Meniscal Repair — Meniscal Root Repair

Orthopedic & Sports Medicine Specialists (OSMS)

Weight-Bearing

TDWB in brace with full extension and crutches x4 wks Phase I; advance to full WBAT (no WB with knee flexion past 90 deg) Phase II; brace/crutches D/C at 6 wks if gait normalized with good quad control; WBAT without brace allowed Phase III

Key Restrictions

A/PROM limited to 0-90 deg Phase I; no PROM >90 deg and no resisted hamstring strengthening Phase II; avoid any WB with knee flexion past 90 deg through wk 6; heat before exercise/ice after Phase III

Timeline & Phases

Phase I (surgery-4 wks): protect repaired meniscus, reduce swelling, control pain, brace locked in extension for sleeping x2 wks, TDWB in brace with full extension and crutches x4 wks, A/PROM 0-90 deg only, quad sets/SLRs with brace on for hip strength, heel slides, patellar mobilization, UBE/upper body circuit; progress to Phase II after 6 wks if safe gait with brace, trace effusion, 0-90 deg ROM; Phase II (4-8 wks): advance to full WBAT (no WB with knee flexion past 90 deg), may unlock brace, progress ROM to full, good quad control, improve hip/core strength/balance/proprioception, D/C brace and crutches after 6 wks if gait normalized with good quad control, wall sits at 90 deg allowed after 6 wks, avoid post-activity swelling, no resisted hamstring strengthening, no PROM >90 deg, gait drills, functional single-plane closed chain movements, balance/proprioceptive exercise, UBE, water walking, stationary bike, Versaclimber/NordicTrack; progress to Phase III after 4 wks if knee PROM 0-120 deg, normal gait on level surfaces, good leg control without extensor lag/pain/apprehension, single leg balance at 30 deg flexion >20 sec; Phase III (8+ wks): good eccentric/concentric neuromuscular control, multiplane limb control, heat before exercise/ice after, WBAT without brace allowed, closed chain exercise progression, lunges 0-90 deg, leg presses 0-90 deg, proprioceptive exercises, begin stationary bike, hip/core strengthening; after 12 wks single leg strengthening and jogging/running progression, sport-specific exercises, return to sport MD-directed generally >16 wks

Notes

OSMS Rehabilitation Guidelines; meniscal root injury repair restores normal anatomy and hoop-stress absorption within the knee joint — failure to repair can lead to meniscal extrusion and premature articular cartilage wear