According to the American Academy of Orthopedic Surgeons 636,000 arthroscopic knee surgeries are performed every year in the United States. The majority of these surgeries are performed to remove or repair a torn meniscus (cartilage). 80% of all MRI scans performed on the knee in the U.S. Identify the presence of meniscus (cartilage) tears. Meniscus tears can be the result of an acute injury such as in sports. This is usually caused by axial load on the flexed and rotated knee. Meniscus injuries can also be caused by a degenerative process that occurs in the middle aged and elderly. These injuries usually result in knee pain, loss of motion, loss of quadriceps strength, and reduced lower extremity function.
Post operative management of these injuries has consisted for many of rest, gradual resumption of activity, and perhaps home exercise instructions. Some are fortunate enough to receive outpatient physical therapy, but it is often delayed by 3-6 weeks post surgery. According to a recent review of research on this subject, optimal rehabilitation to maximize recovery of knee function and range of motion should consist of a referral to outpatient physical therapy that includes an individualized home exercise program to be followed between therapy sessions. The therapy sessions should be performed 3 times weekly and start as soon as possible (Dias, et al., 2013).
Post operative treatment should include:
1. Outpatient Physical Therapy
2. A well planned home exercise program
3. Outpatient Physical Therapy should be done 3 times weekly
4. Treatment should start as soon as possible
At Stover Physical Therapy, we evaluate each individual patient with knee pain following arthroscopic surgery to determine if their current symptoms are arising from an inflammatory or mechanical process. Often in the early phases of treatment inflammation is the predominant source of pain. In this phase advice on rest or relative rest, ice, compression, and elevation is important to promote an optimal environment for the body’s natural healing process. Within the first 7 days to 3 weeks post-surgery the clinical presentation usually shifts to reveal a predominantly mechanical source of knee pain. It is at this point where exercise begins to play a larger role in the recovery process. It is the Physical Therapist’s responsibility to determine the appropriate type, and amounts of exercise to optimize the reduction of knee pain, and restoration of lower extremity function. The PT determines exercise/treatment appropriateness by acquired knowledge of tissue healing, reassessment of clinical findings, and close communication with the patient in regards to the patient’s response to specific movements, loads, and positions.
Each patient with knee pain following arthroscopic knee surgery referred to Stover PT is asked to complete a Lower Extremity Functional Scale (LEFS) during his/her initial evaluation and at any subsequent re-evaluation. The Lower Extremity Functional Scale is a 20-item self-report questionnaire that asks the patient to rate his/her level of difficulty on a 0-4 scale during various daily activities. The score ranges from 0 (extremely low function) to 80 (extremely high function). The minimal detectable change for the LEFS is 9 points (Binkley, et al., 1999).
We have documented outcomes on 42 patients who were treated following arthroscopic knee surgery. The average score on the LEFS for patients these patients was 34/80 initially. After treatment, the average score rose to 60/80. This is a significant change of 26 points. The average number of visits for this group of patients was 12 over a 5 week period.
Binkley, J.M., Stratford, P.W., & Lott, S.A. (1999). The lower extremity functional scale (LEFS): Scale development, measurement properties, and clinical application. Physical Therapy, 79, 371-383.
Dias, J. M., Mazuquin, B. F., Mostagi, F., Lima, T., Silva, M., Resende, B. N., et al. (2013). The effectiveness of postoperative physical therapy treatment in patients who have undergone arthroscopic partial meniscectomy: systematic review with meta-analysis. JOSPT , 43 (8), 56--576.
Don Stover PT
husband and father
PT in private practice
TKD black belt (retired)
hapkido black belt (retired)
outdoor cooking fanatic
hot tub soaker
Thanks for visiting my blog page. My name is Don Stover. I am a seasoned physical therapist in Oklahoma City OK. with over 20 years in the biz. I have a lot of knowledge and training in orthopedic PT and spine care. I will be sharing my thoughts on physical therapy for orthopedic problems such as spinal pain, extremity joint pain, sports injuries, health/fitness, and life in general. I hope you enjoy reading!
Forward Thinking PT
Evidence In Motion
The Naked Physio
The Sports Physio