Traditional Versus Accelerated Rehabilitation following ACL Reconstruction: A One-Year Follow-Up. Decarlo MS, Shelbourne KD, McCarroll JR, Rettig AC. Cochrane Database of Systematic Reviews 2005, Issue 4. Exercise for treating isolated anterior cruciate ligament injuries in adults. A systematic review of evidence for anterior cruciate ligament rehabilitation: how much and what type? Physical Therapy Sport 2004 5: 125-145.Ģ. Pilates Art Physiotherapy / London Sports Medicineĥ0-52 Kilburn High Road, London, NW6 4HJ, UKġ.
Feinwerkbau sport 124 repair full#
Return to full sporting activities by week 12-16ī App Sc Physio Grad Dip Physio (Orthopaedics), SportsMed SA, 32 Payneham Road, Adelaide 5069, Australia.ī.Physio. Specific strength and stability training to overcome any residual deficits shown up in the Isokinetic test One might consider performing isokinetic open chain quadriceps and hamstring tests on the KIN-COM. Balance, strength and stability exercises on the gym ball Closed and open chain resisted exercise in gym using treadmill, bike and leg press Cardiovascular and sport specific exercise Isokinetic closed and open chain quadriceps and hamstring rehabilitation
Stretch programme for quadriceps, hamstring, ITB, calf, hip rotators Pilates based exercises partial weight bearing to maintain range of motion and strengthen quadriceps Gradual increase to full weight bearing walking gait, if previously partial weight bearing Activation of VMO in isometric exercises, IRQ Soft tissue mobilization and reduction of scar tissue Control of swelling with ice, elevation and compression May involve partial weight bearing with crutches, or FWB without crutches Conversely, Tenuta et al found that a similar ARP that placed no restrictions on ROM or weight bearing had a significantly higher number of incompletely healed meniscal repairs(71). Interestingly, Barber et al found that an ARP consisting of FWB without bracing, without restrictions in ROM or pivoting activity, and a RTS as early as 3-4 months post-operatively, did not result in any significant differences in rates of healing or re-injury when compared with standard meniscal repair protocol involving immobilization, restricted weight bearing and later RTS(68). Squats should be avoided for 3 months(65). Posterior horn meniscal tears can be seen arthroscopically to separate from the capsule in knee flexion and reduce into place in extension(70). Increased knee flexion increases the compressive loads transmitted through the posterior horns of the menisci, with 85% of load transmitted at 90 degrees knee flexion compared with approximately 50% in extension(69). Caution should be exercised with leg presses (low loads or double legs are recommended) and low chairs should be avoided. Patients must avoid knee flexion past 90 degrees and deep knee bends while weight bearing for 6 weeks(65). However, excessive weight bearing is discouraged as compressive and shear forces on the joint can damage the healing meniscal repair(66). Weight bearing in full extension assists quadriceps activation and helps to prevent loss of knee extension range(18), and may also promote meniscal healing through early physiological loading(67). Most patients FWB without the routine use of crutches(67), and patients do not require bracing(68). Gym is started from 4-6 weeks (66), and patients typically RTS from 12 to 16 weeks(65,67). Multi-angle isometric quadriceps should be used for the first 2 weeks, rather than CKC exercises, as they do not stress the meniscal repair18. General postoperative advice is given as for arthroscopic menisectomy(66). Patients commence SLR, IRQ, passive and active assisted knee flexion in a seated position on the bed (to 90 degrees only) and passive knee extension (in sit with a ?phone-book?) from day one(66). Ankle pumps are performed immediately after surgery until normal mobility is restored. The functional rehabilitation follows a similar progression to ACL protocols, but with different time-frames. The aim of rehabilitation is to protect the healing meniscus while supporting a graduated RTS as the scar tissue matures(65). It takes approximately 3 months for the meniscal repair to heal(64). Mrs Elizabeth Sharp MSc (Man Ther) MCSP Grad Dip PhysĮSPH ES Physical Health, 116 Lordship Lane, London, SE22 8HD SportsMed SA, 32 Payneham Road, Adelaide 5069, Australia Miss Jennifer Michelle Laver, B App Sc (Physio)(Hons)
North Middlesex University Hospital, Sterling Way, London N18 1QX Mr Henry D.E.Atkinson, MBChB, BSc Med Sci, MRCS, FRCS Tr & OrthĬonsultant Trauma and Orthopaedic Surgeon Henry Dushan Edward Atkinson, Jennifer Michelle Laver, Elizabeth Sharp Rehabilitation following meniscal repair surgery Physiotherapy and rehabilitation after meniscal repair surgery - Henry Atkinson
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