Medial/Lateral Partial Meniscectomy Post-operative Rehabilitation

Scott Gudeman, MD

1260 Innovation Pkwy., Suite 100

Greenwood, IN 46143

317.884.5161

OrthoIndy.com

ScottGudemanMD.com

1 Rev. 12/15

Medial/Lateral Partial Meniscectomy Post-operative Rehabilitation Protocol

Phase I: Day 1 to 2 Weeks

Brace

• Knee immobilizer

• TED hose to be worn until ambulation has returned to normal pre-surgery level or two weeks

• Crutches: weight bearing as tolerated

Goals

  •Decreaseinammationandswelling

• Restore knee range of motion (0 to 115 degrees, minimum 0 degrees extension

to90degreesexionbeforePhaseII)

• Re-establish quadriceps muscle activity/re-education

• Weight bearing as tolerated with use of crutches until normal gait is achieved

  Note:Returntoofceforpost-opappointmentatdayoneortwofordressingchangeand

atoneweekpost-opforsutureremoval.

Knee Motion

  PassiveRangeofMotion:

   • Pronehangorheelprop(withorwithoutice)

  ActiveRangeofMotion:

• Ankle pumps

• Quadriceps sets

• Straigh leg raises

• Hip abduction, adduction, extension

• Gluteal sets

• Heel slides

   • Stationarybike(noresistance,forrangeofmotiononly)

  Strengthening:

   • Partialsquats(completewithsupervisionofphysicaltherapistorcertiedathletictrainer)

  Stretching:

   • Activeassistiverangeofmotionstretching(quadriceps,gastroc,soleusandhamstring)

Modalities

• Neuromuscular electrical stimulation if patient has quadriceps shut down. Thirty minutes,

two times a day, seven days a week.

Phase II: Weeks 2 to 8

Brace

• None

Goals

• Restore and improve muscular strength and endurance

• Gradual return to functional activities

• Restore normal gait

• Improve balance and proprioception

• Re-establish full, pain free range of motion 

• Week two, 0 to 125 degrees

• Week three, 0 to 135 degrees

• Week four, 0 to 145 degrees

Cardiovascular

  •Stairmaster,elliptical,treadmill(norunning)andbike

• Aquatic therapy: running in pool or on AlterG

Anti-Gravity Treadmill

four to six weeks

(incisionneedstobefullyclosed)

Knee Motion

  PassiveRangeofMotion:

• Continue all from Phase I

  ActiveRangeofMotion:

• Continue all from Phase I

  Strengthening:

• Toe raises and calf raises

• Hamstring curls

• Lunges – front and lateral

   • Legpress(notpast90degrees)

• Step-up, step down, lateral step-up

• Four – way hip: standing

   • Kneeextensionexercise:90to40degrees(donotusemachine)

• TKE

• Closed kinetic chain

  Stretching:

• Continue all from Phase I

Proprioception

• Proprioceptive and balance training

Modalities

• Neuromuscular electrical stimulation if patient has quadriceps shut down. Thirty minutes,

two times a day, seven days a week.

Phase III: 8 Weeks +

Goals

• Enhance muscular strength and endurance

• Maintain full range of motion

Knee Motion

  Functional:Begin

• Begin plyometrics/vertical jumps

• Initiate running program

• Agility drills progression

   • Forward/backwardsrunning,cutting,gureeightandcarioca

   • Sportsspecicdrills/activities(beginwithnon-contact)

   Note:Monitorpatellofemoraljointpainandavoidactivitiesthatmayaggravateit.

Helping you achieve the optimal

activity level for your lifestyle

ismyrstpriority.

- Scott Gudeman, MD

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ScottGudemanMD.com.