Post operative rehabilitation after meniscus repair

phase 1 - immediate PO phase: dates

0-4 weeks

phase 1 - immediate PO phase: goals

quadriceps activation, decreased effusion, wound healing, pain reduction, begin proximal strengthening

phase 1 - immediate PO phase: restrictions

WBAT with bilateral axillary crutches, brace locked at 0 degrees, ROM 0-60 degrees with flexion at 4 weeks

phase 1 - immediate PO phase: treatment

RICE, e - stim, glute sets, quad sets, AAROM flexion up to 60 degrees, Hip ABduction and ADduction

phase 1 - immediate PO phase: clinical milestones

full knee extension, ROM 0-60 degrees knee flexion, minimal effusion, no increased pain, single limb stance

Phase II intermediate PO phase: dates

4-6 weeks

Phase II intermediate PO phase: goals

WBAT bilateral axillary crutches, quadriceps control, pain reduction, normal patellar mobility, progress to closed kinetic chain exercises

Phase II intermediate PO phase: restrictions

full WBAT brace opened 0-90 degrees, discontinue crutches as tolerated

Phase II intermediate PO phase: treatment

exercises as previous, patellar mobilization, scar tissue mobilization, AROM progressed to 90 degrees, heel raises, mini squats, step ups, flexibility exercises, balance and proprioception

Phase II intermediate PO phase: clinical milestones

previous milestones, good quadriceps recruitment, normalized patellar mobility, full weight bearing without symptoms, normal gait

phase III advanced strengthening phase: dates

6-10 weeks

phase III advanced strengthening phase: goals

increase strength, power and endurance, normalized quads recruitment, normal patellar mobility, no pain or effusion, preparation for advanced activities

phase III advanced strengthening phase: restrictions

knee flexion motion not greater than 130 degrees, no pivoting

phase III advanced strengthening phase: treatment

progression of previous, advanced balance training, leg presses, endurance exercises, swimming and cycling

phase III advanced strengthening phase: clinical milestones

previous milestones, satisfactory clinical exam, Full ROM, improved stability with unilateral stance, no pain, equal hip strength bilaterally

phase IV return to activity phase: dates

11-16+ weeks

phase IV return to activity phase: goals

increase power and endurance, return to sports and ADLs, return to unrestricted activities

phase IV return to activity phase: restrictions

avoidance of loaded full hyperflexion

phase IV return to activity phase: treatment

previous strengthening, endurance drills, agility drills, plyometrics, initiation of running progression, sports specific drills

phase IV return to activity phase: clinical milestones

previous milestones, full confidence in knee, functional testing > 90% of uninvolved, isokinetic testing >90% of uninvolved