Standard Rehab Protocol After Meniscal Repair

Post Operative

• Cryocuff or ice pack ASAP
• Establish adequate pain control
• Static quads, sliding board knee flexion, passive full extension resting heel on rolled towel
• Advice re reduction of swelling (mobility limits, elevation, ice)
• Stairs practice
• Discharge with outpatient physiotherapy ASAP

• At 48 hours:
  
  Removal of presuure bandages and dressings, with application of fresh dressings plus tubigrip bandaging
• For the 1st 6 weeks:
  
  Crutches, with partial weight bearing plus a hinged knee brace locked so as to allow the knee to only move between full extension (straight) up to about 90 degrees flexed (bent). The brace does need to be kept on day and night to prevent the knee from flexing up. This is because the cartilages in the knee are put under significant stress when the knee flexes, and this can potentially rupture the tiny sutures used in a meniscal repair, causing the repair to fail and the tissue to re-tear. The brace can be removed for washing, but if it is then great care must be taken and the knee must be kept straight.
• At 6 weeks:
  
  The brace is removed and the crutches are discarded. Patients are then encouraged to fully weight bear and to start intensive physiotherapy. The physio treatment is aimed at -
  • Regaining the range of motion in the knee
  • Regaining muscle strength
  • Restoring the reflexes in the joint (proprioception)
• At 12 weeks (3 months):
  
  If your physiotherapist feels that you knee is ready, then you will be able to gradually make a careful return to full exercise and sport, although great caution is urged if the intention is to return to heavy impact or contact sport, in which case a slowly progressive staged return to competition is recommended.