September 9, 2020
Meniscus is a C-shaped disc of cartilage or soft tissue that connects the thigh bone to the shinbone. Its function is to keep the knee stable, facilitate joint gliding, prevent hyperextension, and absorb shock for the bones. Meniscal repair is a surgical procedure to repair a torn meniscus. It is minimally invasive and often undergone as an outpatient. Meniscus tear is common among athletes who play contact sports like hockey and football. However, it can also result from lifting something heavy, especially among older individuals. While meniscus repair surgery offers good results, the recovery time can take a long time.
There are many different factors that can influence the outcomes of post-operative physiotherapy, such as the severity and location of the injury. It is recommended that therapists collaborate closely with referring physicians regarding the findings during surgery and the satisfaction with the strength of repair. A patient goes through the following phases of rehabilitation:
Immediately post-operative to 4 weeks after surgery, physiotherapy appointments begin 3-5 days postoperatively and then approximately 1 time each week. During this period, the goals are to protect the repair site, reduce swelling, and minimize pain. A knee brace is placed to either hold the knee fully extended or allow for controlled motion. Swelling management involves compression, elevation, retrograde massage, and ankle pumps (a type of exercise used for the relief of edema or swelling).
The therapist will work with the patient to restore patellar mobility, restore full extension, gain 90-degree flexion, and re-establish quad control. Patients will be instructed to walk with crutches. Range of motion exercises include prone hangs, heel slides, supine wall slides, and partial weight-bearing.
Suggested therapeutic exercises include quadriceps sets, straight leg raises, four-way leg lifts in standing with a brace on for balance and hip strength, and abdominal isometrics. A patient can progress to the next phase of after surgery rehabilitation if he exhibits pain-free gait without crutches.
Begins 4 weeks post-op if phase 1 criteria are met, rehab appointments are scheduled once every 1-2 weeks. The goal during this phase is for the patient to achieve single leg stand control, normal gait, and no pain with functional movements, including stepping up and down, squatting, and performing partial lunges.
Phase 1 interventions are continued with additional activities such as non-impact balance and proprioceptive drills, stationary bike use, gait drills, hip and core strengthening, stretching for patient-specific muscle imbalances, and quadriceps strengthening. The patient will also do cardiovascular exercises and non-impact endurance training.
The patient can proceed to the next phase of rehabilitation if he exhibits normal gait on all surfaces and carries out functional movements, without pain or unloading the affected leg. He should also demonstrate good control and single-leg balance greater than 15 seconds.
Up to 3 months after surgery, after meeting second phase criteria. Dubai physiotherapy clinic appointments can be scheduled once every 1 to 2 weeks. During this period, the goal is for the patient to achieve good control and no pain with sport and work specific movements, including impact.
The therapist will work with the patient in doing impact control exercises, movement control exercises beginning with low velocity to higher velocity, and strength and control drills related to sport-specific movements. Hip and core strengthening exercises are continued, as well as stretching. Cardiovascular exercises are targeted to replicate the patient’s specific energy demands.
From 3 to 5 months after surgery, early return to sport or work, after third phase criteria are met. The goal for this phase is for the patient to safely initiate a sport specific training program and promote proper movement patterns. The patient is also expected to gain a dynamic neuromuscular control with multi-plane activities without pain or swelling.
The therapist continues all interventions from the previous phases and creates an interval running program, a plyometric program, and an agility program for the patient. The patient can return to sports or work upon getting clearance from his physician that all milestone criteria have been met.
Physical therapy is very important in regaining full function of the knee after meniscal repair surgery. The Scandinavian Physiotherapy Center has experienced physical therapists, who regularly guide patients through meniscus repair rehabilitation. They are offering several treatment modalities including trigger point treatment, craniosacral therapy, electromyo graphique biofeedback, and kinesiotaping. Book an appointment today at +971 4 551 6126.