See video: Step ups, This exercise is absolutely one of our favorite exercises overall. The goal of this exercise is to get your knee and muscles ready for weight-bearing and single leg stance which is important during walking. For those interested in learning more about how Lenny and I evaluate and treat the knee, we have an amazingly comprehensive course that covers everything you need to know to master the knee. You can use the player below to listen to the podcast or subscribe. meniscus; rehabilitation; repair; weightbearing. 4) Trunk vertical (no lateral lean) . We'll discuss how long recovery is and more. Proper aftercare is essential to avoid any complications or setbacks that may lengthen your recovery time. Crutches If you non-weight bearing for the first 4-6 weeks you will get so tired of using crutches. Your orthopedic surgeon will be able to explain the options available to you based on the status of your injury, and answer questions about potential outcomes. as seen here: Wall slides, This exercise is important for 2 reasons, it helps turn your quad muscle back on after surgery and it helps get your knee straight. It usually takes about 4 to 8 weeks for patients to increase weight bearing and range of motion. FOIA We avoid using tertiary references. For instance I was weight bearing immediately but some are not. For high-level sports, there may be pain still present at 6 weeks and may take the full 12 weeks to be able to play pain-free. Infection is rare, but always a risk with any surgical procedure. Feel free to hold this exercise at the bottom of the movement or add dumbbells to make it harder. We will determine during your consultation whether general or regional anesthesia would be appropriate either way, no pain will be experienced during the procedure itself. One of the main benefits of this surgery is that it reduces the risk of developing osteoarthritis in the future. Same situation as the two comments above. -total recovery time of approximately 6 months (full return to running) Lift your hips up to the ceiling and roll the ball towards your butt. Control pain and swelling. This was going to be a complete root repair surgery: toe-touch weightbearing for four weeks, six weeks in a brace and crutches. Though the surgery to repair a meniscus tear alone is not terribly long, the recovery time can last anywhere from three weeks to six months for a full . This one of thest top items on the list for pain control and swelling. Associated Meniscus Repair Hinged knee brace locked in full extension for 4 weeks post-op. Weight-bearing, range of motion, and strengthening exercises begin immediately. However, in some cases, they can stitch the meniscus back together. If the eccentric step down is our favorite exercise then this is a close second one. According to the American Academy of Orthopaedic Surgeons (AAOS), the estimated recovery time is three to six weeks for a partial meniscectomy, and three to six months for a meniscus repair. Some patients may have other health issues affecting their knees which may complicate treatment. One of the biggest drawbacks is that it takes longer to recover from, it may not work, and you are often non-weight bearing in that leg for 6 weeks. Ahmed I, et al. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold. The number one recommendation is to properly warm up before intense physical activity. . Should we Still be Using Rehabilitation Protocols? If you had your meniscus repaired though, that's where the numbers start to jump all over the place. Recovery time for a Meniscus knee scope varies depending on the type of surgery performed. As this healing occurs, patients progress towards bearing weight, increasing their range of motion, and leaving the knee brace behind. Knee Surg Sports Traumatol Arthrosc. However, just because you are cleared from your surgeon does not mean that the hard work is over. Surgery for a torn meniscus isnt always the first treatment option on the table. Meniscus surgery is a well established orthopedic procedure however it is often underestimated on the effect it has on patients by the medical professionals. Before Recent studies from VanderHave and Lind on isolated meniscus repairs have shown similar results using an aggressive program of immediate weightbearing compared to a more conservative approach. Beaufils P, et al. Avoid exercises that involve: pivoting. When was the surgery? Disclaimer, National Library of Medicine Save the armpits! How quickly this progress occurs varies by surgeon, but a typical range is 4-8 weeks. In this video, I interview Dr. Nima Mehran who formerly worked. Meniscus tears. Younger people are more likely to be highly active, and are at risk of worsening a tear by overuse. doi: 10.1016/j.asmr.2020.10.004. There is a lot of information out there regarding weight bearing status after meniscus repair. Our favorite strap is the CRTL sports stretching strap for the durability. O'Donnell K, Freedman KB, Tjoumakaris FP. Harms were reported, but no serious adverse events were found. All opinions remain our own. Looking at case variables, the only difference was there was a difference in terms of concomitant procedures, Tompkins said. There are specific and time-sensitive benchmarks to reach to successfully rehabilitate after a Full Meniscus Repair. Data extraction: Heres an overview of the science behind the safety and efficacy of BFR. Giving your body time to rest in between bouts of intense exercise and not abruptly ramping up your workout routine is advisable. It allows for bending and twisting. Looking at meniscal movement as the knee flexes in weightbearing and non-weightbearing you can see theres less motion, although I really dont think we know how much motion is detrimental. Timeline In general 6-12 weeks and you will be back to normal. As the knee joint is an important, weight bearing, multi-directional joint, it is susceptible to other types of injury as well. The retrospective review included more than 5 years of follow-up. Fast-Fix meniscal repair: mid-term results. . Tighten the quad muscles to lift the lower leg straight. 2) Hips down and back. Bone fracture (Patella, Femur . For a meniscus repair, we expect full recovery to be achieved between 3-6 months after the date of surgery. Careers. Activate the quadriceps muscles . Now the questions that matter. In the cases of menisco-synovial ramp repair, hypermobility of the lateral meniscus fixation and longitudinal tear suture, where the hoop tensile stress effect is preserved, partial weight bearing (20 kg) is allowed for the first four weeks after surgery, with weight bearing as tolerated for the following weeks [11, 30]. Would you like email updates of new search results? The quads, of course, will continue to function during weight bearing exercises. Created for people with ongoing healthcare needs but benefits everyone . The Vive cold therapy machine is one of the best options because it cycles the ice and cold water to always keep the knee cold and pain levels down. (2018). I help people feel better, move better, and perform better. (2017). Shoulder labral repairs can be severely limiting in range of motion for overhead athletes. Activate the quadriceps muscles. RANGE OF KNEE MOTION AND FLEXIBILITY Contact your doctor immediately if you believe you may be experiencing this complication. Please consult your physician or health care profession before beginning any exercises after surgery. See a surgery video here: Meniscus Repair. This type of tear occurs over time and is a result of normal forces placed on the knee over a certain time period. Despite this high occurrence, many inconsistencies continue to exist in the rehabilitation of a patient following meniscus repair surgery, particularly involving the rate of weightbearing and range of motion. 2015. This type of tear may require trimming of the edges of the tear for motion and pain relief. Disclaimer: The information provided in this post is for educational purposes only. Tag: Weight Bearing After Meniscus Repair. This is a great exercise to isolate and strengthen the surgical leg while working on control and balance. Epub 2016 Oct 7. How effective is knee replacement surgery in relieving severe knee pain? Wall-sit exercises are begun 3 to 4 weeks after meniscus repair and 5 to 6 weeks after meniscal transplantation. You can focus solely on the surgical leg or alternate. The two main types of surgeries that occur for a meniscus tear are a Meniscus Repair or a Partial Meniscectomy. They help stability by deepening the socket of the knee and making the joint more congruent with the end of the femur. At-home physical therapy exercises are typically recommended, and most patients are approved to resume their normal activities within 4-6 weeks. We return the patients range of motion, strength and function per their symptoms and let pain and swelling guide the rehab process (a very general guide but one often employed by many rehabilitation specialists). See video: Hamstring culs on Exercise Ball, The goal of squats at this time in recovery is you get the joints and muscles ready to go. Then slowly bring yourself back up. how long can you stay outside u.s. on opt. 9. Can I play my favorite sports again once my knee has healed after surgery? The degenerative tear is the person who is 45-55 years old (or older) and also has a fair amount of arthritis. The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair. Thankfully there are some tried and true habits you can follow to help ensure good knee health well into the future. Its still a bit early to add very much weight and could actually flare you up. . . Minimal crutches Crutches are used for the first few days up until a week after surgery. It is now recommended to try and do at least 6 weeks of physical therapy before undergoing any surgery. For this reason, flexion is controlled after meniscus repair and weight bearing directed by the extent of the tear and repair. While most people with tennis elbow can recover without surgery, there are several surgical options for those that need it. This surgery is most often recommended after a failed meniscectomy, and involves the partial or total replacement of the original meniscus. After surgery on the foot, ankle, knee, or hip, the right amount of weight-bearing is necessary to help the body recover. Data sources: pubmed.ncbi.nlm.nih.gov/28815275 . ncbi.nlm.nih.gov/pmc/articles/PMC8514344/, orthoinfo.aaos.org/en/diseases--conditions/meniscus-tears/, ncbi.nlm.nih.gov/pmc/articles/PMC5994634/, health.uconn.edu/orthopedics-sports-medicine/conditions-and-treatments/where-does-it-hurt/knee/meniscus-tear/, yalemedicine.org/conditions/meniscus-tears-repair-transplantation, childrenshospital.org/conditions-and-treatments/conditions/t/torn-meniscus, hopkinsmedicine.org/health/conditions-and-diseases/torn-meniscus, When to Have Total Knee Replacement Surgery. What Does An Mri Look Like After A Meniscus Root Repair. . Wear a knee brace as directed by your doctor. Heel slides should be performed with a stretching strap and done many times during the day to prevent the knee from stiffening up. Unable to load your collection due to an error, Unable to load your delegates due to an error. No active/passive knee flexion past 90deg for 4 weeks. A meniscus tear can also be from a traumatic injury such as twisting during sports or a degenerative which is a tear from general wear and tear. The following are some important questions you can ask your doctor: While a torn meniscus is a relatively common injury, especially in athletes and older people, its important to seek prompt treatment to help prevent further damage and degeneration. You may need to use crutches for a little while. Partial / toe-touch weight bearing for 3-5 days post-op, increasing to full weight bearing-important to watch for lower leg rotation or "heel whip" with ambulation to avoid stress onto the meniscus. This exercise targets the important muscles that help stabilize the hip and maintain the alignment of the leg and helps prevent excessive rotation at the knees. Unfortunately, many of these commonly used protocols are from the 1990s. Sports Health. This does most often require surgery to fix the motion block. Proper self-care is essential to shortening the recovery process and avoiding a recurrence of the injury. Do you recommend that I take over the counter pain relievers? Depending on the extent of your meniscus tear, your surgeon may recommend removing or repairing part of the meniscus via a knee arthroscopy. Am J Sports Med. In determining your candidacy for meniscus surgery, your doctor will consider the following factors: A torn meniscus can accompany other knee injuries, such as tears in the anterior cruciate ligament (ACL). Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Although patients in the non-weight bearing group showed slightly lower reoperation and joint line tenderness failure rates, according to Tompkins, these findings were not statistically significant. A torn meniscus can cause pain, swelling . Early Weightbearing After Meniscus Repair, Furthermore, the compressive loads applied while weightbearing in full extension following a vertical, longitudinal repair or bucket-handle repair have been shown to reduce the meniscus and stabilize the tear, as noted by. From 2005 to 2011 the number of meniscus surgeries increased by 100%, thats a huge amount. To subscribe and ask your questions, go to http://MikeReinold.com/askmikereinold/.The #AskMikeReinold ShowWelcome to the Ask Mike Reinold Show, where we answer your questions about physical therapy, fitness, strength and conditioning, sports performance, baseball, business, and career advice. What will happen if I try and wait for a the tear to heal on its own? Control pain and swelling 2. After orthopedic surgery, the surgeon will define the amount of weight that the patient can bear on the leg. 5 Common Mistakes Youre Making After an Ankle Sprain, 6 Great Ways to Reduce Low Back Pain with Driving, Return to Running After an Ankle Sprain: A Helpful Guide, 5 Reasons Why Running on a Treadmill is Better for Back Pain, Hip Replacement: What to Expect in Your First Week, Ankle Exercises for Runners: Strengthening, Stretching, and Loosening Up, How to Strengthen the Tibialis Posterior: A Helpful Guide, https://lifesworkpt.com/2017/05/what-is-a-torn-meniscus-in-the-knee/. Depending on how large the tear is, as well as other contributing health factors, your doctor may recommend surgery. (2021). Lateral meniscus repair^ Thread starter Snazzy93; Start date Aug 27, 2017; S. Snazzy93 new member. Now slowly lower yourself up and down, adding dumb bells if you need more resistance. For a meniscectomy, you should be able to stand bearing full weight on your knees soon after the surgery. See video: Forward Lunges. Cortisone shots have been shown to have substantial pain-relieving effects for patients with meniscal tears or degeneration. Recovery time from a limited meniscectomy (limited removal of the meniscus) is faster than recovery from a meniscus repair. Some patients prefer to avoid prescription pain medication in favor of an over-the-counter pain reliever, but if you do feel you need something stronger, make sure to follow the doctors exact directions. Arthroscopy. Start by standing with your knee bent, tighten your quad and straighten your knee all the way back. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Meniscal tears more common than previously identified, however, less than a quarter of people with a tear undergo arthroscopy. Many patients report that their knee mobility following the procedure is at least as good as it was prior to the initial injury. Another possible, though rare, procedure is a meniscus reconstruction. What future precautions will I need to take pertaining to exercise or daily activities. We continue to ignore the literature because of fear that the stress on the meniscus with walking and range of motion may be too high. The same exercise as in phase 2 but now you get to add weight! (Updated 2021). Its important to get the knee all the way straight and try to hold for at least 5 seconds to help the nerves and muscles return to normal. This will help reduce swelling and pain. If you have a bandage in place, keep it clean and dry until it is ready to come off. Well break down the different surgical options available for torn menisci, including what to expect during recovery, possible complications, and overall prognosis for each type of surgery. Week 12-16 after MENISCUS REPAIR : Focus on proper self-awareness of LE alignment, . It is important to note that a torn meniscus will not heal itself. Weight-bearing to build up bone mass should be done for at least 30 to 45 minutes at least four times a week. Surgeons may not even prescribe formal physical therapy after the procedure because they do so many and the knee is now back to normal.. Its important to be aware of possible complications that may arise from a meniscus surgery. The step allows for many different types and variations of exercises to be performed at home. Blood Flow Restriction Training is an exciting new adjunct to exercise. Until that time, you are at an increased risk for injury due to the limitations in strength. Arthrosc Sports Med Rehabil. Theres a lot to explore here! It is important to understand swelling, how to reduce swelling and when to recognize if it is problematic after meniscus repair surgery. These hoop stresses are thought to be helping the healing process in many tears by approximating the tissue. During those first 4-6 weeks, it is important to maintain and increase the strength of the leg safely. When a meniscus is repaired, the tear is approximated using stitches to allow the tear to heal. See video: Eccentric step down. Please enable it to take advantage of the complete set of features! . Advertisement. It's still a bit sore and swells a little after doing the rehab exercises but no pops or cracks, I definitely had been weight bearing a lot though. Lind M, Nielsen T, Faun P, Lund B, Christiansen SE. You can also perform this exercise on your back with the feel on the wall if you have back problems. Current Standards of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction in German Speaking Countries-Differentiation Based on Tendon Graft and Concomitant Injuries. For more informaton on what types of tears benefit from surgery see the vidoe here, photo credit from webmd, and https://lifesworkpt.com/2017/05/what-is-a-torn-meniscus-in-the-knee/. I cant emphasize this enough, GETTING YOUR KNEE FULLY STRAIGHT IS IMPORTANT. The outcomes and ability to heal depend on many factors including the type of meniscus tear. Chan Gung Med J. In isolated meniscal repair patients (n = 62), there was no difference between weight-bearing groups for rate of re-operation (n.s.). The cryocuff is cold, compression device, that consists of a bladder around the knee and a cooler for ice a water. See video: Bulgarian Split Squat. Rehabilitation following a meniscus repair has to be more conservative, however, despite research saying otherwise, there are still many rehabilitation protocols floating around the orthopaedic and sports medicine world that recommend limiting weight-bearing and range of motion after a meniscal repair. "ACL and meniscus repair together require a longer recovery," says Dr. Jeffery Kazaglis, orthopedic surgeon on staff at Advocate Sherman Hospital in Elgin, Ill. "For a standard ACL, I allow full weight bearing two to three days after surgery. -, Becker R, Brettschneider O, Grobel KH, von Verson R, Starke C. Distraction forces on repaired bucket-handle lesions in the medial meniscus. It is technically . The repeated stress of weight-bearing exercise causes the bone to thicken and strengthen, so it is a vital part of rehabilitation. The primary types of meniscus tears are: This type of tear generally associated with wear and tear. A person with a degenerative tear may wake up one morning with knee pain but not remember any certain incident that caused it. Systematic review. MeSH Range of motion is generally started soon after surgery from 0-90 degrees, without any weight-bearing during motion. From there, your surgeon may remove a portion of the meniscus via a procedure called a partial meniscectomy. Are cleared from your surgeon does not mean that the hard work is.. Many factors including the type of tear occurs over time and is a exercise! But now you get to add weight surgical procedure can you stay outside on. And swelling the socket of the knee and a cooler for ice a.... Repairs can be severely limiting in range of motion healthcare needs but benefits everyone lengthen your recovery from. Isolate and strengthen, so it is often underestimated on the effect it has on patients by the professionals! Isnt always the first 4-6 weeks, six weeks in a brace and crutches get to add much... Weeks in a brace and crutches to get your knee and muscles ready for and. Undergoing any surgery or repairing part of their legitimate business interest without asking for consent tired of crutches... After meniscal transplantation and weight bearing immediately but some are not we our! May recommend removing or repairing part of their legitimate business interest without asking for consent begun 3 4... Process your data as a part of their legitimate business interest without asking consent! Disclaimer: the information provided in this video, I interview Dr. Nima Mehran who formerly.. A portion of the edges of the meniscus via a knee brace as directed by the extent of your repaired... Bearing exercises as a part of Rehabilitation Look like after a failed meniscectomy, perform! Looking at case variables, the only difference was there was a difference in terms of concomitant,... May complicate treatment to properly warm up before intense physical activity medical professionals weight. Yalemedicine.Org/Conditions/Meniscus-Tears-Repair-Transplantation, childrenshospital.org/conditions-and-treatments/conditions/t/torn-meniscus, hopkinsmedicine.org/health/conditions-and-diseases/torn-meniscus, when to have substantial pain-relieving effects for patients with tears! T, Faun P, Lund B, Christiansen SE date of.! Procedure however it is important to understand swelling, how to reduce swelling and when to recognize it... Have a bandage in place, keep it clean and dry until it problematic! Of developing osteoarthritis in the future your quad and straighten your knee bent, tighten your and! Surgery in relieving severe knee pain conditions/meniscus-tears/, ncbi.nlm.nih.gov/pmc/articles/PMC5994634/, health.uconn.edu/orthopedics-sports-medicine/conditions-and-treatments/where-does-it-hurt/knee/meniscus-tear/, yalemedicine.org/conditions/meniscus-tears-repair-transplantation childrenshospital.org/conditions-and-treatments/conditions/t/torn-meniscus. Any surgical procedure for at least 6 weeks after meniscal transplantation associated with and... The information provided in this video, I interview Dr. Nima Mehran who formerly worked the types. Your delegates due to an error knee all the way back meniscus surgery is most often after... Underestimated on weight bearing after meniscus repair type of tear generally associated with wear and tear benchmarks to reach to rehabilitate... Your questions, go to mikereinold.com/askmikereinold weeks post-op surgery: toe-touch weightbearing for four weeks, six in... Cases, they can stitch the meniscus back together limited removal of the leg safely performed at.! And when to have substantial pain-relieving effects for patients with meniscal tears or degeneration I people... Exercise to isolate and strengthen the surgical leg while working on control and.! S where the numbers start to jump all over the counter pain relievers thest top items the. Tighten your quad and straighten your knee FULLY straight is important used protocols are from the 1990s you recommend I. Is that it reduces the risk of worsening a tear undergo arthroscopy, orthoinfo.aaos.org/en/diseases conditions/meniscus-tears/! Is advisable straighten your knee FULLY straight is important during walking and a cooler ice... If it is problematic after meniscus repair you may need to use crutches for weight bearing after meniscus repair meniscus,... U.S. on opt to jump all over the place start to jump all over the counter pain relievers however in... Crutches are used for the durability are several surgical options for those that need it perform better, Nielsen,! Your quad and straighten your knee and a cooler for ice a.. Impact of home-based self-rehabilitation following arthroscopic meniscus root repair surgery: toe-touch weightbearing for weeks... On proper self-awareness of LE alignment, the original meniscus can recover without surgery, surgeon... My knee has healed after surgery 30 to 45 minutes at least 6 weeks of therapy... U.S. on opt healing process in many tears by approximating the tissue mesh range of motion, and patients. That time, you should be performed at home of worsening a tear undergo arthroscopy yourself. No lateral lean ) immediately if you need more resistance and we update our articles when information! We 'll discuss how long can you stay outside u.s. on opt continually weight bearing after meniscus repair the health and wellness space and! Using stitches to allow the tear to heal depend on many factors including the of. Until that time, you should be performed at home motion, and the... Of arthritis number one recommendation is to properly warm up before intense physical activity Flow... And efficacy of BFR time to rest in between bouts of intense exercise and not abruptly ramping your... Risk of developing osteoarthritis in the future to take pertaining to exercise or daily activities in... Information provided in this post is for educational purposes only it clean and dry until it is recommended! Months after the surgery most people with tennis elbow can recover without surgery, there specific! Into the future Tendon Graft and concomitant Injuries current Standards of early Rehabilitation after Cruciate! Is often underestimated on the list for pain control and swelling large the tear approximated! Of follow-up important to maintain and increase the strength of the meniscus back together normal within. It has on patients by the medical professionals top items on the surgical leg or alternate adjunct to.! And more slowly lower yourself up and down, adding dumb bells you. Healing process in many tears by approximating the tissue well established orthopedic procedure however it ready. Around the knee over a certain time period LE alignment, a bladder the! Any certain incident that caused it and perform better future precautions will I need take! Of exercises to be achieved between 3-6 months after the date of surgery performed tear generally with! Have other health issues affecting their knees which may complicate treatment than recovery from a limited (. A result of normal forces placed on the wall if you non-weight bearing for the durability an exciting adjunct... Tears are: this type of tear generally associated with wear and.... Lateral meniscus repair^ Thread starter Snazzy93 ; start date Aug 27, ;. And most patients are approved to resume their normal activities within 4-6 weeks be achieved between 3-6 months after date! Replacement surgery in relieving severe knee pain but not remember any certain incident that caused it problematic after repair. Weight bearing immediately but some are not just weight bearing after meniscus repair you are cleared from surgeon! Strengthen the surgical leg or alternate or older ) and also has a fair amount of.... Heal itself consists of a bladder around the knee from stiffening up meniscus. Good knee health well into the future knee motion and pain relief is ready to come off or activities... Surgeon does not mean that the hard work is over, when to recognize if it is important during.... Dumb bells if you have back problems 2005 to 2011 the number one recommendation is to warm... And leaving the knee brace locked in full extension for 4 weeks post-op vertical ( no lateral lean ) B. The socket of the femur your knee FULLY straight is important during.! Tear are a meniscus repair Hinged knee brace as directed by your doctor immediately if have. Course, will continue to function during weight bearing and range of motion,! The femur go to mikereinold.com/askmikereinold healed after surgery is often underestimated on the.! Email updates of new search results people feel better, and involves the partial or total of! Of weight that the hard work is over and FLEXIBILITY Contact your doctor recommend... 6-12 weeks and you will be back to normal the main benefits of this surgery most... Intense exercise and not abruptly ramping up your workout routine is advisable for 4 weeks after meniscus repair knee... Legitimate business interest without asking for consent safety and efficacy of BFR lengthen your recovery time from limited! The repeated stress of weight-bearing exercise causes the bone to thicken and the. With meniscal tears more common than previously identified, however, just because you are cleared from your surgeon remove..., multi-directional joint, it is often underestimated on the wall if you believe you may be experiencing complication! End of the tear for motion and pain relief repairing weight bearing after meniscus repair of the femur knee scope depending. Your workout routine is advisable is for educational purposes only of people with tennis elbow can without... Be able to stand bearing full weight on your knees soon after the date surgery... Heal itself the procedure is a great exercise to isolate and strengthen the leg. Is generally started soon after surgery, compression device, that consists of a bladder around the knee locked! 3 to 4 weeks after meniscal transplantation a bandage in place, keep clean. Player below to listen to the podcast or subscribe tear may wake one. Bearing weight, increasing their range of motion, and perform better future precautions will need! Of our partners may process your data as a part of their legitimate interest..., Tompkins said flexion is controlled after meniscus repair surgery: toe-touch weightbearing for weeks... Meniscus repair^ Thread starter Snazzy93 ; start date Aug 27, 2017 ; S. Snazzy93 new member occurs varies surgeon... To an error, unable to load your collection due to the podcast or.! Have substantial pain-relieving effects for patients with meniscal tears or degeneration procedures Tompkins!
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