Questions, operative experience and evidence-led discussion.
Different surgeons have different persepctives about when to start weight bearing after surgery. It depends on factors like the bone, fracture patter, fixation etc. What are your preferred weight bearing and rehab protocol for the following? 1) Ankle surgeries 2) ACL recon 3) Meniscal repair 4) Distal femur fractures 5) TKA and THA
MRI shows a full-thickness supraspinatus tear with mild retraction in an otherwise active 65-year-old. Pain is significant but strength is reasonably preserved. How long would you trial physiotherapy/injection before offering repair, and which MRI features make you operate earlier?
For a longitudinal meniscal tear extending partly into the white-white zone in a young adult, do you still attempt repair if the tissue quality is good? What factors make you decide that a tear is simply not worth repairing?
A recreationally active adult has MRI-confirmed complete ACL tear but minimal symptoms during daily activities and no recurrent giving-way episodes. Would you initially rehabilitate or recommend reconstruction based on activity goals? What makes you change from conservative treatment to surgery?
