Physiotherapy after Meniscal Repair

Meniscal repair is performed arthroscopically. Following surgery, patients are on crutches for 6 weeks and follow a graduated weight bearing and range of motion protocol outlined below:

 WeekRange of MotionWeight Bearing
10 – 30°Nil
20 – 45°< 25%
3 0 – 60°25%
40 – 90°50%
50 – 105°75%
60 – 120°90 – 100%

Post op exercises (0 – 2 weeks)

  • Ensure you can mobilise safely on crutches and know how to apply and remove brace
  • Circulation drills – foot pumping, static quads and glutes
  • Hamstring stretch, calf stretch with towel / rope
  • Static quads with small roll behind knee. Get VMO to fire. If VMO is sluggish then some NMS (neuromuscular stimulator) may be of benefit
  • Straight leg raise / inner range quad
  • Side leg raise
  • Reverse leg raise

As you are allowed to start weight bearing, ensure a good gait pattern and correct amount of weight (can use scales to determine this).

Review at 2 weeks

  • A graduated progression of exercises / activity over next 2 – 4 weeks or as advised.
  • Clams
  • Calf raise

Review at 6 weeks

  • Progression to full weight bearing with aims of normal range of motion and gait
  • Bridging
  • Squats- sit-stand (care with depth- don’t go beyond parallel)
  • Step ups
  • Band walks (tall lateral, low lateral, reverse skaters- glute drills)
  • Gait re-education
  • Proprioception
  • Bike added at 8 weeks

Review at 12 weeks

  • Commence gym strengthening
  • Can commence running and progress to return to sport program at 16 weeks
  • If onset of reactive swelling, pain, locking, then return for review
  • Return to sport around 5 – 6 months

“Those in whom complex tears are repaired must agree to avoid strenuous activities and deep knee flexion for 4 to 6 months to prevent tear­ing and failure of the repair.” (Noyes et al 2013)

Manual Therapy

The following physiotherapy interventions may be useful in restoring the joint:

  • Patellofemoral mobilisation
  • Release / soft tissue massage lateral thigh and ITB
  • Massage of arthroscopy portals – care with depth until 4 weeks and portals healed
  • The use of NMS (neuromuscular stimulators) for VMO activation