Meniscectomy Rehabilitation Protocol
The protocols provided by Orthopedic Associates of Portland are examples of those used by our physicians and may not be appropriate for every patient. You should use these only if your treating physician has reviewed the protocol and approves of its use for your recovery.
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Post-op visit Number One at I week post-op:
Evaluation of limitations in:
Comfort level/Pain Rating on 1/10 scale
Guarding/apprehension with wt bearing
Proprioception
ROM
Strength
VMO quad control
Leg control
Gait
Compliance with p/o care instructions per physician
Swelling/Effusion and portal inspection for infection
Criteria for continued PT > I visit: 3 or more of the below deficits require F/U in PT:
Pain> 4/10
2+ effusion
Partial Weight Bearing secondary to apprehension, pain, poor proprioception
Unable to single leg balance > 20 seconds
ROM < 5-125 degrees secondary to pain
Strength < 4-/5
Poor-fair VMO control
Poor leg control with transfer/ADL activities
Moderate antalgia with flat surface fwd walking with no assistive device
Poor compliance with p/o instructions per P.T. and physician
ANY SIGNS OF INFECTION REFERRED TO PHYSICIAN IMMEDIATELY
F/U with emphasis on formal PT for 2-8 more visits and progression of home program to include:
Strengthening ex's: LE Control ex's with emphasis on VMO control Weight shifting progression Single leg balance with trunk shift/challenges T-Band squat progression to step downs for aggressive quad work Gait training FWD Retro High step Lat. shuffle step Instruction in proper bike set-up and resistance level Instruction in leg press, leg curls, and calf raises Pool therapy for strengthening, endurance, and ROM as appropriate Discussion re: appropriate progression through resisted ex's increasing weight, reps, and intensity at each session as tolerated.
ROM ex's:
Terminal extension hangs
Standing terminal extension
Flexion stretch in standing and prone
Hamstring Stretch
Effusion Control:
Manual therapy
Ice, elevation, massage, and rest intervals throughout the day
Criteria for D/C:
Pain < 2/10
Minimal effusion
Full wt bearing with no pain/apprehension
ROM: 0- 135 degrees with minimal pain
Strength 4+/5
Good VMO control
Good leg control with Activities of Daily Living (ADL's)/balance test to include: single leg stance > 30 seconds
Minimal antalgia (pain)
Good compliance with home ex. program and activity modification
Return to functional activities without incident
Pt able to demonstrate willingness and ability to progress with all exercises at an appropriate pace, adding weight and reps as tolerated.
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