Meniscal Tears Flashcards
What are the types of meniscal tears?
- medial
- lateral
- peripheral tear
- central tear
What is the mechanism of injury for a medial meniscus tear?
-foot planted on ground and femur internally rotated (ie pivoting, getting in and out of car, clipping injury)
What is the mechanism of injury for a lateral meniscus tear?
- foot planted and lateral rotation on tibia
- simple squatting
What if the meniscal tear is peripheral?
vascularized so often attempt to repair
What if the meniscal tear is central?
avascularized so often remove fully or partially
What is the non operative approach to meniscal tears?
Follow the ligament sprain management
Describe the acute phase for meniscal tears
- watch >90 degrees knee flexion (squats)
- stay in pain free ranges during PROM
Describe the subacute phase for meniscal tears
Precaution: avoid deep squatting >90 degrees of knee flexion or stay in pain free range
Describe the chronic phase for meniscal tears
Same as chronic ligament phase
When is surgical meniscus repair done?
when tear is peripheral (outer 1/3)- the more vascular portion
Describe the expectations after a meniscus repair
- bracing may be used (locked 0-90 degrees or 20-90 degrees) though not always
- WBing
- NWB 2-3 weeks
- FWB at 6 weeks for peripheral tear, 8 weeks for more central tear (K+C)
* *clinically often seen WBAT immediately post-op and off crutches in 1 week
* *Precaution: limit flexion to 120 degrees (for 8 weeks); avoid full squats
Describe the exercise progression after a meniscus repair
-Not doing maximal resistance until 6-8 weeks post op
- 3-6 weeks: bilateral CC then progress to unilateral
- Balance based on WB restrictions
Overall return to function: 20-24 weeks
-unilateral CC
-isokinetics
-plyometrics
-agility and coordination drills
Describe exercise progression for menisectomy partial or total
- Exercise may start in the moderate protection phase
* Precaution: avoid progressing too quickly, high impact activities should be added and progressed carefully
