knee- meniscus- meniscus repair complex tears
This document, authored by Advanced Continuing Education Institute, outlines a structured, phase‑based postoperative rehabilitation program for patients who have undergone meniscus repair of complex tears. The protocol is divided into four sequential phases spanning from immediate postoperative protection (Weeks 1‑6) to full return to sport (6‑8 months). Each phase lists specific clinical goals, detailed timelines for range‑of‑motion (ROM) advancement, weight‑bearing progression, and a graduated list of strengthening, proprioception, balance, and functional exercises. Precautions (e.g., avoiding twisting, deep squatting, hamstring work) are highlighted for each stage, and clear criteria for advancing to the final Return‑to‑Activity phase are provided (full painless ROM, no tenderness, satisfactory clinical exam, isokinetic testing). The document emphasizes gradual loading, independent quadriceps control, and progressive sport‑specific drills, culminating in a timeline for straight‑line running, pivoting, cutting, and agility training, with a target of unrestricted sports participation by 7‑8 months post‑surgery.
Topics
Phase I – Maximum Protection (Weeks 1‑6): Foundational Healing and Early Motion
Defines the initial rehabilitation goals—control inflammation, achieve full passive extension, and establish independent quadriceps control—while protecting the repair.
Stage 1 (Days 1‑10): Immediate Post‑Surgery Management
Details brace usage (locked at 0°), ice/compression, passive ROM limits (0‑90°), early quad sets, straight‑leg raises, hip ab/adduction, and toe‑touch weight bearing with crutches.
Stage 2 (Weeks 2‑4): Progressive ROM and Partial Weight‑Bearing
Outlines incremental passive ROM targets (up to 120° by week 4), weight‑bearing percentages (25‑50% WB week 2, 50‑75% week 3, full WB week 4), and expanded strengthening (multi‑angle quad isometrics, CKC weight shifts).
Stage 3 (Weeks 5‑6): Introduction of Closed‑Kinetic‑Chain (CKC) Exercises
Introduces low‑load CKC movements (½‑squat, leg press, wall squat) and proprioception training (tilt board, Biodex stability), while allowing weight bearing as tolerated.
Phase II – Moderate Protection (Weeks 7‑12): Full ROM and Strength Consolidation
Focuses on achieving full PROM (up to 130°), diminishing swelling, and advancing muscle control with higher‑load leg press, wall/vertical squats, step‑ups, and early hamstring curls.
Weeks 7‑10: Strength and Balance Expansion
Specifies progressive leg press angles, knee extension ranges, hip ab/adduction, balance/proprioception drills (Biodex, rocker board, cup walking), and low‑impact cardio (bike, pool).
Weeks 10‑12: Introduction of Light Hamstring and Calf Work
Adds light hamstring curls and toe‑calf raises while maintaining previous exercise regimen, still avoiding twisting, pivoting, and deep squatting.