Meniscal Repair: Difference between revisions
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<div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox"> | <div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox"> | ||
'''Original | '''Original Editor '''- [[User:Rachael Lowe|Rachael Lowe]], [[User:Jennifer Uytterhaegen|Jennifer Uytterhaegen]] | ||
'''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | '''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | ||
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== Definition/Description == | == Definition/Description == | ||
{| width="40%" cellspacing="1" cellpadding="1" border="0" align="right" | {| width="40%" cellspacing="1" cellpadding="1" border="0" align="right" | ||
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An arthroscopic meniscectomy is a surgical procedure to cut out part or all of the knee meniscus via keyhole surgery. A complete meniscectomy is where all of the meniscs right up to and including the meniscal rim is removed. Partial meniscectomy describes the procedure where not all of the meniscus is removed which may vary from minor trimming of a frayed edge to anything short of removing the rim. This is a minimally invasive procedure often undergone as an outpatient. | An arthroscopic meniscectomy is a surgical procedure to cut out part or all of the knee meniscus via keyhole surgery. A complete meniscectomy is where all of the meniscs right up to and including the meniscal rim is removed. Partial meniscectomy describes the procedure where not all of the meniscus is removed which may vary from minor trimming of a frayed edge to anything short of removing the rim. This is a minimally invasive procedure often undergone as an outpatient. | ||
== Clinically Relevant Anatomy == | |||
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== Indication<br> == | == Indication for Procedure<br> == | ||
[[Meniscal Lesions|Meniscal tears]] that are not suitable for [[Meniscal Repair|meniscal repair]].<br> | [[Meniscal Lesions|Meniscal tears]] that are not suitable for [[Meniscal Repair|meniscal repair]].<br> | ||
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*Imaging <br> | *Imaging <br> | ||
== Pre-Op == | == Medical Management <br> == | ||
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== Physical Therapy Management <br> == | |||
==== Pre-Op ==== | |||
add text here relating to the pre-operative advice | add text here relating to the pre-operative advice | ||
== Post-Op == | ==== Post-Op ==== | ||
The goal of rehabilitation is to restore patient function based on individual needs. It is important to consider the type of surgical procedure, which meniscus was repaired, the presence of coexisting knee pathology (particularly ligamentous laxity or articular cartilage degeneration), the type of meniscal tear, the patient's age, preoperative knee status (including time between injury and surgery), decreased range of motion or strength, and the patient's athletic expectations and motivations. <br> | The goal of rehabilitation is to restore patient function based on individual needs. It is important to consider the type of surgical procedure, which meniscus was repaired, the presence of coexisting knee pathology (particularly ligamentous laxity or articular cartilage degeneration), the type of meniscal tear, the patient's age, preoperative knee status (including time between injury and surgery), decreased range of motion or strength, and the patient's athletic expectations and motivations. <br> | ||
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*progress weight bearing - weight bearing and joint stress are necessary to enhance the functionality of the meniscal repair so should be progressed as indicated by the consultant. Excessive shear forces may be disruptive and should be avoided initially. | *progress weight bearing - weight bearing and joint stress are necessary to enhance the functionality of the meniscal repair so should be progressed as indicated by the consultant. Excessive shear forces may be disruptive and should be avoided initially. | ||
== Key | == Key Research == | ||
add | add links and reviews of high quality evidence here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== Resources <br> == | == Resources <br> == | ||
add appropriate resources here <br> | |||
[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=155528 Timothy Brindle,John Nyland and Darren L. Johnson (2001) The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation. Journal of Athletic Training, 36(2), 160–169]. | [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=155528 Timothy Brindle,John Nyland and Darren L. Johnson (2001) The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation. Journal of Athletic Training, 36(2), 160–169]. | ||
== | == Clinical Bottom Line == | ||
add text here <br> | |||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
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<references /> | <references /> | ||
[[Category:Articles]] [[Category:Procedures]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Knee]] [[Category:Videos]] | [[Category:Vrije_Universiteit_Brussel_Project|Template:VUB]] [[Category:Articles]] [[Category:Procedures]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Knee]] [[Category:Videos]] | ||
Revision as of 18:24, 9 November 2010
Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
Original Editor - Rachael Lowe, Jennifer Uytterhaegen
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Search Strategy[edit | edit source]
add text here related to databases searched, keywords, and search timeline
Definition/Description[edit | edit source]
An arthroscopic meniscectomy is a surgical procedure to cut out part or all of the knee meniscus via keyhole surgery. A complete meniscectomy is where all of the meniscs right up to and including the meniscal rim is removed. Partial meniscectomy describes the procedure where not all of the meniscus is removed which may vary from minor trimming of a frayed edge to anything short of removing the rim. This is a minimally invasive procedure often undergone as an outpatient.
Clinically Relevant Anatomy[edit | edit source]
add text here
Indication for Procedure
[edit | edit source]
Meniscal tears that are not suitable for meniscal repair.
Clinical Presentation[edit | edit source]
- joint line tenderness and effusion
- symptoms are frequently worsened by flexing and loading the knee, activities such as squatting and kneeling are poorly tolerated.
- complaints of 'clicking', 'locking' and 'giving way' are common
Diagnostic Tests[edit | edit source]
- Joint line tenderness has been reported to be the best common test for meniscal injury[1].
- McMurray's test positive if a pop or a snap at the joint line occurs while flexing and rotating the patient's knee.
- Apley's test performed with the patient prone, and with the examiner hyperflexing the knee and rotating the tibial plateau on the condyles.
- Steinman's test performed on a supine patient by bringing the knee into flexion and rotating.
- Ege's Test is performed with the patient squatting, an audible and palpable click is heard/felt over the area of the meniscus tear. The patient's feet are turned outwards to detect a medial meniscus tear, and turned inwards to detect a lateral meniscus tear.
- Imaging
Medical Management
[edit | edit source]
add text here
Physical Therapy Management
[edit | edit source]
Pre-Op[edit | edit source]
add text here relating to the pre-operative advice
Post-Op[edit | edit source]
The goal of rehabilitation is to restore patient function based on individual needs. It is important to consider the type of surgical procedure, which meniscus was repaired, the presence of coexisting knee pathology (particularly ligamentous laxity or articular cartilage degeneration), the type of meniscal tear, the patient's age, preoperative knee status (including time between injury and surgery), decreased range of motion or strength, and the patient's athletic expectations and motivations.
- control the pain and inflammation - cryotherapy, analgaesics, NSAIDs,
- restore ROM - ROM exercises within any limts in range that the consultant has requested
- restore muscle function - specific strengthening exercises including qudriceps, hamstrings, calf, hip
- optimize neuromuscular coordination - propriocetive re-education
- progress weight bearing - weight bearing and joint stress are necessary to enhance the functionality of the meniscal repair so should be progressed as indicated by the consultant. Excessive shear forces may be disruptive and should be avoided initially.
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Timothy Brindle,John Nyland and Darren L. Johnson (2001) The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation. Journal of Athletic Training, 36(2), 160–169.
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
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