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PHASE I - IMMEDIATE POST-SURGICAL PHASE (DAYS 1 - 14)

Goals:

  • Maintain integrity of the repair
  • Diminish pain and inflammation/effusion
  • Prevent muscular inhibition
  • Full passive knee extension
  • Gradually increase knee flexion

Days 1-14:

  • Elevation
  • Brace locked at 0 degrees for ambulation and sleeping
  • Cryotherapy/Ice for pain and inflammation - 15-20 minutes every hour
  • PROM 0-45 degrees
  • Patella mobilization
  • Stretch hamstrings and calf
  • Strengthening exercises ul>
  • Quad sets
  • SLR flexion of hip
  • Hip Abd/Adduction
  • Knee extension
  • Foot Flat Weight Bearing (FFWB), weight of leg, with two crutches

PHASE II - PROTECTION PHASE (WEEKS 2 - 4)

Goals: As above

Precautions: AVOID TWISTING, DEEP SQUATTING, AND STOOPING

Weeks 2-4:

  • Continue cryotherapy/ice
  • Continue brace locked for ambulation
  • Strengthening exercises
    • Multi-angle quad isometrics
    • SLR in all 4 planes
    • Knee extension 90-0

ROM Guidelines:

  • Week 2: 0-45 degrees
  • Week 3: 0-65 degrees
  • Week 4: 0-90 degrees
  • Week 5: 0-100 degrees
  • Week 6: 0-110 degrees
  • Week 7: 0-120 degrees
  • Week 8: 0-135 degrees

Weight Bearing Guidelines:

  • Week 2: FFWB
  • Week 3: FFWB
  • Week 4: FFWB
  • Week 5: 25% WB
  • Week 6: 50% WB
  • Week 7: 75% WB
  • Week 8: 100% WB

(Will discontinue crutches and brace by week 8)


PHASE III – MODERATE PROTECTION PHASE (WEEKS 5 - 8)

Goals:

  • Full PROM
  • No swelling/inflammation
  • Re-establish muscle control
  • Proper gait pattern

Precautions: AVOID TWISTING, PIVOTING, RUNNING AND DEEP SQUATTING

Weeks 5-8:

  • Cryotherapy/Ice as needed
  • Continue ROM and stretching to maintain 0-135 degrees
  • Strengthening exercise
    • Leg press 70-0 degrees
    • Knee extension 90-40 degrees
    • Hip Abd/Adduction
    • Lateral step-ups
  • Balance/Proprioception training

PHASE IV – CONTROLLED ACTIVITY PHASE (WEEKS 9 - 16)

Goals:

  • Improve strength and endurance
  • Maintain full ROM
  • Gradually increase applied stress

Weeks 9-16:

  • Continue all strengthening exercises as above
  • Initiate light resisted hamstring curls
  • Initiate stair stepper
  • Toe calf raise
  • Progress balance training
  • Progress to isotonic strengthening program

PHASE V - RETURN TO ACTIVITY PHASE (WEEKS 24+)

Goals:

  • Improve strength and endurance
  • Prepare for unrestricted activities

Criteria to progress to Phase V:

  • Full, pain-free ROM
  • No pain or tenderness
  • Satisfactory clinical exam
  • Satisfactory isokinetic test or other comparisons (need 85% strength ofcontralateral)

Exercises:

  • Continue and progress all strengthening exercises and stretching drills
  • Deep squatting permitted at 4 months
  • Initiate straight line running at 4 months
  • Initiate pivoting and cutting by 5 months
  • Initiate agility training by 5 months
  • Return to sports by 6 months

Please use the links provided to learn more about meniscus repair rehabilitation.

Meniscus Repair Rehabilitation