Important
This is the fast, early-motion pathway for a simple knee scope (partial meniscectomy, debridement, or chondroplasty). For a meniscal repair or meniscal root repair, follow that dedicated protocol instead — those are more restricted to protect the healing meniscus.
Principles
- Progress quickly — there is no meniscal repair to protect; the pace is limited only by pain, swelling, and quad control.
- Control effusion: over-aggressive loading that causes a reactive effusion should be backed off a step.
Phase 1 · Week 0–1 (Control & Activate)
- Goals: control pain and swelling; ROM 0–90°+.
- Immediate weight bearing as tolerated — most patients do not need crutches; wean early.
- Quad sets (add NMES if quad lag), short-arc quads (0–30°), SLR ×4; mini-squats 0–45° with UE support.
- Patellar mobilizations, heel slides, calf pumps; hamstring activation (bridging); double-leg heel raises; bike for ROM.
- Cold therapy with the knee elevated in full extension after exercise.
Phase 2 · Weeks 1–3 (Full Motion & Gait)
- Goals: full ROM and a normal gait; wean any assistive device.
- AAROM/AROM to 0–120°+; continue SLR; hip and core strengthening.
- Wall squats to 30°; forward, lateral, and retro step (UE support); single-leg heel raises; progress the stationary bike.
- Leg press and hamstring curls may begin as tolerated (no need to defer to 6 weeks as in a repair).
Phase 3 · Weeks 3–6 (Strength & Endurance)
- Goals: walk 2 miles and manage stairs; near-symmetric strength.
- Progress resistance: wall squats and leg press 0–90°, hamstring curls, hip machine (4-way).
- Proprioception: single-leg balance (eyes open/closed), unstable surfaces; slide board.
- Treadmill walking → jogging progression; elliptical; pool therapy once the wound is closed.
Return to Sport (Criterion-Based)
- No effusion and full pain-free ROM.
- Quadriceps and lower-extremity strength symmetric to the other leg.
- Tolerates sport-specific demands (agility, cutting, impact).
References
- The Formal EU-US Meniscus Rehabilitation 2024 Consensus (ESSKA–AOSSM–AASPT), Part I — Management after Meniscus Surgery. JOSPT Open, 2025.
- Rehabilitation Protocol for Arthroscopic Partial Meniscectomy. Massachusetts General Hospital.