Knee injury, meniscus injury, is the second most common injury to the knee, with an incidence of 12% to 14%. Prevalence has been reported to be 66 per 100.000 inhabitants, 61 of which result in meniscectomy. Surgery is usually indicated in <50 years old, or in good health and physically active patients. The objective of meniscal surgery is to reduce pain, restore functional meniscus and prevent development of degenerative osteoarthritis in the involved knee.
Biomechanical assessment of the musculoskeletal system provides us objective medical information related with functional capacity.
Integrating the clinical history with several biomechanical tests allows us to estimate rehabilitation treatment efficiency.
Integration testing strength and muscle tone provide us much knowledge about the injure evolution.
In BAASYS, knee protocol is developed using sEMG (surface electromyography) and isokinetic. The aim is the evaluation of muscle function while movement is being performed, to determine the muscular activity and strength during extension-flexion exercises.
One of the most frequency complications after surgery is residual pain. Testing knee extensors or flexors peak torques, Hamstrings/ Quadriceps coefficient, should provide more precise information about stability of knee after surgery as well as the distribution of intra-articular loadings. This phenomenon is observed at 60 s−1 and 180 s−1 angular velocity.
Deficits of the thigh muscle force can be evoked by mechanical injuries of meniscus proprioceptors during surgery. This was confirmed using the sEMG. This method indirectly allows for assessment of the motor units recruitment, confirmed the muscle origin reason of the force deficits on operated knee.
The pain of knee after trauma leads to disturbance of its stability and disables the patient to load the extremity, and could cause the muscle atrophy as well as the decrease of force.
A global rehabilitation could restore complete knee function after surgery.
The rehabilitation treatment begins from the first postoperative day with the pharmacological pain control, the resolution of swelling and individual exercises programs, to restore, as soon as possible and carefully, knee joint mobility, muscular forces, and physiological gait.
Rehabilitation following injury or surgery to the menisci of the knee should, therefore, incorporate a proprioceptive retraining program. It means an ability to develop muscular force more rapidly and is an important factor in performing activities that require neuromuscular coordination and control.
Isokinetic and sEMG during rehabilitation program are valuable in order that we obtain a tone and strength feed-back, being suitable for control and progress rehabilitation program.
The patient’s condition can be dramatically improved and at the same time, we can control and reduce pain.
In our experience, over 70% of our patients improve. Average length of treatment is 7 weeks. Results indicate that treatment gains are maintained at 6 months follow up and beyond.
The rehabilitation program is designed individually for every patient.