Progressive Knee Motion,

Weight Bearing, and Return

to Sport for Meniscus Injury

Benidektus Adi Prianto, S.Fis, M.Or | 2023

Curriculum Vitae:
Pendidikan:
- D3 Fisioterapi | Universitas Muhammadiyah Surakarta - 2012
- Transfer S1 Fisioterapi | Universitas Muhammadiyah Surakarta - 2015
- S2 Sains Keolahragaan | Institut Teknologi Bandung - 2023
Course:
- FIFA Diploma in Football Medicine by FIFA - 2017
- Course Football Medicine by PSSI & AFC - 2018
- Course Level 1 of sport physiotherapy by PFOI - 2018

Nama : Benidektus Adi Prianto, S.Fis, M.Or, AIFO

- Course Five Core Movement 1 by Tesseract Centre Malaysia - 2019
TTL : Bandung, 16-april-1994 - Course Ahli Ilmu Faal Olahraga(AIFO) by PAIFORI - 2019
Email : bendex16@gmail.com
- Workshop ISEAPT TITAFI by IFI - 2022

Pekerjaan sekarang:
- Fisioterapi Tim Utama Persib Bandung 2016-…
- Founder Bintang Physio Bandung 2017-…
- COO(Chief of Operating Officer) Kinesterra klinik 2023-…
Benidektus Adi Prianto | 2023
 DEFINITION

Sport Injury: sports injury denotes the loss of bodily function or

structure that is the object of observations in clinical examinations
Sport Trauma: is defined as an immediate sensation of pain,
discomfort or loss of functioning that is the object of athlete self-
evaluations
Timpka et al, 2014

Rehabilitation: a set of interventions designed to optimize

functioning and reduce disability in individuals with health
conditions in interaction with their environment
World Health Organization

Benidektus Adi Prianto | Manajemen Cedera Olahraga | 2023

 Why Injury Happens?

Intact ACL Tensile Loads

2160 N Load > Capacity = Injury
MN Doral et al, 2018 3250 N > 2160 N = Broken

F = m.a
- 80 kg x 35 m/s2
- 60 kg x 35 m/s2

Rotational Force
2800 N
Benidektus Adi Prianto | Manajemen Cedera Olahraga | 2023
Meniscus anatomy:

C
O

M:C & L:O

1. anterior insertional ligament of the medial meniscus
2. posterior insertional ligament of the medial meniscus
3. anterior insertional ligament of the lateral meniscus Fox AJS et al, 2012
4. posterior insertional ligament of the lateral meniscus

Benidektus Adi Prianto | 2023

Meniscus anatomy:
Fungsi meniscus:
1. Bertanggung jawab untuk meningkatkan
kesesuaian / harmoni pada lutut
2. shock absorber & load transmision
3. stabilitas sendi
4. membatasi fleksi & ekstensi
5. proprioseption
6. lubrikasi
Bhan K, 2020

Meniscus area:
1. Red-Red Zone: sedikit vaskularisasi
2. Red-White Zone
2. White-White Zone: sangat sedikit
vaskularisasi

Jenis Robekan:
1. Longitudinal tear
2. Radial tear
3. Oblique tear
Spang RC et al, 2018 4. Bucket handle tear
Benidektus Adi Prianto | 2023
Meniscus load:
Fox AJS et al, 2012

Translation during flexion & extension, M: 2 mm, L: 9 mm

Benidektus Adi Prianto | 2023

Cartilage anatomy:

Semba JA et al, 2020

Benidektus Adi Prianto | 2023

Cartilage anatomy:

Fungsi meniscus:
1. menurunkan friksi saat gliding pada
permukaan
2. shock absorber.
3. Minimizes peak pressures on the subchondral
bone.

Jenis kerusakan:
1. Partial thickness defect
2. Full thickness defect
3. Subcondral defect

Bhosale & Richardson, 2008

Benidektus Adi Prianto | 2023

Cartilage load:
Fox AJS et al, 2012

Benidektus Adi Prianto | 2023

Loading:

Static Stance
Zhang K et al, 2019

Benidektus Adi Prianto | 2023

Loading:
Slight Flexion
Zhang K et al, 2019

Benidektus Adi Prianto | 2023

Surgery vs Non Surgery:
Van Der Graff SJ et al, 2021 (BJSM)

Surgery(menisectomy) N=49
Non Surgery N=51

Kesimpulan:
pada pasien atlet muda 18th - 45th,
penanganan dengan menisectomy tidak
terlalu superior

Benidektus Adi Prianto | 2023

Surgery Management:

Meniscus: Cartilage:

1. Menisectomy (partial/full): pemotongan 1. Bone Marrow Stimulation: debridement, microfracture

sebagian atau penuh 2. Mosaic Plasty
2. Meniscus Repair: dengan teknik jahitan 3. Carbon Fibre Implant
3. Meniscus Recontruction: pemberian 4. Perichondrial graft
implant 5. Periosteal graft
6. Osteotomy
7. Autologus Chondrocite implantation

Benidektus Adi Prianto | 2023

 diagnosis
meniscus & cartilage:
Logerstedt DS et al, 2018

Special tests: Special tests:

1. Mc Murray test 1. symptom asses
2. Apley's test 2. Imaging
3. Thesally test
Benidektus Adi Prianto | 2023
 Measure
meniscus & cartilage:
Logerstedt DS et al, 2018

Benidektus Adi Prianto | 2023

 Interventions
meniscus & cartilage:
Logerstedt DS et al, 2018

Benidektus Adi Prianto | 2023

Knee motion and weight bearing
meniscus:

Koch M et al, 2020

Benidektus Adi Prianto | 2023

Knee motion and weight bearing
meniscus:
Koch M et al, 2020

Benidektus Adi Prianto | 2023

Knee motion and weight bearing
cartilage:
Rolf S et al, 2022

Benidektus Adi Prianto | 2023

Knee motion exercise:
Fleksi
CPM (Continues Passive Motion) CAM (Continues Active Motion)

Benidektus Adi Prianto | 2023

Knee motion exercise:
Ekstensi Mobilisasi

Hodac AK et al, 201

Benidektus Adi Prianto | 2023

Knee motion exercise:
Fleksi-Ekstensi

Hambly et al, 2006

Benidektus Adi Prianto | 2023

Weight bearing exercise:

Pembebanan: Contoh BB 60 Kg

NWB: 0% = 0 Kg
PWB: 10%-40% = 6 Kg - 24 Kg
HWB: 50% = 30 Kg
FWB: 100% = 60 Kg

dokumentasi pribadi

Benidektus Adi Prianto | 2023

Recommendations:

Knee motion Exercise

Weight bearing

Logerstedt DS et al, 2018

Benidektus Adi Prianto | 2023

stages of rehab:

(Lucky P, 2021:SPORTS REHABILITATION PHASES: A LITERATURE

REVIEW )
Benidektus Adi Prianto | 2023
Goal of Rehab:

Benidektus Adi Prianto | 2023

Goal of Rehab:

Benidektus Adi Prianto | 2023

Starrt (Strategic Assessment of Risk and Risk Tolerance) Framework :

(Ian Shrier, 2015 & Himmat Dillon et all, 2017)

Benidektus Adi Prianto | 2023

Terima Kasih

Benidektus Adi Prianto | 2023