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Knee Arthroscopy Rehab Protocol

meniscal tear classifcation

 

 

General Guidelines

  • Individualized to the patient depending on procedures performed and patients pre-operative activity/sport.
  • Indicated for partial meniscectomy, loose body removal, plica excision, diagnostic arthroscopy, synovectomy, debridement.

Phase I

  • Patient is Weight Bearing As Tolerated (WBAT)
  • Stretching (e.g. hamstrings, gastroc/soleus, hip flexors)
  • Active range of motion (AROM)
  • 4-way SLR
  • Quad sets, gluteal sets
  • Ankle pumps
  • Ice, Compression, Elevation (I.C.E.)
  • Muscle stimulation, biofeedback if needed
  • Bicycle within available ROM
  • D/C electrical stimulation when no quad lag

Phase II

Criteria

  • Independent ambulation with assistive device as needed, full weight bearing (FWB)
  • AROM (o°-110°)
  • Independent straight leg raise
  • Mild/No swelling

Suggested progression           

  • Continue strengthening and stretching exercises from Phase I
  • Basic closed chain exercises, limited to 110 degree (e.g. mini squats, mini lunges, total Gym)
  • Advanced closed-chain exercises (e.g. Fitter, Shuttle)
  • Aerobic exercises (e.g. bike, treadmill, NordicTrac, stairclimber, swimming)
  • Proprioceptive exercise (e.g. BAPS board, ground stars)

Phase III

Criteria

  • Straight leg raise without quad lag
  • Strength 4/5
  • No apprehension with single leg hop on involved leg
  • Able to balance on involved leg and reach with uninvolved leg 80% of distance reached with opposite leg

Suggested progression

  • Continue strengthening and stretching exercises from Phase II
  • Slow form jogging/running
  • Weight strengthening program
  • Sport specific training – lateral stepping, cariocas

Phase IV: Return to sport/discharge

Criteria

  • Full/functional AROM
  • Independent ambulation without deviation
  • No swelling
  • > 80% quadriceps and 85% hamstring strength (BIODEX test)

Suggested progression

  • Plyometrics
  • Advanced sport/activity specific training