Arthroscopic Meniscal Repair Rehabilitation Protocol

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Phase 1 (0-6 weeks)

  • Goals: Control swelling, restore neuromuscular communication loops, prevent kinesiophobia; gait training
  • Modalities: Compressive cyrotherapy, e-stimulation
  • Weight bearing:
    • 0-6wks: Non-weightbearing
  • Brace: worn at all times except for hygiene and PT
  • ROM: Early goal is to capture terminal extension.
    • Brace locked in extension for 48 hours.
    • Brace ROM advanced after 2-days to 0-90° through 4 weeks.
    • Weeks 4-6wks ROM is opened 90-120°
  • Exercises:
    • NO weight bearing with flexion > 90° 0-4wks
    • Quadriceps sets, SLR, patellar mobilizations, heel slides

Phase 2 (6-12 weeks)

  • Weight bearing: Advance to full weightbearing
  • Brace: Begin to wean from brace as tolerated, advocate to continue in uncontrolled settings or adverse weather
  • ROM: Progress to full ROM
  • Exercise: Progress closed chain activities. Begin hamstring work, lunges/leg press 0-90, proprioception exercises, balance/core/hip/glutes. Begin stationary bike when able. Heel slides, quad sets, patellar mobs, SLR, SAQ; addition of heel raises, total gym (closed chain), terminal knee extensions. Activities w/brace until 6 weeks; then no brace as tolerated

Phase 3 (12-20 weeks)

  • Weight bearing: Full
  • Brace: None
  • ROM: Full

Exercises: Progress phase 3 exercises and functional activities: single leg balance, core, glutes, eccentric hamstrings, elliptical and bike. Swimming ok at 12 weeks. Advance to sport-specific drills and running/jumping after 16 weeks once cleared by MD.