Knee arthroscopy with meniscal repair

Post-op recovery	First 2 weeks	Date
Goals	Protect the knee and surgical incision Recover from swelling and inflammation Control of post-surgical pain
Precautions	Non-weight bearing on crutches
Brace	Locked in extension At rest the brace can be loosened to allow swelling and discomfort to settle Sleep in brace
Recommendations	Rest and elevate as required Ice the knee up to 3 times a day – particularly in the first 72 hours Range of motion exercises of ankle Range of motion exercises of hip
Suggested exercises	Static quads contraction Supine straight leg raise Side leg raise Ankle pumps Supine knee extension – foot elevated/supported

Phase 1	Week 2 to week 6
Goals	Begin range of motion – gentle Begin strengthening hip and core
Precautions	Non-weight bearing on crutches The foot may rest on the ground when stationary
Brace	Locked in extension when mobilising Unlock brace at rest and when doing ROM exercises At rest the brace can be loosened to allow swelling and discomfort to settle Sleep in brace (locked in extension) weeks 3-4 Sleep without brace weeks 5-6
Recommendation	Gently move knee from 0 – 90 degrees (wear brace but unlock). No resistance, no strengthening Hip and gluteal muscle strengthening Ankle range of motion
Suggested exercises	Static quads contraction Supine straight leg raise in locked brace Ankle pumps Supine bed supported knee bend Sitting supported knee bend Supine knee extension – foot elevated/supported Side leg raise – knee straight in locked brace

Phase 2	Week 7 to week 12
Goals	Comfortably walk normally Increase range of motion
Precautions	No running No deep squats (including kneeling, crouching down to or sitting on floor) No forced high flexion of the knee (0-100 degrees only)
Brace	No brace required
Recommendations	Gradually begin taking weight through your leg when you walk. Fully weight bear as able Discard crutches when walking safely Achieve full extension – passive and active Flex actively as comfortable, but no forced high flexion (0-110) Gluteal and hip strengthening Ankle and calf strengthening Short walks
Suggested exercises	Wall slide mini squat Double leg squats (0-60) Sitting unsupported knee extension and flexion Single leg stance – knee straight, knee flexed Straight leg raise Step ups Double calf raises progress to single calf raise Side leg raise – knee straight, knee flexed Gluteal band exercises Bridging with gluteal contraction Exercycle – low resistance, short interval

Phase 3	3 Months – 6 months
Goals	Gain full function and strength Gain full range of motion of knee
Precautions	Avoid collision sports or high risk recreational activity Return to vigorous athletic activity as physiology allows (rapid return to rigorous strength training or endurance and speed training can lead to tendinopathies or injury)
Recommendations	Achieve full range of motion including high flexion Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Gain in confidence during athletic activity. Neuromuscular control and co-ordination of leg Long walks Return to running in sensible progressive time frame
Suggested exercises	Double leg squats (0-90) Single leg squats Single leg hop Step ups – increase height Hop ups Step downs Resisted quads and hamstring weight training Gluteal band exercises Bridging Exercycle – increase resistance and training length