Knee Arthroscopy Rehab Protocol

Meniscectomy, debridement, or chondroplasty — therapist reference

Physical Therapy Protocols · From Dr. Allred · Transcribed from the printed sheet · 7 sections

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If you have questions about a protocol or a specific patient, call the clinic where the surgery was performed.

After hours & emergency numbers → Weekdays, business hours.

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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.
Questions about this sheet? Call the clinic where the surgery was performed. I'm happy to talk through the plan. Numbers are at the top of this page, and every after-hours line is on the emergency numbers page.