This protocol is intended to be a general outline only. The physician reserves the right to either advance or delay this protocol as deemed necessary. If so, this should be done by direct communication with the therapist, or in writing on the therapy referral form given to the patient on the day of surgery.

Guidelines for Crutches and TROM Brace

  • Bilateral axillary crutches to be used immediately post-op.
  • Meniscal Repairs:
    • SMALL AND STABLE:
    • Maintain NWB with brace locked in extension for 4 weeks
    • After Week 4, WBAT with TROM locked in extension weaning from crutches.
    • Once crutches have been discontinued, advance to unlocking TROM, then removing brace.  Patient must demonstrate excellent quadriceps control.
    • LARGE OR UNSTABLE:
    • Maintain NWB with brace locked in extension for 6-8 weeks
    • After Week 6-8, WBAT with TROM locked in extension, wean from crutches.
    • Once crutches have been discontinued, advance to unlocking TROM then removing brace.  Patient must demonstrate excellent quadriceps control.
  • TROM brace to be worn and locked in 0o extension with all ADL’s for time frame as specified above.
  • TROM may be removed for bathing and exercises.
  • TROM brace may be unlocked for slight flexion in sitting for short periods of time and for driving.

Initial goals/precautions:

  • Achieve full ROM by 8-10 weeks post-op
  • No closed-chain knee flexion for first eight weeks
  • No resisted hamstring exercises (open or closed chain) for first three weeks
  • Avoid hyperextension of knee
  • No deep squats or lunges past 45 degrees of flexion until 16 weeks post-op
  • Knee flexion ROM performed in supine or prone to tolerance is OK after restrictions are removed
    • Knee flexion restricted to 90 degrees for the first 4-8 weeks pending size of repair. To be indicated on PT referral.
  • No running till 4 months post-op
  • No torsion or cutting drills until 6 months post-op
  • No competitive sports participation until 8 months post-op

 
Guidelines for Wound Care

  • Place occlusive dressing over steri-strips at wound sites at first visit. Change occlusive dressing every other day, leaving steri-strips on unless they come off easily. Cover old steri-strips with new ones if needed.
  • Keep wound