Noyes Knee Institute Rehabilitation Protocol: Meniscus Repair

Transcription

1 Noyes Knee Institute Rehabilitation rotocol: Repair ostoative Weeks ostoative Months 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: gastroc-soleus, 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, multihip press (70- ) Balance/proprioceptive training: Weight-shifting, mini-trampoline, BAS, BBS, plyometrics onditioning: Up body ergometer Bike (stationary) Aquatic program Swimming (kicking) Stair climbing machine Ski machine *Running: straight *utting: lateral carioca, figure 8 s *Full sports HYSIOINQ O Bo 1448, arramatta BD 2124 Fa number ABN

2 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 Range of Motion, Fleibility, and Modality Usage Following Repair ostoative, 1-2 weeks -4-4 weeks weeks 7-8 weeks weeks 2 Etension- Fleion Limits atellar Mobilization 0 - (if required) (should be full) Fleibility 5 secs, quadriceps, iliotibial band, quadriceps, iliotibial band Electrical Muscle Stimulation s ryotherapy s HYSIOINQ O Bo 1448, arramatta BD 2124 Fa number ABN

3 Muscle Strengthening Eercises Following Repair.O., 1-2 weeks /day s -4 weeks 2- /day s 5-6 weeks 2 /day s 7-8 weeks 2 /day s 9-12 weeks 2 /day s 1-26 weeks. 2 /day s Quadriceps Isometrics (Active) 1 set (every hour) angle 0, 60 1 set each angle 0, 60, 90 2 Straight Fle Fle, et, adducti on Ankle wt < % of bodyw eight abducti on rubber 0 0 high speed, 0 Knee Etension (Activeassisted) 90-0 Toe heel raises Wall Sits (to fatigue) Mini Squats Lateral Stepups (5- cm block) Hamstring urls eripheral Only Active, rubber 0-40, All Active, Active, hip (Fle, Et, Abd, ) ress 70 -.O., wks. 1 /day - 0 s Quadriceps Isometrics (Active) Straight high speed, 0 Knee Etension (Activeassisted) 90-0 Toe Wall Sits (to fatigue) Mini Squats Lateral Stepups (2-4 block) Hamstring urls hip (Fle, Et, Abd, ) ress 70 - HYSIOINQ O Bo 1448, arramatta BD 2124 Fa number ABN

4 .O., postoative; fle, fleion; et, etension; abd, abduction; add, adduction;, repetitions.o., -4 weeks 1-2 /day UBE Bicycle (stationary) Water Swimmin g Stair limbing Machine (low resistanc e, low stroke) Ski Machine (short stride, level, low resistance) Running (Straight) utting Functional Training 5-6 weeks 2 /day 7-8 weeks 1-2 /day 9-12 weeks 1 /day 1-26 weeks /week weeks /week eipheral Only^ 27 weeks and beyond /week 0 weeks and beyond Jog 1/4 mile Walk 1/8 mile Backwar d run yards -0-0 omple 0 wks. Advance program as Lateral, carioca, figure 8's, yards omple Menisc us > 5 wks. Advanc e lyometrics bo hops, level, double-leg secs., 4-6 Sports Specific Drills 4-6 omple > 5 wks. Advance program as HYSIOINQ O Bo 1448, arramatta BD 2124 Fa number ABN

5 progra m as Mins., s ^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. HYSIOINQ O Bo 1448, arramatta BD 2124 Fa number ABN