Meniscal Repair Rehabilitation Protocol

Meniscal Suture

Restrictions

• 6 weeks range of motion limitation 0 – 90 degrees.

• 6 weeks onwards start gradual increase in range to full flexion

• No weight bearing in more than 90 degrees flexion for 12 weeks

• There may be a restriction to 20kgs loading for the first 2 – 6 weeks

• Gradual increase in loading avoiding limited by pain and swelling

• Avoid cycling for the first 6 weeks post-operative

• Light jogging on a treadmill from week 12 onwards

  • Must have

    • Full range of motion and quadriceps control.

    • Walking for 30 minutes pain and swelling free

• Avoid pivoting and contact sports for 4 months

Meniscal Root Suture and Radial Meniscal Tear Repair

Restrictions:

• 6 weeks of limited range of motion 0 – 90 degrees flexion

• Loading limited to 20 kgs for 6 weeks

  • Gradual increase in loading limited by pain and swelling

• Loading and knee flexion limitations

  • Week 7 – 9 : 0- 40 degrees

  • Week 10 – 16 : 0 – 70 degrees

  • Week 16 - 18 : 0 - 90 degrees

  • Week 18 onwards gradual increase to full range with loading

    • Limited by pain and swelling

• No isolated hamstring training for 6 weeks with meniscal root sutures

• No cycling for 6 weeks

• Light jogging on aa treadmill from week 20

  • Must have

    • Full range of motion

    • Good quadriceps control

    • 30 minutes of pain and swelling free walking

• No contact sports up to 6 months post operatively

Generally this procedure is performed as day surgery and patients will go home same day.

Phase 1 : Day 0 – operative day to 6 weeks

Goals

Reduce swelling, range of motion within limits, quadriceps activation and control, walking safely within weight bearing limits

Action

• Elevate leg, straighten knee, cool the knee, gentle compression

• Ankle range of motion

• Occasionally a brace will be requested to be fitted

• Standing and walking with crutches with weight bearing limitations

• Gentle quadriceps activation 4 – 6 x per day with 10 repetitions

• Gentle range of motion exercises 4- 6 x per day with 10 repetitions

  • Increase range of motion to 90 degrees

Criteria to move to next Phase

Knee flexion to 90 degrees, full knee extension, good quadriceps control. Minimal swelling and pain especially in extension

Phase 2 : 6 weeks to 4 months

Goals

Full range of motion, normal gait, normalise activities of daily living, improve muscle strength and dynamic stability of knee

Action

• Increase range of motion

• Gradual removal of crutches as tolerated by pain and swelling

• Light cycling

• Increase strength including during dynamic function

• Balance training in coronal and sagittal planes

• Neuromuscular training – from stable to unstable base

• Off balance training

• Strength training with focus on increasing load and low repetitions

• Light jogging on a treadmill from week 12

  • Conditional on

    • Full range of motion

    • Good quadriceps control

    • Pain free walking for30 minutes without swelling

• When approaching jump training – focus on soft and controlled landing

  • Keep repetitions low initially between 4 – 6 x 3 sets

Criteria to move to phase 3

Controlled full knee extension from high bend, full active knee flexion, no swelling, no pain with activities, can complete a hop on a low step, can run 10 minutes without pain and swelling. Strenght and hop test at 95% of the non injured side