Rehabilitation After Meniscal Repair

Key Principles

• The rehabilitation protocol after meniscal repair depends critically on tear characteristics and surgical technique, requiring direct communication with the operating surgeon 1, 2
• The British Journal of Sports Medicine recommends that the early rehabilitation phase must be adapted according to the surgeon's specific instructions when concomitant meniscal repair is performed 1

Range of Motion

• Immediate knee mobilization should be initiated, but with flexion restrictions that are progressively advanced 2
• The recommended progressive flexion protocol is:

Bracing

• Postoperative knee bracing should NOT be routinely used, as it is associated with a 2.83-fold increased failure rate and lower quality of life scores 3, 4, 5

Exercise Progression

• Quadriceps strengthening exercises should be initiated on postoperative day one, but with modifications to protect the meniscus 4
• Closed kinetic chain exercises should be prioritized over open kinetic chain 2, 4
• Open kinetic chain exercises (90-45°) may begin at 4 weeks, but add no extra weight for first 12 weeks to prevent graft elongation 2
• Neuromuscular training should be combined with strength training 2, 6

Return to Sport Criteria

• Return to sport should be based on objective criteria, not time alone 2, 6
• Minimum criteria include:
• The rehabilitation timeline is typically 9-12 months when combined with ACL reconstruction 2