Your companion after the operation

You have successfully survived the operation with a meniscus suture. But what happens next? When can you shower again? How much weight can be put on the knee? Who will give the antithrombosis injection? Questions upon questions. This treatment schedule is intended to provide postoperative assistance as well as detailed guidance and instructions. The prescribed chronological sequence of the individual therapeutic measures is based on our many years of experience and the guidelines developed from it. The aim is to achieve a customized, individual rehabilitation as a basis for further optimal healing success after the operation.

Treatment calendar meniscus suture technique

The contents in the aftercare after meniscus suture technique (also after meniscus root suture and meniscus ramp suture) are treatment recommendations based on our many years of experience in the treatment of this injury. Deviations from the guideline values are possible at any time, or necessary if medically indicated.

Mobility

movement-after-knee-surgery-meniscus
  • Mobility of the knee joint: Immediately after the operation, we put on a Genuloc/Mecron splint in a 10° bent position.

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus s utures e.g. posterior horn suture of the meniscus alone : extension/ flexion: 0-10-70 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-10-70 degrees for 4 weeks
  • Physiotherapy: The following also applies in physiotherapy: extension/bending: 0-10-70°, i.e. the knee joint should be moved in this ROM. Focus: Lymphatic drainage, walking school and treatment of the iliopsoas muscle.
  • important to knowThe iliopsoas muscle is the strongest of the Flexor of the hip joint. It is also involved in raising the trunk from the supine position as this is done by flexion in the hip joint. It is prone to considerable tension due to compensatory overload caused by the failure of the quadriceps in the context of an injury or after an operation on the knee joint, and should be treated by their Physiotherapists should be included in the treatment regime after surgery!
    → WATCH VIDEO
  • CPM splint: (motor movement splint)-adjustment of ROM stretching/bending mobility: 0-10-70 degrees possible !

artromot active k movement bar

  • Medical check-up: at the Freiburg OZ or at your orthopaedist's office for follow-up treatment.
  • independent self-exercises: You start with tensioning exercises (quadriceps activation) for the thigh muscle in the intended range of motion of the knee joint (also possible in the orthosis). These first isometric exercises include parts of coordination training, repetitive muscle contractions without changing the length of the muscle.

→ WATCH VIDEO

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus s utures e.g. posterior horn suture of the meniscus alone : extension/ flexion: 0-10-70 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-10-70 degrees for 4 weeks
  • Physiotherapy: The following also applies in physiotherapy: extension/bending: 0-10-70°, i.e. the knee joint should be moved in this ROM. Focus: Lymphatic drainage, walking school and treatment of the iliopsoas muscle.
  • important to knowThe iliopsoas muscle is the strongest of the Flexor of the hip joint. It is also involved in raising the trunk from the supine position as this is done by flexion in the hip joint. It is prone to considerable tension due to compensatory overload caused by the failure of the quadriceps in the context of an injury or after an operation on the knee joint, and should be treated by their Physiotherapists should be included in the treatment regime after surgery!
    → WATCH VIDEO
  • CPM splint: (motor movement splint)-adjustment of ROM stretching/bending mobility: 0-10-70 degrees possible !

artromot active k movement bar

  • independent self-exercises: You continue the tensioning exercises (quadriceps activation) for the thigh muscle in the intended range of motion of the knee joint. These first isometric exercises include parts of coordination training, repetitive muscle contractions without changing the length of the muscle.
    → WATCH VIDEO

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis.

:→ WHAT IS ROM

  • For non-complex meniscus s utures e.g. posterior horn suture of the meniscus alone : extension/ flexion: 0-10-70 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-10-70 degrees for 4 weeks
  • Physiotherapy: The following also applies in physiotherapy: extension/bending: 0-10-70°, i.e. the knee joint should be moved in this ROM. Focus: Lymphatic drainage, walking school and treatment of the iliopsoas muscle.
  • important to knowThe iliopsoas muscle is the strongest of the Flexor of the hip joint. It is also involved in raising the trunk from the supine position as this is done by flexion in the hip joint. It is prone to considerable tension due to compensatory overload caused by the failure of the quadriceps in the context of an injury or after an operation on the knee joint, and should be treated by their Physiotherapists should be included in the treatment regime after surgery!
    → WATCH VIDEO
  • CPM splint: (motor movement splint)-adjustment of ROM stretching/bending mobility: 0-10-70 degrees possible !

artromot active k movement bar

  • independent self-exercises: You continue the tensioning exercises (quadriceps activation) for the thigh muscle in the intended range of motion of the knee joint. These first isometric exercises include parts of coordination training, repetitive muscle contractions without changing the length of the muscle.
    → WATCH VIDEO

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • for non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : extension/ flexion: now 0-0-90 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-10-70 degrees for 4 weeks

Physiotherapy: The same applies here:

  • for non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : extension/ flexion: now : 0-0-90 degrees
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-10-70 degrees for 4 weeks
  • Focus: Lymphatic drainage, walking school and treatment of the iliopsoas muscle.
  • important to knowThe iliopsoas muscle is the strongest of the Flexor of the hip joint. It is also involved in raising the trunk from the supine position as this is done by flexion in the hip joint. It is prone to considerable tension due to compensatory overload caused by the failure of the quadriceps in the context of an injury or after an operation on the knee joint, and should be treated by their Physiotherapists should be included in the treatment regime after surgery!
    → WATCH VIDEO

CPM splint: (motor movement splint)-Adjustment of ROM extension/ flexion mobility:

  • for non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone: extension/ flexion: now 0-0-90 degrees
  • For complex meniscus sutures e.g. basket handle tear meniscus: extension/ flexion: 0-10-70 degrees for 4 weeks

artromot active k movement bar

  • independent self-exercises: You continue the tensioning exercises (quadriceps activation) for the thigh muscle in the intended range of motion of the knee joint (also possible in the orthosis). These first isometric exercises include parts of coordination training, repetitive muscle contractions without changing the length of the muscle.
    → WATCH VIDEO

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-0-90 degrees for 2 weeks

Physiotherapy: see ROM above, i.e. in this ROM the knee joint should be moved. Focus: Lymphatic drainage, muscular and neuromuscular training and treatment of the iliopsoas muscle.

CPM rail: (motor movement rail)

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear meniscus: extension/ flexion: 0-0-90 degrees for 2 weeks

artromot active k movement bar

  • independent self-exercises: You continue the tensioning exercises (quadriceps activation) for the thigh muscle in the intended range of motion of the knee joint. These first isometric exercises include parts of coordination training, repetitive muscle contractions without changing the length of the muscle.
    → WATCH THE VIDEO

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: 0-0-90 degrees for 2 weeks

Physiotherapy: ROM see above, i.e. in this ROM the knee joint should be moved. Focus: muscular and neuromuscular training and treatment of the iliopsoas muscle.

artromot active k movement bar

  • independent self-exercises: You continue the tensioning exercises (quadriceps activation) for the thigh muscle in the intended range of motion of the knee joint. These isometric exercises include parts of coordination training, repetitive muscle contractions without changing the length of the muscle.
    → WATCH VIDEO

Mobility of the knee joint: free

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear : extension/ flexion: free
  • CPM rail: (motor movement rail): no longer necessary
  • Therapy goals Physiotherapy: Normalisation of everyday motor skills - Achievement of physiological muscle balance of the entire pelvic-leg axis
  • Special rehabilitation measures: now possible, required for competitive athletes !

 

Load

meniscus-load-after-surgery

Walking with two crutches:

Adjustment of the crutches: In order to be able to walk reasonably with walking sticks, the length of these walking aids must also be the right one, i.e. the correct length must first be determined. The correct and suitable length is decisive in order to be able to use the walking sticks safely and stably. This depends, among other things, on the height of the user. If the walking sticks are too short, one must always bend slightly forward to support oneself. If the length is too high, it is more difficult to keep your balance.

Walking with forearm crutches with partial weight-bearing- Three point gait-

→ WATCH VIDEO

Walking with two crutches:

important to know

Stand on a scale at home, first with the healthy leg, then with the operated leg, to "feel" what load about 20 kg requires!

Walking with two crutches:

Walking with two crutches:

meniscus-important-to-knowFull weight bearing initially only in the home environment for short distances (still possible with both walking sticks at the beginning), no hikes or longer walks.!

Walking with two crutches:

meniscus-important-to-knowFull load also possible for longer distances, no hiking or longer walks!

Walking with two crutches:

  • Medical check-up at the OZ Freiburg: One month after surgery

Walking with two crutches:

Walking with two crutches:

Medicines

medication-after-meniscus-op
  • The antithrombosis injection: they have already received it in the clinic! Here we show them how to inject themselves with their heparin syringe:

Injection instructions for the use of a heparin safety syringe for self-injection:

→ WATCH VIDEO

  • Pain medication: Take according to doctor's prescription!
  • Blood thinners: If you have already taken blood thinning medication (anticoagulants), such as Marcumar or Xarelto, or ASS (Aspirin), before the operation, close consultation with the surgeon, general practitioner and anaesthetist is required before the operation!
  • Theantithrombosis injection: you will receive it today from us or from your treating doctor during the check-up!
  • Pain medication: can be continued or reduced or taken as needed depending on pain intensity.
  • Blood thinners: If you have already taken blood thinning medication (anticoagulants), such as Marcumar or Xarelto, or ASS (Aspirin), before the operation, close consultation with the surgeon, general practitioner and anaesthetist is required before the operation!

They must continue to "administer" theantithrombosis injection themselves until they are fully loaded!

Here we show you how to apply them yourself:

Injection instructions for the use of a heparin safety syringe for self-injection:

→ WATCH VIDEO

  • Pain medication: can be reduced or no longer taken, depending on the intensity of the pain!
  • Blood thinners: If you have already taken blood thinning medication (anticoagulants), such as Marcumar or Xarelto, or ASS (Aspirin), before the operation, close consultation with the surgeon, general practitioner and anaesthetist is required before the operation !

The antithrombosis syringe:

Pain medication: is often no longer necessary during this treatment period

Risk factors: Risk of thrombosis!

meniscus-important-to-know

If risk factors are present, e.g. family history of thrombosis or if you have had thrombosis in the past, urgent consultation with us or your attending physician is required! → In this case, continue the antithrombosis injections until clarification by the surgeon or the doctor providing follow-up treatment!

The antithrombosis syringe:

Pain medication: is often no longer necessary at this stage of treatment

Risk factors: Risk of thrombosis!

meniscus-important-to-know

If risk factors are present, e.g. family history of thrombosis or if you have had thrombosis in the past, urgent consultation with us or your attending physician is required! → In this case, continue until clarification by the surgeon or the doctor providing follow-up treatment!

The antithrombosis syringe:

Pain medication: discontinued!

The antithrombosis syringe:

Pain medication: discontinued!

The antithrombosis syringe:

Pain medication: discontinued!

Orthosis

meniscus orthosis
  • Orthosis (spl int fitting): Immediately after the operation, Genuloc/Mecron splint fitting in 10° flexion position.

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus s utures e.g. posterior horn suture of the meniscus alone : extension/ flexion: 0-10-70 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: 0-10-70 degrees for 4 weeks

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus s utures e.g. posterior horn suture of the meniscus alone : extension/ flexion: 0-10-70 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: 0-10-70 degrees for 4 weeks

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus s utures e.g. posterior horn suture of the meniscus alone : extension/ flexion: 0-10-70 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: 0-10-70 degrees for 4 weeks

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • for non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : extension/ flexion: now 0-0-90 degrees for 2 weeks
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: 0-10-70 degrees for 4 weeks

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: 0-0-90 degrees for 2 weeks

Mobility of the knee joint: ROM (range of motion or neutral zero method) in the orthosis:

→ WHAT IS ROM

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: 0-0-90 degrees for 2 weeks

Mobility of the knee joint: free

  • For non-complex meniscus sutures e.g. posterior horn suture of the meniscus alone : Extension/ flexion: free
  • For complex meniscus sutures e.g. basket handle tear, ramp lesion or meniscus root tear: extension/ flexion: free

Important

meniscus-important-to-know

They were successfully operated on the cruciate ligament and are now either back at home or in hospital as inpatients.

inpatients: If they are treated as inpatients after an operation, everything is taken care of. The nursing staff is there for them 24 hours a day, regular medical visits ensure a complication-free healing process.

outpatients : If they continue to be treated as outpatients after an operation, the following should be taken into account:

  • Cooling: Keep ice packs (Cool Packs) ready to put on the bandage! (20 min./hour)
  • Drainage: If you have received drains (Redon drainage) after the operation to drain blood and fluid from wound or joint cavities by means of suction, leave them untouched. It is usually removed the next day (1st day after the operation) by us or your orthopaedic surgeon.
  • Contacting us: In the case of an outpatient operation, our team will contact you by telephone after you have returned to your home environment.

meniscus-important-to-know

Please inform us of your availability by telephone on the day of the operation during the consultation!

Inpatients: The medical visit takes place in the clinic with wound control, dressing change, possibly removal of the drainage.

outpatients:

  • Medical check-up: at the Freiburg OZ or at your orthopaedist's office for follow-up treatment.
  • Dressing change: Removal of drains (Redon drainage).
  • Ice pack: Continue to use ice packs or cool packs (20 min/hour).
  • Physiotherapy: Continuation with focus on lymphatic drainage and walking school
  • Ice pack: Continue to use ice packs or cool packs (20 min/hour).
  • Antithrombosis syringe: please do not forget!
  • Showering: as of today, showering is possible and allowed! The use of a shower plaster is advantageous. Orthosis can be removed when showering.

Exception:

meniscus-important-to-know

Due to effusion formation with development of pain and restriction of movement, a puncture of the joint was performed after the operation. Then there should be one day between puncture and showering.

  • Bath applications/sauna: Baths and sauna of any kind are prohibited
  • Ointment dressings: Ointment dressings and applications of any kind are prohibited, e.g. no ointments containing cortisone!
  • Medical check-up at the OZ Freiburg: for wound control and thread removal
  • Showers: Showering possible and allowed! Advantageous, but not absolutely necessary, is the use of a shower plaster. Orthosis can be removed when showering.
  • Work incapacity: Depending on the occupational activity, it may be possible to work in the orthosis, e.g. with more sedentary activities (desk work) and irritation-free knee joint findings.
  • Driving a car: not possible with orthosis!
  • Showers: Showering possible and allowed! Advantageous, but not absolutely necessary, is the use of a shower plaster
  • Work incapacity: Depending on the occupational activity, it may be possible to work with the orthosis, e.g. in the case of more sedentary activities (desk work) and irritation-free knee joint findings.
  • Driving a car: not possible with orthosis!
  • Medical check-up at the OZ Freiburg: Don't forget your check-up! Four weeks after the operation, you will have to decide whether you can increase your exertion beyond the everyday stresses!
  • Bathing/sauna: Baths and saunas of any kind are now possible if the wound is completely closed and the knee is not irritated, e.g. there is no irritation.
  • Ointment dressings: Ointment dressings and applications are now possible when there is complete wound closure (please let us know which ointment you would like to use). Ointments to prevent excess scarring (e.g. Contractubex) can be used.
  • Work incapacity: Depending on the occupational activity, it may be possible to work with the orthosis, e.g. in the case of more sedentary activities (desk work) and irritation-free knee joint findings.
  • Driving a car: not possible with orthosis!
  • Work incapacity: Depending on the occupational activity, it may be possible to work with the orthosis, e.g. in the case of more sedentary activities (desk work) and irritation-free knee joint findings.
  • Driving a car: not possible with orthosis!
  • Ability to work: possible for occupational sedentary work. Longer walking distances are not yet possible! Heavy physical activities are not yet possible
  • Special rehabilitation measures: now possible, required for competitive athletes !
  • Orthosis: no longer necessary!
  • Driving a car: possible!