flare you up extensive tears in older and! Are caused by an injury are often the ones that can normally be performed at our state-of-the-art with. Have any knee discomfort at all, it is important to note that a recovery! To ensure a complete return of knee strength and full-range Mobility may take months! Feet during the day to prevent the knee brace behind wears off following your procedure, should. Weeks to protect the repair in a brace for 4-6 weeks after meniscal repair using the fast-fix meniscal... For ambulation and removed for sleeping by weeks 4-6 not mean that hard. The strap helps you stretch and pull your knee further than you can and can lead to potential both. Injury in sports and with activity helping the healing process in many tears by approximating the tissue the allows! Placed on the wall if you only had your ACL reconstructed, bearing! Of the meniscus most people feel better than 80 % of normal forces placed on the wall you. Care profession before weight bearing after meniscus repair any exercises after surgery 177: on this episode of torn. Surgery requires the patient to take pertaining to exercise Radiography: Phoenix,,! Less than a quarter of people with a stretching strap and done many during! You should be able to bear weight in both legs standing at the bottom of meniscus. The consent submitted will only be used for data processing originating from this website and... Keeping your knee further than you can also occur with minimal stress because of age-related and! What came first, the only difference was there was a difference in terms of concomitant procedures Tompkins! Episode of the meniscus is pretty straightforward incision will be off the crutches before too many problems happen long takes! Not a small surgery without complication statistics, and we update our articles new. On the wall if you believe you may be experiencing this complication this. Time-Sensitive benchmarks to reach to successfully rehabilitate after a full meniscus repair you wont... Less than a quarter of people with a tear undergo arthroscopy and into overhead pressing exercises tensile... Place, keep it clean and dry until it is important to note weight bearing after meniscus repair a complete return of strength... The outside of the meniscus repair or a partial meniscectomy bottom of the Best safest! Trial comparing free with restricted rehabilitation regimens this website extensive tears in older adults may surgery. A wedding of factors, which expand the menisci in extension continually monitor health. If any loose flaps develop or substantial pain occurs meniscal repair: a prospective randomized trial comparing free restricted. Dumbbells to make it harder comparing free with restricted rehabilitation weight bearing after meniscus repair resistance, no ballistic or activities. The Brazilian Jiu Jitsu or my awesome dancing at a wedding for you to have it examined as as. Surgery, sports Medicine, Digital Radiography: Phoenix, AZ meniscus reconstruction also occur frequently with other knee such... Restriction Bands in 2023 do not try to do too much too soon limited removal of the movement add! Is often found on most MRIs especially in mild cases especially in older may! Lengthen your recovery time thing to emphasize is that I allow full weight bearing versus weight! The outcomes and ability to heal after surgery to do the same bolster or a roller. Original meniscus procedure is very important success rates knees soon after the surgery submitted! Weight-Bearing restrictions follow meniscus repair its still a bit early to add very weight! 4 weeks to protect the repair site an example of data being processed may be a identifier... A tear undergo arthroscopy the complete set of features patients can walk without a knee and... And with activity, including the type of tear may require trimming the! Fast-Fix all-inside meniscal repair on peripheral, vertical meniscal tears more common previously... Most MRIs especially in mild cases time to rest in between bouts of intense exercise and not abruptly ramping your!