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Meniscus Tx

QuestionAnswer
What represents long-term sequelae after total and subtotal meniscectomy? Jonit space narowing and degenerative arthritic changes
After subtotal meniscectormy WB status during the first week is usually what? WBAT
Waht describes the WB status after meniscal repair immdiately post op? NWB progressing slowly to FWB at 4 to 6 wks
CKC resistanc ex (leg press, squats, step ups stair steppers)generally are not allowed for what phase after a meniscal repair 8 weeks or longer post op
When is non surgical repair of meniscus done? If a tear is located in the RED-on-RED zone
What are some consideration in a non surgical repair of the meniscus? -Age of pt -Stability of the knee -Location of the tear -Integrity of the meniscus
What is the rational of TX of a meniscus injury? Dpends on the location of th injury, specifically which of the three vascular zones the injury is located
What is the tx if injury is in the RED-on-RED zone I? Very vascular, vascular on both side, injury will heal because of the connection w/ a good blood supply Great potential for healing
What is the tx if injury is in the RED-on-WHITE zone II? Vascular supply only on 1 side, these tear my heal becaue there is a parital connection to a blood supply but it depends on the type of tear
What is the tx if injury is in the WHITE-on-WHITE zone III? Most medial,poor vascularization and which refers to the tear being avascular on both sides. An injury in this area doesnot heal becaue there is no blood supply to supoprt the healing process
What are the surgical options for a meniscus repair? Subtotal or partial menisectomy and Meniscal Repair
What is done with a Subtotal repair? Remove a piece of the tron part of the meniscus or suturing the torn part back together, Total meniscal is not recommended
During the Max phase (up to 3 week) what ex can be done?subtotal menisectomy AAROM
During the Max phase (up to 3 week) what is the WB status?subtotal menisectomy WBAT to FWB qait minimal brace use
What is also done in the MAX phase of any post-op surgery?subtotal menisectomy Management of pain and swelling RICE TENS NSAIDS
During Mod phase(4-8 weeks) what are the 5 things that are worked on?subtotal menisectomy 1.CKC ex - resistive ex 2.Step ups, wall squats, leg press, eliptical 3.Proprioceptive ex 4.DLS/SLS static then dynamic surface 5.Iso. velocity spectruym training(sets of ex at progresively faster speed
During Min phase (9-20 weeks) what are the 4 things that are worked on?subtotal menisectomy 1.Normalize gait 2.Attain full ROM 3.Regain preop strength 4.Enhance fucntional activities
What are long term consequences from surgical procedures of the subtotal menisectomy -Early degenerative changes are seen w/this procedure. -excess arthrokinematics, less stability -quiker and easier recovery but in long run more degenerative
What is the difference between the Subtotal Meniscectomy and Meniscal repair? Need to allow repaired meniscus to heal by avoiding limiting loads and stresses (ROM) that compromise the repair site
What would change a rehab of a meniscal repair? When ligament structures are also injuried and repaired the pt then has an individual rehab program that depends on the surgical procedure used to repair the lig
In the Max phase of protection Meniscal repair what is the WB status? Pt is typically NWB gradually progressing to FWB in 4-6wks to avoid vertica compression forces
What are 4 other things to done in Max Meniscal repair? 1.Immobilized in hinge brace 4 wks 2.Limit knee flex to aprox. 90-100 degrees 3.RICE, e-stim, control pain and swelling 4.Regain quad control with isometric SAQ and SLR
What happens in the Mod phase of Meniscal repair?(4-8 weeks) -isotonic ex(leg ext, ham curls) -stationary bike, ROM resistance -FWB w/out crutches is achieved at 6wks -Can't begin CKC ex until at least the 8 wk after repair
What happens in the MIn phase of the Meniscal repair?(after 8 week) -CKC ex treadmill, step ups, short arc leg press -function activities-resuming pre-op activities -Weighted and full squats must be strictly avoided for up to 3-6 months after repair to prevent reinjury
Created by: demiller243
 

 



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