When Can Patients Weight Bear After Meniscus Repair? | Knee Surgery - Ask FPF Episode 26

To go along with today's episode I have a nice infographic to share...

Sign up to receive FREE: Meniscus Pathology - The Evidence Based Cheat Sheet

Click HERE to Download FREE

Grab the rest of the Mini Course and Sign up for the Certification Pre-sale list:

• FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
• The Fitness Pain Free Certification

In today's episode we go over When Can Patients Weight Bear After Meniscus Repair? | Knee Surgery - Ask FPF Episode 26:

As physical therapists, we play a critical role in helping our patients recover from meniscus repair surgery. One of the most important considerations in this process is determining when it is appropriate to begin weight bearing activities.

Meniscus repair surgery is a common procedure used to address tears in the meniscus. After surgery, patients must allow the repaired tissue to heal properly to ensure a successful outcome.  Physical therapists must strike a delicate balance between allowing the surgical site to recovery by protecting it and not allowing excessive stiffness, weakness and atrophy.

While each patient's recovery timeline may vary, and research is limited to guide our clinical reasoning there are general guidelines that can help determine when weight bearing activities may be safely resumed. A few factors you may consider to guide your speed of weight bearing progression may be:

• Surgeon's preference
• Size of the tear
• Location of the tear
• Type of tear (Vertical vs. radial vs. complex)
• Patient age
• Chronicity of tear

It is crucial for physical therapists to work closely with their patients and the surgeon to monitor progress and determine when weight bearing activities can be safely introduced. The fear is that rushing into weight bearing too soon can lead to re-injury or further damage to the repaired tissue, which is no bueno.

In today's episode we dive into the literature and come up with some practical guidelines for returning your patients back to weight bearing after meniscus repair surgery.

In conclusion, understanding appropriate timelines for weight bearing after meniscus repair surgery is essential for physical therapists. By working closely with your patient, the surgeon and using your best clinical reasoning, therapists can help ensure a successful recovery and return to normal training.

My meniscus is tired...

Dan Pope DPT, OCS, CSCS

Show Notes / Relevant Articles:

• Meniscus Repair Surgery Physical Therapy [Case Study - Elite Powerlifter] Part 1
  
• Meniscus Repair Surgery Physical Therapy [Case Study - Elite Powerlifter] Part 2
• When SHOULD and SHOULDN'T Your Patients Have Meniscus Surgery? | Meniscectomy, Meniscus Repair
• Physical Therapy Rehabilitation After Meniscus Repair Surgery - Evidence Based Guide: Part 1
• Physical Therapy Rehabilitation After Meniscus Repair Surgery - Evidence Based Guide: Part 2
• FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
• Physical Therapy Evaluation and Treatment for Meniscus Tears [Case Study] | Traumatic | Non-operative | Conservative Management
• The Best Beginner Knee Physical Therapy Exercises

Want to support me and decide topics for future episodes?  Click HERE to sign up for FPF "Insiders" for just a dollar. You'll gain access to 100+ webinars, e-books and complete guides.  Plus, you'll get private access to the "Insiders" Facebook group where you can have all of your questions answered by me.  

Looking for other ways to support me that are 100% free?

• Like, comment and share on youtube, facebook and instagram 
• Leave a 5-star review on apple podcasts

Thank you!

Dan Pope DPT, OCS, CSCS

References:

1. Spang Iii RC, Nasr MC, Mohamadi A, DeAngelis JP, Nazarian A, Ramappa AJ. Rehabilitation following meniscal repair: a systematic review. BMJ Open Sport Exerc Med. 2018 Apr 9;4(1):e000212. doi: 10.1136/bmjsem-2016-000212. PMID: 29682310; PMCID: PMC5905745.

2. Calanna F, Duthon V, Menetrey J. Rehabilitation and return to sports after isolated meniscal repairs: a new evidence-based protocol. J Exp Orthop. 2022 Aug 17;9(1):80. doi: 10.1186/s40634-022-00521-8. PMID: 35976500; PMCID: PMC9385921.

3. Harput G, Guney-Deniz H, Nyland J, Kocabey Y. Postoperative rehabilitation and outcomes following arthroscopic isolated meniscus repairs: A systematic review. Phys Ther Sport. 2020 Sep;45:76-85. doi: 10.1016/j.ptsp.2020.06.011. Epub 2020 Jul 13. PMID: 32688294.

4. Escamilla RF. Knee biomechanics of the dynamic squat exercise. Med Sci Sports Exerc. 2001 Jan;33(1):127-41. doi: 10.1097/00005768-200101000-00020. PMID: 11194098.

5. Thambyah A, Fernandez J. Squatting-related tibiofemoral shear reaction forces and a biomechanical rationale for femoral component loosening. ScientificWorldJournal. 2014;2014:785175. doi: 10.1155/2014/785175. Epub 2014 May 20. PMID: 24982995; PMCID: PMC4054786.

6. Nagura T, Matsumoto H, Kiriyama Y, Chaudhari A, Andriacchi TP. Tibiofemoral joint contact force in deep knee flexion and its consideration in knee osteoarthritis and joint replacement. J Appl Biomech. 2006;22(4):305‐313. doi:10.1123/jab.22.4.305

7. Van Rossom S, Smith CR, Thelen DG, Vanwanseele B, Van Assche D, Jonkers I. Knee Joint Loading in Healthy Adults During Functional Exercises: Implications for Rehabilitation Guidelines. J Orthop Sports Phys Ther. 2018;48(3):162‐173. doi:10.2519/jospt.2018.7459

8. Chirichella, P. S., Jow, S., Iacono, S., Wey, H. E., & Malanga, G. A. (2018). Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics. PM&R. doi:10.1016/j.pmrj.2018.08.384

9. Raj MA, Bubnis MA. Knee Meniscal Tears. [Updated 2020 July]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: 

10. van Rossom S, Smith CR, Thelen DG, Vanwanseele B, Van Assche D, Jonkers I. Knee Joint Loading in Healthy Adults During Functional Exercises: Implications for Rehabilitation Guidelines. J Orthop Sports Phys Ther. 2018;48(3):162‐173. doi:10.2519/jospt.2018.7459

Images:

1. Medial Meniscus - Source: https://commons.wikimedia.org/wiki/File:Medial_Meniscus_Injury.png - Attribution: BruceBlaus / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0) Edited by fitness pain free LLC

2. Types of Meniscus Tears - Source: https://commons.wikimedia.org/wiki/File:Meniscus_tear_types.svg - Attribution: Mikael Häggström / CC0 - Edited by fitness pain free LLC