Rehabilitation plan after arthroscopic meniscus total resection or revision. Cao Xuewei, Department of Orthopedics and Joints, Guangdong Provincial Hospital of Traditional Chinese Medicine. Tel: 135805166891. You can start ankle pump exercises after recovering from anesthesia on the day after surgery. The method is: Method As follows: When the patient lies in bed and straightens both lower limbs, the ankles should be naturally relaxed first, and then do back extension. The back extension must be reached to the maximum extent. Then start doing plantar flexion from the maximum dorsiflexion state, and the plantar flexion should also reach the maximum. Repeat this over and over again. The patient can continue to perform plantar flexion and dorsiflexion exercises while lying in bed watching TV, reading books or newspapers, and talking with family members. 2. Within 24 hours after surgery, in addition to starting ankle pump exercises of the ankle joint, you can also start active exercises of the hip joint (30 times - 1 day). When performing ankle pump exercises and hip joint exercises, the knee joint remains stationary. ; However, quadriceps contraction and relaxation exercises for the surgical knee joint can be performed (100 times per group, 3 groups/day). Quadriceps contraction and relaxation exercise method while lying in bed: The patient lies on the bed, straightens the legs naturally, and repeatedly contracts the thigh muscles of both lower limbs for 5 seconds and then relaxes for 2 seconds. You can perform quadriceps contraction and relaxation exercises with both knees at the same time, which can increase the efficiency of quadriceps exercises by 30%. 2. On the second day after surgery, you can walk with crutches on the ground and fully bear weight (the total daily walking time with crutches is 30 minutes, and each walking time is about 5 minutes). The quadriceps training consists of "static contraction" Training” was changed to “straight leg raise training”. (20 times→10 times→5 times is one group, 1-2 groups/day, and can be practiced in the morning and afternoon). The knee joint can perform micro-movements of 0-30° within the cotton pad. Other exercises are the same as those within 24 hours after surgery. 3. On the third day after surgery, the knee joint can move with a range of 30-60°. Other activities are the same as on the second day after surgery. 4. On the third or fourth day after surgery, the wound dressing is changed from "cotton leg" to "elastic bandage". You can start walking without crutches. The total walking time per day is controlled to 30 minutes, and the time of each walking is controlled. within 10 minutes. That is, if you walk for 10 minutes each time, you can walk up to 3 times a day; if you walk for 5 minutes each time, you can walk 6 times a day. At the same time, perform quadriceps contraction and relaxation training. The knee must be bent over 90 degrees, and the patient can be discharged from the hospital at this time. 5. The sutures will be removed in the outpatient clinic 1 week after the operation. The patient can walk normally without crutches, and the daily walking time should be controlled within 1 hour. The range of motion of the knee joint should reach more than 100 degrees. 6. Training at home for the second week after surgery: (1) Range of motion training 0-45-90-120 degrees. From the beginning of the second week after surgery to the weekend of the second week after surgery, the range of motion gradually increases. (2) Muscle strength training begins with silent squatting at 45-80 degrees. ① Start squatting silently to practice quadriceps strength. Silent squat practice method: The posture is the same as the horse riding crotch movement in Chinese martial arts or becomes a stance movement. The patient's legs are spread apart, the distance between the feet is slightly wider than the shoulders, the body remains in an upright position, and cannot lean forward. At this time, the knees begin to bend and squat. The bending angle of both knees varies according to the patient's physical condition and muscle strength. If the patient is in good physical condition and has good thigh muscle strength, the squatting angle can reach 90° with the knees bent. If the patient is in poor health and has weak thigh muscles, a slight bending of the knees is enough. At this time, the squatting position is higher and the patient saves effort. , as the muscle strength increases after practice, increase the angle of knee flexion. Decide the number of exercises based on your physical condition. It is generally required to practice 2-3 groups a day, with each group practicing 10-15 times. The time of each exercise varies from person to person. For example, if the muscle strength is good, one squatting time can last for 5 minutes, while if the muscle strength is weak, one time only If you can squat for 2 minutes, in short, no matter whether your muscle strength is good or not, you should squat until your legs are shaking and you can't hold on anymore. This is considered as one practice. ② Straight leg raise exercises the strength of the medial head of the quadriceps. Straight leg raise training: The method of straight leg raise exercise is: the patient lies on the bed, his legs are naturally straightened, the affected limb is raised 15° with the knee joint straightened, and the 15° raised position is maintained until it becomes weak. . Rest for 2 minutes and repeat again. Just complete it 10-20 times a day. 7. 3 weeks to 5 weeks after surgery: "Specialized walking training" can be carried out. During this period, it is generally recommended to walk at a slow or medium speed and to minimize fast walking. The best daily walking distance is around 1,000 meters in the 3 weeks after surgery, can be increased to 1,500 meters in 4 weeks after surgery, and can exceed 2,000 meters in 5 weeks after surgery. However, it must be based on the fact that the swelling of the knee joint does not increase significantly after walking. If the swelling of the knee joint increases significantly after walking the above distance, please reduce the walking distance, first by 500 meters. If the swelling no longer increases, you can break at the reduced distance, and then increase the distance the next week. 8. After 6 weeks after surgery, you can start walking without limiting the distance, you can also resume all daily activities and work, and try jogging. If joint swelling increases after too much walking or running, such exercises should be postponed appropriately. For athletes, if their muscle strength has recovered well at this time, they can start participating in auxiliary training and quickly transition to formal special training. 9. After 9 weeks after surgery, normal activities can basically be resumed.
Guangdong Provincial Hospital of Traditional Chinese Medicine-Orthopedics-Deputy Chief Physician Cao Xuewei View original post >>