Meniscus Replacement Surgical Video
Rehabilitation and Fitness Video


General Considerations:

•    Partial weight-bearing status for 4 weeks post-op. 10-20% toe-touch for 1-2 weeks,
     progress as tolerated
•    Most patients will be in a hinged rehab brace locked in full extension for 4 weeks
     post-op unless otherwise indicated
•    Regular assessment of gait to avoid compensatory patterns
•    Regular manual mobilizations to surgical wounds and associated soft tissue to
     decrease the incidence of fibrosis
•    No resisted leg extension machines (isotonic or isokinetic)
•    No high impact or cutting / twisting activities for at least 4 months post-op
•    M.D. follow-up visits at Day 1, Day 8-10, 1 month, 4 months, 6 months, and 1 year
      post-op
•    During the first 4 weeks: TWICE PER DAY: Without brace and seated with feet off
     the ground, gently bend knee back as tolerated BUT NO MORE THAN 90
     DEGREES for a good knee stretch without increase in pain. Relax knee and stretch
     for 60 seconds


Week 1:

•    M.D. visit day 1 post-op to change dressing and review home program
•    Icing and elevation regularly. Aim for 5x per day, 15-20 minutes each time. For ice
     machine: use as directed


Exercises:

1)    straight leg raise exercises (lying, seated, and standing): quadriceps/adductio
       /abduction/gluteal sets
2)    twice daily passive and active range of motion exercises
3)    theraband calf presses
4)    well-leg stationary cycling
5)    upper body training
6)    core/trunk training

•    Soft tissue treatments to musculature for edema and pain control
•    Manual daily patella glides up/down/side to side by therapist and patient


Weeks 2 - 4:

•    M.D. visit at 8 - 10 days for suture removal and check-up
•    GENTLE and BRIEF pool / deep water workouts after the first 8-10 days and with the
     use of a brace. No more than 30 minutes per workout; no more than 3 workouts per
     week
•    Continue with pain control, gentle range of motion, and soft tissue treatments
 

Weeks 4 - 6:

•    M.D. visit at 4 weeks post-op, will progress to full weight bearing and discontinue use
     of rehab brace
•    Increase stretching and manual treatments to improve knee range of motion.
     Extension should be full, and flexion should be near 100 degrees
•    Incorporate functional exercises (i.e. partial squats, calf raises, mini-step-ups, light
     leg pressing, proprioception)
•    Stationary bike and progressing to road cycling as tolerated
•    Slow walking on treadmill for gait training (preferably a low-impact treadmill)
•    Gait training to normalize movement patterns


Weeks 6 - 8:

•    Increase the intensity of functional exercises (i.e. cautiously increase depth of
     closed-chain exercises., Shuttle/leg press).  Do not overload closed- or open-chain
     exercises
•    Continue to emphasize normal gait patterns
•    Range of motion: extension full, and flexion to 120 degrees


Weeks 8 - 12:

•    Add lateral training exercises (side-step ups, Theraband resisted side-stepping,
     lateral stepping)
•    Introduce more progressive single leg exercise
•    Patients should be pursuing a home program with emphasis on sport/activity-specific
     training
•    Range of motion should be near normal


Weeks 12-16:

•    Low-impact activities until 16 weeks
•    Increasing intensity of strength and functional training for gradual return to activities