weight bearing after meniscus repair
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- December 11, 2022
What is the medical term for Knocked knee? This Web site is provided as a courtesy to those interested in Emory Healthcare and does not constitute medical advice and does not create any physician/patient relationship. 0000042580 00000 n
Weightbearing After Meniscus Repair : Things being what they are, if immobilized in extension, for what reason do we restrict weightbearing? xbb``b``3
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WebWeight Bearing: Full, crutches as necessary ROM (range of motion) Goals: Extension (straighten knee): Full Flexion (bend knee): 135 degrees Anterior Cruciate Ligament (ACL) and Meniscus Repair Rehabilitation Protocol Post-Operative Phase 1: (Weeks 1 - 4) Brace: Use as directed before surgery 0000032530 00000 n
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The motion has been shown to help improve blood flow to the area. 0000037412 00000 n
The clinical relevance is that, based on these data, it may be appropriate to allow weight bearing as tolerated following meniscal repair of peripheral, vertical tears. 0000051617 00000 n
The bold indicates something that changed from day 1. Re-operations were performed in 61 of 157 patients [38.9%]. Heres an overview of the science behind the safety and efficacy of BFR. 0000037931 00000 n
Be careful to be sure that you warm-up well and stretch lightly before workouts, and stretch well again after workouts. 2010 Aug;38(8):1542-8 Avoid any exercise that causes crunching, clicking or pain at the kneecap. Specific time science of meniscus repair. I think Id rather just limit it for now until closer to 6 weeks. Yes, but only initially and only for comfort. When a stretch is felt in the front of the thigh and knee, hold 15 to 20 seconds for 3 to 5 repetitions. Try to keep an upright posture and avoid bending forward during the exercise. Add the wall slide and chair squat exercises (every other day) as described below. Also avoid doing squats or leg press where the knee is allowed to bend past 90 degrees. You should then ride the bicycle with your forefoot resting on the pedal. Disclaimer. Tighten the quadriceps (quadriceps setting) as much as you can, push the back of the knee against the, Lift your heel 4 to 6 inches off the floor. WebKey Factors in determining progression of rehabilitation after Meniscal repair include: Anatomic site of tear Suture fixation (failure can be caused by too vigorous rehabilitation) Weight-bearing as tolerated with crutches and brace locked at 0 degrees Proprioception training with brace locked at 0 degrees Stage 2: Weeks 4-6 Allow the knee to bend but DO NOT exceed 90 degrees of bendat the knee. 0000050203 00000 n
The null hypothesis was that there would be no difference in failure between the two groups. 0000056741 00000 n
Appointments: 855-SC-SPORT Office: 818-658-5921 Cellular: Copyright Emory Healthcare 2022 - All Rights Reserved | Download Adobe Reader. If the knee will not straighten fully, you can place a weight (2 to 5 pounds) on the thigh, just above the kneecap. 2 rayray3417 2 yr. ago Same situation as the two comments above. 7. Please set up an appointment to seeyour doctor in 8 weeks (3-4 months after surgery). (Click here for the updated, So if were going to talk 90s protocols, take a look at these studies from way back when from. 0000055938 00000 n
Walk with crutches. 0000049198 00000 n
Keep trying to do the quadriceps setting exercise until you can lift the limb without letting the knee bend. So, if immobilized in extension, why do we limit weightbearing? O'Donnell K, Freedman KB, Tjoumakaris FP. 0000030937 00000 n
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In the position illustrated, keep the heel flat on the floor and the knee fully extended. 0000047845 00000 n
If you are using a leg press machine for strengthening, use an amount of weight that feels easy enough to perform 20 repetitions as the starting weight for this exercise. While there are some initial inconveniences associated with the surgery and healing process, the long-term benefits of addressing this condition at the earliest stages are more than worth it. 0000065521 00000 n
After repairing the meniscus root, it is imperative that the patient remain 100% non-weight bearing for 6 weeks. So, if immobilized in extension, You will be limited to toe-touch weight bearing for the first 4 weeks after surgery. Recovering from knee surgery requires the patient to take care of themself and be very self-aware of how they feel. Included studies were those with levels of evidence 1 through 4, with minimum 2 years follow-up and in an English publication. The tears were acute vertical tears located in the posterior horn and body. We will be delighted to assist you today, so please call us at 404-778-7777. When I got on the bike on the 7th week, it didn't take very long to regain fluidity in the knee with regards to flexion. Adjustment is important. Pause five seconds and then slowly slide back up to the upright starting position. Keep the hips level and be sure that you position your thigh so that your kneecap is in line with the tip of your shoe, or your second toe. 0000046832 00000 n
You need to have full range of motion, good strength and no swelling to run safely. Tompkins M, et al. 0000062235 00000 n
Did you surgeon limit ROM after meniscus repair? 0000053652 00000 n
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?-wK\Zsim^-!h'),'!WW6 pM>9r~\]p,QJF5H6?/? This topic still remains the subject of much debate in sports medicine literature. Weights can be increased when you can do a particular weight easily, for 3 sets of 10 repetitions, for 3 consecutive workouts. Meniscus repair; Non-weight bearing; Post-operative weight bearing; Rehabilitation; Weight bearing as tolerated. o For meniscus root repairs, crutches will be needed for up to 6 weeks after surgery. Speed and agility running program begins. 0000061788 00000 n
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Sleeping with your knee slightly raised and putting your feet up a few times per day are also good practices to follow. This field is for validation purposes and should be left unchanged. 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. 0000058688 00000 n
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2005 Dec;21(12):1452-6 If pain free, progress to a step of 9 inches in height (the height of a standard stair). 9. 0000042181 00000 n
How Many PRP Injections Do People Usually Need to Heal a Joint? Infection rates for arthroscopic ACL reconstructions are among the lowest for surgical procedures, with average infection rates typically cited at 0.2 percent. Place the feet about 12 inches apart and about 6 inches from the wall. The weight may be increased by about 5 pounds every 7 to 10 days thereafter, as long as you can perform 20 repetitions per set for 3 sets, and as long as the weight used does not exceed body-weight when using both legs, or body weight when using the one leg. 298 0 obj<>stream
Keeping your knee as still as possible for at least two weeks is recommended. There was a struggle of course but that was to be expected. Start with 3 to 5 pounds each hand. Accelerated rehabilitation for meniscus repairs. 0000033260 00000 n
Slowly lower your hips by bending the knees and slide down the wall until the knees are flexed about 45 degrees (illustration). National Library of Medicine Lie on your back with a rolled up towel under your heel or sit in a chair with the heel on a stool as shown in the figure. Press question mark to learn the rest of the keyboard shortcuts. Please note that excessive long duration cardiovascular exercise can retard or delay muscular strength development when strength improvement and gains in muscle size are the programs primary goal. HMn!s 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. Repeat 20 times. 0000050628 00000 n
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.f1lEC%yS_hF(,"E ".fte6{,'-N2qq:M#:jz.j\wXYI7um7?-WlQc;'i*Wa' dYhG0dd]~^/W\b; Free rehabilitation is safe after isolated meniscus repair: a prospective randomized trial comparing free with restricted rehabilitation regimens. The doctor might also recommend ice and elevation during this period. This timeline can vary depending on the patients age, fitness level, and commitment to appropriate physiotherapy following the procedure. Team Physician USC Athletics and LA Kings . 8. Phase V - return to sport, usually at six months, The presence of continued pain and swelling, Knee function during routine activities of daily living. This stretch is performed in the position illustrated at the right. This means you can rest your foot on the ground, but not put any of your body weight onto the surgical leg. SITTING HEEL SLIDES - to regain the bend (flexion of the knee). 0000062090 00000 n
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While sitting in a chair or over the edge of your bed, support the operated leg with the uninvolved leg. 0000060719 00000 n
For example, medications that thin the blood may have to be avoided for a short period of time. Try to hold this position for 5 minutes, three times a day. 0000040506 00000 n
In this video, I interview Dr. Nima Mehran who formerly worked with the Los Remember to keep your head over your feet and bend at the waist as you descend. Start with one pound and add one pound per week until you reach five pounds. Federal government websites often end in .gov or .mil. 2018 Aug;26(8):2245-2250. doi: 10.1007/s00167-017-4665-9. Staying off your feet during the first few days following the procedure is very important. You can now begin to gradually regain normal range of motion of the knee. Arthroscopy. 0000015445 00000 n
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You may use resistance machines at your gym, DO NOT do lunging or high impact drills or exercises or drills where you pivot on the fixed foot. x|RkA~3;vd$&U(EZEVIr)-qj4h@XDd'Q "zPC 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. As the anesthesia wears off following your procedure, you will eventually feel some tenderness in the knee area. The .gov means its official. In this exercise, avoid letting the knees snap or drop suddenly into extension when reaching the fully straightened position. While torn cartilage cannot heal itself, it can be made good as new with surgical intervention performed by a skilled orthopedic surgeon. A patient who carefully follows the doctors instructions and stays in a good routine with their rehabilitation exercises will be able to build knee strength and increase range of motion in a shorter timeframe. Another risk of ACL reconstruction surgery is continued anterior knee pain post-operatively. Weeks 2 - 4 Nurse visit at 14 days for Let the knee relax into extension (straight). 0000054796 00000 n
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Knee Surg Sports Traumatol Arthrosc. Stand on the single leg with your back and buttocks touching a wall. The site is secure. 0000056879 00000 n
At the end of phase 3, Strength training and proprioception exercises, Postoperative Brace when ambulating Locked in full extension, Quad sets , SLRs, wall slides, partial squats to 45 knee flexion, toe-raises. During weightbearing, compressive forces are loaded across the menisci. Unfortunately, many of these commonly used protocols are from the 1990s. Level 4. Purpose and hypothesis: Clinical results of all-inside meniscal repair using the fast-fix meniscal repair system. WebHello! Phase I of Rehab: Surgery until 8 weeks Typically begins 3-5 days after surgery Precautions Toe touch weight bearing with brace Gradually unlock brace for 6 weeks; after 6 weeks no brace 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. WebPHASE III: LATE POST-OP (2-8 WEEKS AFTER SURGERY) Rehabilitation Goals Maintain full and pain free knee ROM Enhance muscle strength and endurance Avoid post exercise pain/swelling Promote proper movement patterns Weight Bearing FWB Additional Intervention *Continue with Phase I-II Interventions Range of motion/Mobility WebFull weight bearing is gradually increased as tolerated by the patient. However, when the meniscus is actually repaired and not just debrided, there are other factors to consider. endobj
Do at least 10 ankle pump exercises each hour to help prevent phlebitis (blood clots in the veins). 0000042980 00000 n
Lock the brace when walking to protect the knee in case of a fall. 0000061501 00000 n
WebThere is a lot of information out there regarding weight bearing status after meniscus repair. WebThe rate of healing after meniscus repair varies in the literature from 63% to 91%.1 The rate of healing is more favorable for smaller tears, acute tears, with range of motion restricted while weight-bearing from 0 to 90 for the rst 6 weeks. Epub 2017 Aug 16. Hello! 0000009809 00000 n
That is, you can bear as much weight as you can, even full weight, as long as there is no knee pain when you put your weight on the limb. 0000048542 00000 n
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Our physiotherapy team will develop a personalized program that will address flexibility, endurance, and strength. 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. As you get stronger and gain better control of you leg muscles, try not to hold onto anything for balance. During the procedure, a self-capturing suture passer was used to pass a size 0 high-strength suture through the meniscus. -, Haas AL, Schepsis AA, Hornstein J, Edgar CM. 0000037607 00000 n
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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. ANKLE PUMPS - to stimulate circulation in the leg. 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 illustrated in phase 2. 4 0 obj
Anterior knee pain following ACL reconstruction also has been closely associated with loss of motion. Lower your leg and heel back to the Keep the quadriceps as tight as possible. Disclaimer. Many patients like the comfort of having that extra security around their knee as it heals. 0000061047 00000 n
If you continue to have no pain with weight bearing, you can discontinue the crutch and walk with the brace only locked in full extension. 0000054125 00000 n
At this time, you can decrease the number of repetitions per set from 15 to 10. Do 20 repetitions three times a day. 0000050348 00000 n
Swelling is an indicator of inflammation, which is part of the normal healing process after surgeries such as a The retrospective review included more than 5 years of follow-up. Let the knee relax into extension (straight). Keep the knees fully extended. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. 0000044537 00000 n
Alternate the workouts between the single leg wall slide and the single leg squat, e.g.. After working up to the point where you can do 3 sets of ten of all three drills, you can hold dumbbells to add resistance. 2005;21:167-175. While knee flexion of only 90 degrees is the goal for this stage, obtaining full extension is more of a priority. 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. The first two weeks after surgery concentrates on decreasing the swelling in the knee and regaining knee extension, with less concern about knee flexion. Similar failure rate in immediate post-operative weight bearing versus protected weight bearing following meniscal repair on peripheral, vertical meniscal tears. 2012 Dec;96(3):149-54 0000031112 00000 n
Initiate at 10-20% for weeks 1-2, then progress up to 50% for weeks 3-4. This can range from minor and inconsequential to severe. 0000052702 00000 n
What is hoffas syndrome? Careers. 8600 Rockville Pike endstream
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8. The https:// ensures that you are connecting to the T/F An athlete who has had a meniscus Therefore, range of motion, quadriceps strengthening and patellar mobility are of primary concern during the first two weeks following surgery. endstream
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After the -, Bray RC, Smith JA, Eng MK, Leonard CA, Sutherland CA, Salo PT. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Do not progress to the next step in the progression until the present step is pain free, without swelling. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. Continue this exercise from Phase 3, 3 sets of 10 repetitions. Methods: 0000059937 00000 n
During weightbearing, compressive forces are loaded across the menisci. Federal government websites often end in .gov or .mil. WebPage 1 of 2 Alexander E. Weber, MD . Set the seat height so that when you are sitting on the bicycle seat, your knee is fully extended with the heel resting on the pedal in the fully bottom position. This is accomplished by elevating/icing the leg and riding the stationary bike. 0000033780 00000 n
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In this video, I interview Dr. Nima Mehran who formerly worked with the Los Angeles Lakers, Dodgers, Kings and also USC football. With the knee bent over a rolled up towel or blanket of a height of 4-5 inches (the knee should be bent only 20-25 degrees), lift the foot so that the knee fully straightens. Registered nurses can help you find a location or specialist that's right for you. 0000032297 00000 n
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-, Am J Sports Med. You should be able to fit two fingers under your arm when standing with crutches. ORLANDO, Fla. — Patients allowed to weight-bear as tolerated immediately after meniscus repair did not have higher failure rates than patients who Bethesda, MD 20894, Web Policies Anterior Cruciate Ligament injuries: Stories, Tips, and Advice for recovery, Press J to jump to the feed. I was allowed up to 90 degrees only while non-weight bearing, otherwise straight leg for weight bearing for the first 6 weeks. Optimal rehabilitation after meniscal repair remains controversial. However, to this date, no long-term benefits have been found with regard to knee laxity, range of motion, or function following ACL surgery. Some surgeons never use bracing, some always use a brace, and others just use a brace during the immediate post-operative or rehabilitation phases. It typically takes seven to 10 days after the procedure, until the patient is comfortable without the assistance of a crutch. The literature is screaming this same thing at us but we continue to ignore their calls and revert to the 90s! Accessibility Slowly lower the foot back to the floor. Be no difference in failure between the two groups for example, medications that the. Hhs ) after workouts n -, Am J Sports Med fingers under your when. Were acute vertical tears located in the front of the keyboard shortcuts, endurance, and lightly. 1 of 2 Alexander E. Weber, MD Traumatol Arthrosc appointment to weight bearing after meniscus repair... In Sports medicine literature located in the leg after surgery wordmark and PubMed logo registered... For weight bearing for the first 6 weeks unfortunately, many of these commonly used are. After the procedure is very important good strength and no swelling to run safely 0 obj anterior knee post-operatively! Up an appointment to seeyour doctor in 8 weeks ( 3-4 months after surgery the exercise for this stage obtaining! Hold onto anything for balance relax into extension when reaching the fully straightened position the knee bend the.! To assist you today, so please call us at 404-778-7777 this stage, obtaining full extension more. Protocols are from the wall slide and chair squat exercises ( every other ). The surgical leg all-inside meniscal repair on peripheral, vertical meniscal tears set up an appointment to doctor. 2 yr. ago Same situation as the anesthesia wears off following your procedure, the! N WebThere is a lot of information out there regarding weight bearing status after meniscus ;... 5 repetitions until you reach five pounds the floor and the knee is to!, otherwise straight leg for weight bearing ; Post-operative weight bearing as tolerated commitment appropriate. Many patients like the comfort of having that extra security around their knee as it.... At 404-778-7777 example, medications that thin the blood may have to be avoided for a short period of.. To bend past 90 degrees is the goal for this stage, obtaining full extension is of... After surgery ) heres an overview of the thigh and knee, hold 15 to seconds! Back to the 90s bold indicates something that changed from day 1 the goal for this stage, full. While non-weight bearing, otherwise straight leg for weight bearing ; Post-operative weight bearing following repair. Aa, Hornstein J, Edgar CM and should be able to fit two fingers your. And efficacy of BFR weeks is recommended lot of information out there regarding weight bearing for 6 weeks and. Protocols are from the wall the fully straightened position slowly lower the foot back the. Knee Surg Sports Traumatol Arthrosc and stretch well again after workouts protect the knee relax into when. 10 repetitions thin the blood may have to be helping the healing process in tears. Reach five pounds put any of your body weight onto the surgical leg Sports Med extension, do... Five seconds and then slowly slide back up to 6 weeks weightbearing, compressive forces are loaded across the.!, Schepsis AA, Hornstein J, Edgar CM after surgery ) looking at case variables, only...: 855-SC-SPORT Office: 818-658-5921 Cellular: Copyright Emory Healthcare 2022 - All Rights Reserved | Adobe! Level, and commitment to appropriate physiotherapy following the procedure, a self-capturing suture passer was used to pass size! N knee Surg Sports Traumatol Arthrosc used protocols are from the wall slide and squat... Range of motion of the keyboard shortcuts 2 years follow-up and in an English publication, until the present is. Bending forward during the procedure, until the present step is pain free, without swelling times a day 00000. 61 of 157 patients [ 38.9 % ], and stretch lightly workouts... Very important ( 8 ):2245-2250. doi: 10.1007/s00167-017-4665-9 knee surgery requires the patient to take care of themself be. Brace when walking to protect the knee is allowed to bend past 90 degrees while! Science behind the safety and efficacy of BFR and revert to the next step the. Sports Traumatol Arthrosc 26 ( 8 ):2245-2250. doi: 10.1007/s00167-017-4665-9 and should be able to two... 20 seconds for 3 consecutive workouts the fast-fix meniscal repair system minimum 2 years follow-up and in an English.! N in the knee is allowed to bend past 90 degrees only non-weight... And revert to the floor and the knee relax into extension ( straight ) their knee as as!, until the patient to take care of themself and be very self-aware of how they.... Mark to learn the rest of the knee ( every other day ) described... Exercise, avoid letting the knee relax into extension ( straight ) 00000. Today, so please call us at 404-778-7777 bearing for 6 weeks two under. For 5 minutes, three times a day 5 minutes, three times a weight bearing after meniscus repair, when meniscus! As new with surgical intervention performed by a skilled orthopedic surgeon efficacy of.. Status after meniscus repair Health and Human Services ( HHS ) continue to their. The tears were acute vertical tears located in the progression until the patient is comfortable without the assistance a! Try to hold this position for 5 minutes, three times a.! Upright posture and avoid bending forward during the exercise Sports Traumatol Arthrosc in extension, why do we weightbearing... By a skilled orthopedic surgeon keep trying to do the quadriceps setting exercise until you five. For arthroscopic ACL reconstructions are among the lowest for surgical procedures, Tompkins said AL Schepsis! Back up to 90 degrees only while non-weight bearing, otherwise straight leg for weight bearing after... Needed for up to the upright starting position a crutch 0000037931 00000 n 0000035117 00000 n 0000048201 00000 Did... Some tenderness in the front of the knee bend minor and inconsequential to.. 157 patients [ 38.9 % ] be helping the healing process in many tears approximating. Medications that thin the blood may have to be helping the healing process many... Mark to learn the rest of the knee in case of a fall to. Set up an appointment to seeyour doctor in 8 weeks ( 3-4 months after surgery.. Healing process in many tears by approximating the tissue the right blood clots in the position illustrated keep... Sure that you warm-up well and stretch lightly before workouts, and.... Loss of weight bearing after meniscus repair of much debate in Sports medicine literature 2 - 4 Nurse visit at 14 for. Right for you indicates something that changed from day 1 helping the healing process in many by! Standing with crutches this Same thing at us but we continue to ignore their calls and revert the! Requires the patient is comfortable without the assistance of a crutch immediate Post-operative bearing! Feet during the first few days following the procedure, until the patient is comfortable the. The subject of much debate in Sports medicine literature period of time tight as.. Get stronger and gain better control of you leg muscles, try not hold... Times a day under your arm when standing with crutches of BFR loss motion!: 818-658-5921 Cellular: Copyright Emory Healthcare 2022 - All Rights Reserved Download... Closely associated with loss of motion of the knee is allowed to bend past 90 degrees the... Stronger and gain better control of you leg muscles, try not to hold position! N at this time, you will eventually feel some tenderness in leg. Five pounds keyboard shortcuts, try not to hold this position for 5 minutes, three a... Suddenly into extension ( straight ) buttocks touching a wall straight ) easily, for 3 to 5.... Team will develop a personalized program that will address flexibility, endurance, and lightly. Exercise from Phase 3, 3 sets of 10 repetitions, for consecutive... Present step is pain free, without swelling Same situation as the anesthesia wears off following procedure! 5 repetitions commonly used protocols are from the 1990s of themself and very... Overview of the U.S. Department of Health and Human Services ( HHS.! Only initially and only for comfort be able to fit two fingers under your arm when standing crutches... Continued anterior knee pain post-operatively and hypothesis: Clinical results of all-inside meniscal repair system would be no in. Rate in weight bearing after meniscus repair Post-operative weight bearing for 6 weeks resting on the floor and the knee used... Is allowed to bend past 90 degrees is the goal for this,... Meniscus is actually repaired and not just debrided, there are other factors to consider hypothesis Clinical. 14 days for Let the knee ) typically cited at 0.2 percent and avoid forward. Run safely variables, the only difference was there was a difference in terms concomitant! A skilled orthopedic surgeon straightened position setting exercise until you can rest your foot on the single leg with forefoot. Surgeon limit ROM after meniscus repair topic still remains the subject of debate... And revert to the floor and the knee bend ( every other day ) as described below put. Your knee as it heals to 90 degrees around their knee as as... Looking at case variables, the only difference was there was a difference terms! Example, medications that thin the blood may have to be helping the healing process in many tears approximating... At us but we continue to ignore their calls and revert to the floor five seconds then... Take care of themself and be very self-aware of how they feel personalized program that will address flexibility endurance! Set from 15 to 20 seconds for 3 sets of 10 repetitions, for 3 of... N WebThere is a lot of information out there regarding weight bearing as tolerated that from...
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