Monitoring
Treatment of a meniscal tear requires close follow-up with the orthopedist and adherence to physiotherapy. Treatment is standardised during the initial phase of follow-up and is then customised based on patient demands and return to sport expectations. For high-level athletes, it is important to communicate with and involve their athletic trainers and coaching staff. This helps to ensure that the appropriate regimen is adhered to, and allows for optimum feedback and appropriate phasing of return to play.
Patient Instructions
Patients should be advised to rest the affected leg, use ice packs and elastic compression bandaging around the knee, and elevate the leg above the level of the heart. This protocol, known as RICE, helps to reduce pain, minimise swelling, and protect the injured tissue, all of which help speed up the healing process.
As NSAIDs should be used for only short periods because of the negative effects on musculoskeletal healing, patients should be advised that paracetamol is the preferred drug for reducing pain because it acts centrally and does not interfere with the healing process. [21] [22]
As symptoms allow, gentle, active range-of-motion and strengthening exercises may be instituted. Biking, treadmill walking, swimming, core stability work, and other low-impact exercises can be performed to maintain fitness. Activities should be pain-free.
Following a partial meniscectomy patients are advised to use crutches for the first post-operative week and progress to weight bearing as tolerated. Weight bearing after a meniscus repair is approached more cautiously, and full weight bearing should be delayed for at least 4-6 weeks after surgery to reduce strain on the repair site. In addition, all patients are instructed to avoid impact and twisting of the knee for 4 weeks after surgery. They are also encouraged to start upper body exercises and single, non-operative leg biking during physiotherapy as soon as tolerated.
