Advertisement  
   Forum Home CyberPT Home Page      
Forum Home Forum Home > Specialty Forum for PTs/Healthcare Professionals > Orthopedics
  New Posts New Posts RSS Feed - Meniscus Replacement
  FAQ FAQ  Forum Search   Events   Register Register  Login Login

Meniscus Replacement

 Post Reply Post Reply
Author
Message
Previous CPT Forum View Drop Down
Senior Member
Senior Member
Avatar

Joined: Jun 24 2008
Status: Offline
Points: 131
Post Options Post Options   Thanks (0) Thanks(0)   Quote Previous CPT Forum Quote  Post ReplyReply Direct Link To This Post Topic: Meniscus Replacement
    Posted: Jul 08 2008 at 2:19pm

SCPT

USA
10 Posts
 
Posted - 02/09/2006 :  14:49:06  Show Profile  Reply with Quote
I will be seeing a patient that has a diagnosis of meniscus replacement of the knee this coming up Monday. I am wondering if anyone has worked with a patient with such a diagnosis before. I would be interested in learning and discussing more about your treatment approach and experiences with this condition.

SCPT

USA
10 Posts
 
Posted - 02/13/2006 :  09:54:31  Show Profile  Reply with Quote
My patient ended up not having the meniscus replacement. When the surgeon performed the surgery he felt that the patient was not a good candidate because of the amount of deterioration of the cartilage and meniscus. The surgeon ended up scoping his knee and performing a medial meniscetomy.
I did find useful information on meniscus replacement at: www.meniscustransplantation.org/patients/questions.asp

Also protocol:
Post-Operative Physical Therapy Protocol
General Considerations:
-Partial weight-bearing status for 4 weeks post-op. 10-20% toe-touch for 1-2 weeks, progress as tolerated.
-Most patients will be in a hinged rehab brace locked in full extension for 4 weeks post-op unless otherwise indicated.
-Regular assessment of gait to avoid compensatory patterns.
-Regular manual mobilizations to surgical wounds and associated soft tissue to decrease the incidence of fibrosis.
-No resisted leg extension machines (isotonic or isokinetic).
-No high impact or cutting / twisting activities for at least 4 months post-op.
-M.D. follow-up visits at Day 1, Day 8-10, 1 month, 4 months, 6 months, and 1 year post-op.
-During the first 4 weeks: TWICE PER DAY: Without brace, allow GRAVITY ONLY to bend knee back as tolerated BUT NO MORE THAN 90 DEGREES for a good knee stretch without increase in pain. Relax knee and stretch for 60 seconds.

Week 1:
-M.D. visit day 1 post-op to change dressing and review home program.
-Icing and elevation regularly. Aim for 5x per day, 15-20 minutes each time. For ice machine: use as directed.
-Exercises: 1) straight leg raise exercises (lying, seated, and standing): quadriceps/adduction/abduction/gluteal sets; 2) once daily passive and active range of motion exercises;
-Hip and foot / ankle exercises, well-leg stationary cycling, upper body conditioning.
-Pool / deep water workouts after the first 8-10 days and with the use of a brace.
-Soft tissue treatments for edema / pain control and to posterior musculature, patella and incisions.

Weeks 2 - 4:
-M.D. visit at 8 - 10 days for suture removal and check-up.
-Manual resisted exercises (i.e. PNF patterns) of the foot, ankle and hip. Trunk stabilization program.
-Continue with pain control, range of motion, soft tissue treatments and proprioception exercises.
-Non-weightbearing aerobic exercises (i.e. unilateral cycling, UBE, Schwinn Air-Dyne with uninvolved leg and arms only, pool workouts).

Weeks 4 - 6:
-M.D. visit at 4 weeks post-op, will progress to full weight bearing and discontinue use of rehab brace.
-Stretching and manual treatments to improve range of motion (especially extension).
-Incorporate functional exercises (i.e. partial squats, calf raises, mini-step-ups, proprioception).
-Stationary bike and progressing to road cycling as tolerated.
-Slow walking on treadmill for gait training (preferably a low-impact treadmill).

Weeks 6 - 8:
-Increase the intensity of functional exercises (i.e. cautiously increase depth of closed-chain exs., Shuttle/leg press). Do not overload closed- or open-chain exercises.
-Patients should be progressing to walking without a limp and range of motion should be at 80%.

Weeks 8 - 12:
-Add lateral training exercises (side-step ups, Theraband resisted side-stepping, lateral stepping).
-Introduce more progressive single leg exercise.
-Patients should be pursuing a home program with emphasis on sport/activity-specific training.

Weeks 12-16:
-Low-impact activities until 16 weeks.
-Increase the intensity of strength and functional training for gradual return to activities.

Back to Top
Sponsored Links


Back to Top
 Post Reply Post Reply
  Share Topic   

Forum Jump Forum Permissions View Drop Down

Forum Software by Web Wiz Forums® version 11.03
Copyright ©2001-2015 Web Wiz Ltd.

This page was generated in 0.078 seconds.