Meniscal Injuries: Pathway 2 - Surgical Rehabilitation
Different operations require different timelines and restrictions.
Meniscal Repair
For an in-depth guide see the following link. https://www.rjah.nhs.uk/media/vmtkizoc/meniscal-repair-rehab-guide.pdf
Goal:
Preserve and heal the meniscus.
Usually performed when tears occur in areas with good blood supply.
Rehabilitation considerations:
Early phase:
Protected weight bearing
ROM restrictions
Control swelling
Progression:
Strength restoration
Single-leg loading
Return to running
Sport progression
Return timelines often range between 4–6 months, sometimes longer.
Meniscectomy
Part of the damaged meniscus is removed.
Recovery is often faster because healing of repaired tissue is not required.
Rehabilitation emphasis:
Restore motion quickly
Build quadriceps strength
Reintroduce loading
Improve impact tolerance
Many return to activity within weeks, depending on symptoms.
Meniscal Root Repair
For an in-depth guide see the following link.
https://www.rjah.nhs.uk/media/bj1jnxp4/meniscal-root-repair-guide.pdf
Used when root attachment tears occur.
These injuries alter load transmission significantly.
Typical rehab includes:
Longer protection period
Restricted weight bearing
Gradual flexion progression
Delayed impact activities
Return may take 6 months or more.
Meniscal Transplant
For an in-depth guide see the following link.
https://www.rjah.nhs.uk/media/2ivbuxfw/meniscal-allograft-transplant-guide.pdf
Replacement meniscus tissue is inserted when substantial meniscal loss exists.
Usually considered in younger active individuals with persistent symptoms.
Rehabilitation goals:
Protect graft
Restore mobility
Gradual strengthening
Controlled return to impact
Long rehabilitation is expected.
ACI (Autologous Chondrocyte Implantation)
For an indepth guide see the following link. https://www.rjah.nhs.uk/media/zehdci0p/ascot-rehabilitation-following-cell-implantation-to-femoral-condyle.pdf
Used to restore cartilage defects.
Cartilage cells are harvested, grown, and reimplanted.
Rehabilitation focuses on:
Cartilage protection
Controlled loading
Progressive strengthening
Slow return to sport
Recovery may extend to 9–18 months.
OATS Procedure
(Osteochondral Autograft Transfer System)
For an in-depth guide see the following link.
https://www.rjah.nhs.uk/media/v2tm4ljm/femoral-condyle-oats-rehab-guide.pdf
Healthy cartilage and bone plugs are moved into damaged areas.
Rehabilitation includes:
Phase priorities:
Protect graft site
Restore movement
Strength progression
Impact progression
Sport-specific training
Recovery length depends on lesion size and location.
How Physiotherapy Helps - With or Without Surgery
Physiotherapy aims to restore:
Strength
Improving muscle capacity around the knee and hip.
Movement Quality
Reducing excessive load and improving control.
Confidence
Returning to walking, exercise, work and sport.
Function
Helping patients achieve their goals whether that means:
Climbing stairs
Running
Returning to sport
Gym training
Daily activities
Treatment is not simply about the MRI result — it is about improving how the knee performs.
