An estimated 850,000 meniscus surgeries are done each year in the U.S. Previously, we reviewed the keys to recovery after menisectomy surgery.¬† Menisectomy is the most common type of surgery for meniscus tears.¬† With this procedure your surgeon removes the torn portion of your meniscus.¬† Recovery is quick and straightforward.¬† However, this type of surgery is associated with accelerated knee arthritis and knee replacement surgery.¬† Therefore, the preferred surgery is a meniscus repair.
With a meniscus repair, the torn edges of your cartilage are sewn back together.¬† Repair of your meniscus leads to a decreased risk for arthritis and improved outcomes compared to meniscectomy.¬† An individualized rehabilitation program is crucial for you to get the best results after a meniscus repair.¬† This article highlights who should get their meniscus repaired and how to best recover.
Who Gets a Meniscus Repair?
Your surgeon considers many different factors to determine if you are a candidate for a meniscus repair.¬† This includes the following factors:
- Younger (usually < 40 but not always) active person
- No significant medical problems
- Not overweight or obese
- Smaller tears
- Tears located in areas with good blood flow (for healing)
- Tears < 3 months old
- Minimal to no arthritis in your knee
- Willingness to comply with a slower rehabilitation (read on for more about this)
Meniscus Repair Recovery: Slow or Fast Rehab?
Historically, there has been very little consensus on how to best rehabilitate after a meniscus repair.¬† This is changing. Recent research offers guidance on how to best get back to your favorite activities.
The key questions to consider after surgery are:
- How much weight is safe to put through your healing meniscus?
- How much knee bending is safe for your healing meniscus?
- When can you progress through your strengthening program?
- When can you safely return to sports?
Conservative rehabilitation programs restrict knee range of motion and weight through your injured leg.¬† Restrictions last for 4 to 6 weeks.¬† With this slower approach, you will wear a locked knee brace.¬† Also, you will walk with crutches until cleared by year surgeon.
Prolonged time in a brace with restricted weight bearing leads to knee stiffness and weakness.¬† Accelerated rehabilitation programs avoid these problems.¬† However, some question the safety of this approach on the healing meniscus.
Accelerated Meniscus Repair Recovery: A Proven Approach
In their review, restricting range of motion and weight bearing showed no benefit over an accelerated approach.¬† Long-term results (1 to 2 years after surgery) are similar for the conservative and accelerated approaches.
Early weight-bearing and full range of motion avoids the unnecessary decline in strength and function that happens with restricted rehabilitation.¬† We advocate for an accelerated approach.¬† However, pain and swelling have to be respected during the process.¬† Your rehab is progressed based on meeting specific milestones.¬† These include full range of motion and walking without a limp.
3 Easy Exercises to Start Early After Your Meniscus Repair¬†
Regardless of which rehabilitation approach your surgeon allows, you want to begin exercising your knee right away.¬† You start non-weight bearing exercises from your home the day after surgery.¬† Focus your efforts on straightening your knee fully, activating your quadriceps, and slowly progressing your knee bending.
3 Weight Bearing Exercise Progressions
Weight bearing and advanced exercises come in later during your rehab.¬† Your physical therapist walks you through these exercises.¬† Avoid deep squats or knee bends until your physical therapist clears you for these exercises.¬† The following 3 exercises are a safe way to start.¬† Focus your efforts on improving single leg balance and avoiding compensations with your other leg.
Don’t Delay Your Rehab After Surgery
Meniscus repair is preferred over menisectomy surgery.¬† Rehab is slower after a repair.¬† However, if you start early and commit to your exercises, the long-term results will make it well worth it.¬† Early on it is important you minimize knee stiffness and loss of your muscle strength.¬† As you progress in your rehab, your physical therapist will specifically target your exercises towards your movement patterns and goals.
A progressive rehab program is so important for your recovery!¬† Some people ignore their surgeon and physical therapist recommendations.¬† Unfortunately, we see this too often.¬† This results in a rollercoaster rehab with inconsistent improvements.¬† More importantly, this also leads to a knee that continues to be painful years later.
If you are looking for help after your meniscus repair surgery,¬†call our office¬†to schedule an appointment.¬† Our¬†doctors of physical therapy¬†have been helping people in Southern Ocean County move without pain for more than 15 years.