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Sunday, January 31, 2016

Meniscus Injuries treatment

Meniscus injuries rehabilitation simple Tips

Anatomy of meniscus 
Bismillahirahmanirahim , quite early for me to go for sleep so it give me some idea to write and share about asimple tips of meniscus repair care.
For our understanding each knee joint has two crescent-shaped cartilage menisci. These lie on the
medial (inside of knee) and lateral (outside of knee) of the upper surface of the
tibia (shin) bone. They are essential components of the knee, acting as shock
absorbers as well as allowing for the proper interaction and weight
distribution between the tibia and the femur (thigh bone). The meniscus is a piece of cartilage that provides a cushion between your thighbone (femur) and shinbone (tibia). There are two menisci in each knee joint. They can be damaged or torn during activities that put pressure on or rotate the knee joint.

Meniscus Repair Tips 

What can we understand a rehabilitation of meniscal repair?
I always explain to the patient and guide them to be understand that this rehabilitation protocol was developed for patients who have isolated meniscal repairs. Meniscal repairs located in the vascular zones of the periphery or outer third of the meniscus are progressed more rapidly than those repairs that are more complex and located in that avascular zone of the meniscus it will be dependent upon the location of the repair, weight bearing status post-operatively as well as the intensity and time frame of initiation of functional activities will vary. 

What is the Goal of meniscal repair after surgery ?
Most of my orthopedic surgeon have setup their own goal and here i compile all the overall goals of the repair and rehabilitation are to:
• Control pain, swelling, and hemarthrosis
• Regain normal knee range of motion
• Regain a normal gait pattern and neuromuscular stability for ambulation
• Regain normal lower extremity strength 
• Regain normal proprioception, balance, and coordination for daily activities
• Achieve the level of function based on the orthopedic and patient goals

When can physiotherapy can be start?
In our practice the physiotherapy should be initiated within 3 to 5 days post-op. It is extremely important for the supervised rehabilitation to be supplemented by a home fitness program where the patient performs the given exercises at home or at a gym facility, it will guide the patient to be more aware about their recovery process.

What are Important post-op signs to monitor?
I always tell to my patient this is the type of sign their need to monitor after the surgeries 
 • Swelling of the knee or surrounding soft tissue
• Abnormal pain response, hypersensitive
• Abnormal gait pattern, with or without assistive device
• Limited range of motion
• Weakness in the lower extremity musculature (quadriceps, hamstring)
• Insufficient lower extremity flexibility

What are the suitable time to return back to activity ?
This is one of the hot question ask by my patient , some of them think after surgery their can start their sport and work immediately but to understand return to activity requires both time and clinic evaluation. To safely and most efficiently return to normal or high level functional activity, the patient requires adequate strength, flexibility, and endurance. Isokinetic testing and functional evaluation are both methods of evaluating a patient’s readiness to return to activity. Return to intense activities such as impact loading, jogging, deep knee flexion, or pivoting and shifting early post-operatively may increase the overall chance of a repeat meniscal tear and symptoms of pain, swelling, or instability should be closely monitored by the patient .wallahuaklam.

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