Weightbearing After Meniscus Repair
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- Опубліковано 24 лис 2024
- #177: On this episode of the #AskMikeReinold show we talk about our thoughts on weight-bearing restrictions follow meniscus repair. While we lean towards allowing weight-bearing, there are some important things you have to consider. To subscribe and ask your questions, go to MikeReinold.com....
The #AskMikeReinold Show
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Thanks for this video. It's reassuring to me since I've been told to partial weight bear right after surgery. While a lot of other folks online seem to have no weight bearing for the first 2 weeks. Your explanation clears up any doubt.
1) focal hyperintensity in the cartilage 3x1mm with underlying subchondral marrow contusion/edema measuring 1.2x1.1cms in size in the lateral femoral condule - s/o low grade osteochondral injury.
2)small sized pockets of fluid collection under the LCL and FCL with diffuse increased signal intensity of LCL seen however fibre continuity is maintained - s/o grade II injury.
3)inflamatory/edematous changes with fluid signal intensity in the hoffa's fat pad.
4)focal grade I signal intensity in the anterior horn of lateral meniscus.
5)Tiny hyperintense signal(4mm) involving cartilage of medial femoral condyle.
6) Minimal joint effusion seen extending into medial and lateral recess and adjacent to anterior horn of lateral meniscus
My surgeon said he didn’t even recommend pt post op. He said just walk when you want. I was walking full weight bearing on day 2. He didn’t even recommend a brace. I think I messed up my knee but then I hear it takes up to a yr for full recovery. So maybe I didn’t mess it up. I don’t even know.
2 months later I got ACL with meniscus repair. I’m on day 5. I was full weight bearing on day 4 but now day 5 I’m hurting and can’t put weight on it. I cannot wear my brace - allergic reaction to glue. Huge blister over an incision.
I’m trying to get into PT but keep hitting obstacles. 😢
Had a radial tear at posterior horn, surgery 9 days ago. This video is excellent, thank you!
Hey how are u now
Thank you team I was operated on the 1st of this month and the surgeon put me on full weight bearing but am scared for it to reoccur
What about root tear? I’m 12 days post op medial meniscus root repair. I’m locked in extension and non weight bare for 6 weeks.
I’m on day 2 post op , any advice for my next 6 weeks ? Staying someone active ? Home upper body work outs ? How to avoid weight barring ?
How about after a meniscus root repair with gracilis graft?
Had menicus repair twice now right knee did no weight bearing on crutches for weeks, had my left knee meniscus done yesterday done weight bearing im now walking day 2
Any differences?
So you can move around without crutches?
Makes sense, 4 days out from minor tear repair. Thanks.
How long was the recovery? Did u not wear a brace the first couple weeks
My doctor said use the crutches for 6 weeks but i am already able to walk with my crutches right after surgery i only put very little weight on it
Hi. I had miniscus repair surgery about 1 week ago. My question is, do I need to sleep with my brace on? I feel that information we get before surgery does not always match what we are told after. It's a moment of asking yourself are you crazy. I did ask about sleeping with my brace before surgery and was told it was okay. However, after surgery I feel that information wasn't as clear anymore. What are your thought?
Laura H
I just got my meniscus repair surgery two days ago and my surgeon called me yesterday to check up on me and he said I do not have to sleep with the brace on and I can take it off when I’m laying down or sitting. He said it’s really only needed when you’re using your crutches and going somewhere
@@kellytush1571 how's it going now?
@@ru2253 Mich better!! I’m basically done with Physical Therapy and I’m cleared to go back to skiing and my other activities. I healed much better from this surgery than my ACL surgery
sorry for the late reply but how many months post op before you were able to ski?@@kellytush1571
Hey Guys thank you for answering my question and I think in my area its mostly surgeon dependent to an extent. A lot have been sending their patients over with the Champion sports medicine protocols( Im guessing from Mike, Kevin, and Dr. Andrews?) and WB is as tolerated or only limited for the first couple of weeks. Lenny are the articles you mentioned referenced in your blog post? If not all are would you mind commenting the names? Thanks again for answering the question and for all yall are doing to further our profession.
Thanks John! Head here for the article: mikereinold.com/weightbearing-after-meniscus-repair/
@@Mikereinold I get that weight bearing is good. But when can you go for walks, say a 30-60m walk?
Love this team! Thank you for all the great info!
Horizontal medial tear + radial posterior horn tear, I was weight bearing same day after surgery. 3 weeks into my 6 weeks initial PT order, still dealing with swelling, but making progress. Hoping to get back to at least 90% (I'm 51, great health, but I'm tempering my expectations) - looking for SAFE muscle-building exercises, glad I came across this video (hoping to find something to help build mass and stability, any help is appreciated!)
what type of movements are you told to avoid early and after 6 weeks?
@@GoodByeSkyHarborLive anything that involved flexion beyond what was tolerable, after 8 weeks I am at 135ish degrees. Even now I've been told to avoid any exercises that involve torsion movements, I'll likely do that at least through March/April - for now just building strength and adjusting... after exercise swelling is pretty much the norm, although it's less each week... hope this helps!
Dude i have a horizontal tear in medial and lateral meniscus is it repairable
@@varun-72 mine was - took almost a year to fully recover but I feel better than ever now!
@@xelnjare3945 ohh did it get stiched or they trimmed it and how long it took to put weight on your leg after surgery i have tear in both meniscus and acl🥲
i had a medial and lateral tear, degenerative no way could i put any weight on leg day 2 nope,,,
Same
What is your update now ?
What about a root tear meniscus repair? Just had this done two days ago. I live alone so I have to move around a lot. Currently using a walker and hopping is exhausting. I have a brace but it slips down when I walk.
I also live alone. I had a posterior horn repair done 2 weeks and 5 days ago (no brace, I'm 34). My doctor told me that the movement that risks ruining the repair are those in which the leg flexes with weight, because the closer you get to a straight/acute angle, the pressure on the menisci increases as it becomes squeezed with friction. I was told I can absolutely put all my weight if my leg is entirely straight, but only 30% when using crutches. I would ask your doctor, but these are 2 tips I would give you being 2 weeks ahead of you:
1.- buy crutches too if you can (or rent them). I bought everything hahah, I got a walker, armpit crutches and Canadian crutches, and I can tell you I've used all of them. The walker tires out my wrists super fast, so at this point I only use it to sit on the toilet and to sit on the chair in the shower. For going up/down stairs, I use the armpit crutches, as they don't tire my wrists and are super stable, but they are quite bulky. So I use the Canadian ones to go out and walk around the house.
2.- There are 2 signs that damage has been done, if none of them happen, you're good: sudden swelling and pain. Now, naturally there is some swelling because of the surgery, but if there is a sudden burst of swelling that just does not make sense based on where you were, then you've injured yourself. As long as you don't have any of those two, you can trust the process.
How are feeling now.... I had a surgery 2weeks back for medial meniscus tear root
Hi,
Would this advice be the same for a lateral posterior meniscal root repair?
Thank you for this!! Very helpful. I have a complex medial tear on the red white border, I think. Still good to weight bear?
Just had lateral meniscus tear surgery and was told to put weight on it pretty much right away! To bend it often, and I could start some of the physical therapy exercises I already know. I'm feeling pretty good day 2, only ibuprofen for pain today! It was a white/white area tear also
Nice. I’m going in on the 27th lateral bucket handle tear. Doc said probably a brace and 3 week recovery.
i was told 6 weeks of non weight bearing😢 i had an accident on my stairs and i was crutching down and i flew forward because i lost balance and i stomped super hard on my non weight bearing leg. i didn’t twist or bend or anything but it was definitely really scary. i wasn’t even in pain after but i’m just worried i messed it up again and have to go through this whole process again
@@catecurleyy Same happened to me, is your leg doing ok?
@@wyattgeorge9696 yes it’s doing fine. no more pain than there was before but i’m worried i won’t have a full recovery. how about you?
@@catecurleyy how is your leg holding up now
I am 2 weeks post-op today and my doctor told me he still wants me non-weight bearing for two more weeks. He said I can put weight on it while standing tho just no weight while it's bent.
How soon are leg extensions safe for meniscus repair
Ya man please tell me also do you do legwork out after recovery
so are you saying weight bearing is ok as long as you have a brace??
I just had my bucket handle tear stitched up 11 days ago, very stressful afterwards but I felt comfortable walking small distances as soon as 5 days after surgery without my crutches but the brace still on. Just looking for multiple opinions, but is it possible that I may have created an issue with repair process by baring too much weight too soon, even walking with little to no pain? Assuming so, how could I tell? Im worried I fucked myself and wont ever be able to return to Jujitsu again
How are you holding up now?
Here’s something profound too... knee brace doesn’t do much either. And this artificially locked in extension thing is also over pushed. I get the patient might need the feedback - and reminder. But overall - you can get more flexibility and benefits of weight bearing by not completely hinging the joint. The studies although often comparing weight bearing with locked brace vs non weight bearing with more movement... the best approach to me - is for the most part partial weight bearing - without restriction of movement entirely. Anecdotally certainly makes most sense - and the literature is also hinting at it.
can you provide some literature examples for this. I'm currently in my brace and it doesn't feel like it is helping me repair.
@@elizabethmasad7117 “Some authors recommend immobilisation in full extension, reportedly due to the observation that peripheral posterior horn tears move away from the capsule in flexion and reduce in extension. This recommendation stems from direct viewing of periph- eral posterior horn tears using a 70° arthroscope and observing the reduction of these tears during passive knee extension. However, this observation and the subsequent practice of immobilising meniscal repairs in extension has not been shown to be beneficial clinically and may not be relevant to other tear types. Some inves- tigators recommend immobilisation in various degrees of flexion,and others still advocate for limited early motion. Despite more aggressive protocols allowing for free ROM immediately postoperatively, 90° of flexion appears to be a comfortable restriction for surgeons. Up to 85% of the load travels through the menisci with the knee in 90° of flexion, while less (50%) of the load passes through the meniscus in extension.”
bmjopensem.bmj.com/content/bmjosem/4/1/e000212.full.pdf
Tldr - the postulation of keeping brace in extension is based on cadaver studies - and postulated for a single type of tear. Obviously you need to be smart about your biomechanics. But - yeah - people just assume you need to be in extension for weight bearing. The shear forces - especially in limited WB and allowing some knee flexion... gets you best of both worlds. Ofcourse communication with surgeon is also important - as not all repairs are the same. But overall - surgeons as they mentioned are stuck in the 90s of being super safe. And the physios above I feel still respect a bunch of cadaver studies on “biomechanics” a bit too much. I once had a lecturer and phd professor who did cadaver studies - and honestly - it’s the most rediculous types of studies I’ve ever read, after the biomedical bullshit on benefit of certain “machines” for physical therapy that were all to sell useless biomed equipment.
@@sandman3881 appreciate you sharing this article 👍. Relevant to me now as we speak.
@@db4419 remember that weight bearing into flexion needs adapted ambulatory walking coaching. We get patients to walk in a different style to avoid the sheer associated with what I like to refer to as “model ramp stage walking”. Less pivot in hips leading to internal and external sheer of tibia on femur.
One surgeon put it best. They use brace as biofeedback restrictive tool…
The reasoning is because you can’t properly sway with your hips and expand gate with a straight brace. That’s litteraly the reason you see safety protocols locking it down. People sometimes don’t have the proprioceptive ability to walk injured safely.
I have a medial meniscus tear from a year ago and pain was about 5 or 6, until I used my knees to build a carport. Now pain got really bad to about 8 to 9 sometimes so my doc suggest repair with stitches since it's year old injury what's my recovery rate? I'm 24
Hi brother. I was kinda in the same situation as yours, just got my tear repaired yesterday
Hi Mike. I tore my right knee meniscus and some cartilage in June 23rd. Surgery scheduled for sept. 19th. Pain is still pretty bad with swelling. My question is. Should I consider a new line of work after surgery as my job consists of 4 flights of stairs every other hr at a water treatment facility. I'm assuming no more karate or activity of that nature. My dr. Is going to remove the maniscus do to my age. 48
How are you feeling now 2 years post surgery?
@@chemagomez155 well. 2 years later my water yreat.e t job is no longer. The facility left me go after 30 years with a severance and walking papers. Go figure. I've since found another position doing maintenance for a senior living facility. My knee still tends to buckle every now and again but I can still walk. So. I guess with only having one good side of my knee left and the other meniscus removed it makes sense why I still get a buckle on occasion.
@@Whitebeard1715 As an HR professional it saddens me to read that they terminated you. Hopefully the severance package was juicy. I'm glad you can still walk and that it's only on rare occasions when it buckles. Thanks for sharing! :)
Do you have enough evidence with your patients, by letting them do load bear?
Do you think medial knee pain always constitutes a trip to the ortho (pain for over a month) or is it something that can just heal on its own.
R u sure it's healed by itself
I had by mistake put weight for half minute while urinating after my grade III tear meniscus surgery ...I felt no pain.. would it have caused damage to meniscus 🤦♂️??
It's been 2 months how did u feel now how's ur knee I hade the same tear and surgery just 10 days ago
I did the same thing tonight while peeing. I put a bit of weight and prayed I didn’t mess anything up. I think I’m being overly cautious and that can hinder progress
What about a root tear?
I had acl reconstruction and lateral meniscus repair , i was advised 3 weeks of no weight bearing and 3 weeks of partial weight bearing my 3 weeks of no weight bearing is done , i want to ask is 3 full weeks of partial weight bearing required? Or can it be shortened?
Everyone different, go by what the doc recommended!
Hello, how is your meniscus tear now? Is it healing well?
@@chloebeeforth7022 it s healing well , i m doing alternate day leg workouts in the gym right now and proprioception exercises
@@docmedp892 that’s great to know Thankyou! I’m 4 weeks pre op
@@chloebeeforth7022 all the best , may god bless the first few weeks r gonna be difficult dont skip your exercises afterwards you ll definitely see progress
My surgeon has told me no weight bearing for 6 weeks iv had a reps and a partial meniscectomy.
How are you now?
I have the same type of surgery and I will appreciate to know how is your recovery going
Hey! I’m currently on week 3 post op off of a bucket handle meniscus repair surgery and my surgeon told me no weight bearing for 5 weeks. My progress is excellent with range of motion and quad strengthening. Even though you have now knowledge of me, you think it’s okay for partial weight bearing on this third week
Hope your recovery goes well man! I just started week 3 after bucket handle repair and acl reconstruction. The doctor just told me to sit around for 6 weeks, with no therapy, no weight. I just started putting a little weight on it and excersises at home. Pain and swelling were cut in half. I Definitely recommend to try for yourself, test the waters a little. Keep your chin up, we'll both be back to running in no time!
How is your knee bro?
How are you progressing?
@@klayrivera7905 what’s up man recover has been tough man, impact was so hard my meniscus moved into a place where it wasn’t supposed to be so it was double the trouble it took me 18 days to get surgery and in those day I built scar tissue so when it was time to progress my knee was extremely tough, I had to do therapy on my own and it was the worse pain ever to get full range of motion. So now my knee finally feels normal again but it’s still weak
@@Danieldork what's up bud, how are you feeling now?
Were you are allowed to put weight on your knee after surgery or did you have to wait a couple weeks?
Thats normal, usually can do partial weight bearing week 5 and 6 (that means still using crutches any apply about %25 weight) do not rush it alot of people are full of crap on this topic.
I had lateral meniscus surgery is it ok to feel pain after 1 month?
What about meniscus transplant?
Can I ask you a question??? I’m 2 months out of acl repair and both meniscus being stiched. I was told 8 weeks non weight bearing
Hey I just had a similar thing happen any advice
You went next level with the camera, gj man
I put weight on mine right after surgery
How are you now which type of tear you had
I've had three meniscus surgeries each knee from college sports... the first time I did surgery on both knees at the same time.
Never allowed to use crutches, no actual brace - just compression sleeves - and started rehab 2 hours after surgery back in the training room.
Our trainers, surgeons, and doctors believed in weight bearing immediately and PT immediately... the faster you could get that blood and fluid and swelling out of there the faster the recovery.
I was jogging and doing light cutting/agility work 2-3 weeks out and was back to normal in less than six weeks.
It was the same for all the fellow athletes at my college.
Literally just got home from surgery
Hope you doing ok man!
What is weight bearing?
I walked the same day the nurse didn’t roll me out of the hospital so ya I walk around my own house because I cannot see myself paralyzed and not try to walk luckily I have my Children who cheer me on walking up 12 steps up to my room You have to add weight onto your leg in order to get better
was it a full repair or trim?
Can be possible if you had mensicus repair u must have had mensicectomy
Well I'm having surgery Thursday so I came here from another video and I found this video comment and it makes me feel so much better that you brought to walk out of the hospital and walk around your own house. I'm just hoping my surgeon says get up and walk because I will
Just had my second acl/meniscus surgery and I was told no weight bearing for 6 weeks both times. I’m so confused but I’m terrified that it’s going to tear again and I feel like my acl relies on my meniscus which scares me. Any advice?
@@jesussaves1827 my dads side of the family are Pentecostal and tried brainwashing me for years. It worked at first but I’ve come to realize that I’m better off relying on myself and science when it comes to situations such as these. Bad things are constantly happening to good people and until there’s an explanation for that I will continue to rely on myself.
Everyone is a little different, so be sure to follow what the MD and PT recommend!
Dr. Trey looks like Gerard Pique.
I sure hope he doesn't see this huge compliment... :)
Question. After my meniscus repair I get a noise. That sound like a Squeaky door hinge. I think it’s the sucher slipping through the bone. What can be done to fix this? Thank you
A lot of pt
I had surgery a month ago and I also have that noise. Does it improves with time?
The guy in the background looks like Adam Goldberg from SAVING PRIVATE RYAN
The Boston accent is deep brah 🤣
I just got a root meniscus tear surgery. I didn’t put any weight on my leg till after 72hrs of surgery however my right leg is feeling the pain of putting majority of the weight on it. Should I start walking around and put some weight on it and of course I used crutches any advise.
Hiya, how is your meniscus repair now? Did it heal successfully?
You guys are a fidgeting bunch. Lol
They're PTs, c'mon LOL.
God Jesus Christ and Holy Spirit will guide and provide for you always. Faith over sight and fear. Fear God. Jesus Christ is the King of Kings
Don't mind them Boston guys are ruff eddie munster
Hello I had a Meniscus Repair non weight bearing for 5 weeks and doing pretty good BUT I have no Reflex! So in a sitting position my leg I can’t kick up. Any ideas why this is happening? Had Emg but it did not conclude anything per the ortho dr. But going for a MRI next week. Any ideas why this could be happening please help I work in a hospital and need to go back to work :( please any ideas would help
Hello, how is your meniscus repair now? Did it heal successfully?
@@chloebeeforth7022 did you have any surgeries?
Honey did u make a sure you washed my gray work shirt ? Sure did baby I got all the feline spray off it. Great thanks I need to go
Jimmy Garopolo
God Jesus Christ and Holy Spirit will guide and provide for you always. Faith over sight and fear. Fear God. Jesus Christ is the King of Kings
2:18