Noyes Knee Institute Rehabilitation Protocol: Meniscus Repair

Transcription

1 Noyes Knee Institute Rehabilitation rotocol: Repair Brace: Long-leg postoative Range of motion minimum goals: Weight bearing: Toe touch 1/2 body weight /4 to full Toe touch 1/4 body weight 1/2 to /4 body weight Full atella mobilization Stretching:, iliotibial band, quadriceps Strengthening: Quad isometrics, straight leg raises, active knee etension losed-chain: gait retraining, toe raises, wall sits, mini-squats Knee fleion hamstring curls (90 ) Knee etension quads (90-0 ) Hip abduction-adduction, multi-hip press (70- ) Balance/proprioceptive training: Weight-shifting, mini-trampoline, BAS, BBS, plyometrics onditioning: Up body ergometer Bike (stationary) Aquatic program Swimming (kicking) Walking Stair climbing machine Ski machine ostoative Weeks ostoative Months *Running: straight *utting: lateral carioca, figure 8 s *Full sports Key: = all meniscus repairs, = ipheral meniscus repairs, = comple meniscus repairs etending into middle third region. BAS = Biomechanical Ankle latform System (amp, Jackson, MI), BBS = Biode Balance System (Shirley, NY). *Return to running, cutting, and full sports based on multiple criteria. atients with noteworthy articular cartilage damage are advised to return to light recreational activities only. SOURE: Heckmann T, Noyes FR, Barber-Westin SD: hapter 0: Rehabilitation of meniscus repair and transplantation procedures. Noyes Knee Disorders: Surgery, Rehabilitation, linical Outcomes, Saunders, hiladelphia, 09, pp

2 Range of Motion, Fleibility, and Modality Usage Following Repair Time ostoative, /day, minute -4-4 /day, minute 5-6 /day, minute /day, minute /day, minute Etension- Fleion Limits atellar Mobilization 0-90 Mediallateral 0-1 Mediallateral 0-15 Mediallateral Fleibility 5 secs 0-15 (if required), quadriceps, iliotibial band (should be full), quadriceps, iliotibial band Electrical Muscle Stimulation ryotherapy

3 Muscle Strengthening Eercises Following Repair Time.O., 1-2 /day /day /day Quadriceps Isometrics () 1 set (every hour) Multiangle 0, 60 1 set each Multiangle 0, 60, 90 2 Straight Fle Fle, et, adduction Ankle wt < % of bodyweight Knee Etension (assisted) 90-0 Toe heel raises Wall Sits (to fatigue) Mini- Squats Lateral Stepups (5- cm block) Hamstring urls 0-90 eripheral Only, Multihip (Fle, Et, Abd, ) ress /day /day /day abduction rubber 0 0 high speed, 0 rubber 0-40, All,,

4 Time.O., wks. 1 /day -0 Quadriceps Isometrics () Straight high speed, 0 Knee Etension (assisted) 90-0 Toe Wall Sits (to fatigue) Mini- Squats Lateral Stepups (2-4 block).o., postoative; fle, fleion; et, etension; abd, abduction; add, adduction;, repetitions Hamstring urls 0-90 Multihip (Fle, Et, Abd, ) ress 70 -

5 Aerobic onditioning Eercises Following Repair Time.O., /day UBE Bicycle (stationary) Water Walking Swimming Walking Stair limbing Machine (low, low stroke) Ski Machine (short stride, level, low ) Running (Straight) utting Functional Training /day /day /day 1-26 /week /week eipheral Only^ 27 and beyond /week 0 and beyond Jog 1/4 mile Walk 1/8 mile Backward run yards omple 0 wks. p.o. program as needed Lateral, carioca, figure 8 s, yards omple > 5 wks. p.o. program as needed Mins., ^Begin running program when no more than 0% deficit elicited on isokinetic testing; begin cutting program when no more than % deficit elicited on isokinetic testing. lyometrics bo hops, level, double- leg secs., 4-6 Sports Specific Drills 4-6 omple > 5 wks. p.o. program as needed