York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

KNEE MENISCUS REPAIR – PHYSICAL THERAPY PROTOCOL

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Weeks 0 to 5

  • Toe-touch weightbearing with knee brace locked in full extension when ambulating
  • Cryotherapy (20 minutes each hour)
  • Continuous Passive Motion (CPM) (4-6 hours/day)
  • Patella mobilizations
  • Scar mobilization
  • Hourly ankle pumps
  • Electric stimulation

Range of motion exercises – 4 times daily

  • Passive flexion: sitting with leg over edge and bend using non-operative leg to assist. Hold each pose for 5 seconds.
  • Heel Props: leg straight with heel propped up on towels to keep calf off the table and hold for 5 seconds.
  • Heel slides – Use your good leg to pull the involved heel toward the buttocks, flexing the knee. Hold for 5 seconds; straighten the leg by sliding the heel downward and hold for 5 seconds.
  • Prone hangs – lie face down on a table/bed with the legs hanging off the edge of the table; allow the legs to sag into full extension.

Strengthening Exercises – twice daily (1 set of 10 repetitions on day 1; progress to 3-5 sets of 10 repetitions on day 2)

  • Four-way straight leg raises
  • Hip abduction / adduction / ER isometrics
  • Cycling daily (no resistance)
  • Start mini squats at week 3-4 (less than 60 degrees flexion)

Phase II (weeks 6 to 11):

Criteria for progression to Phase II

  • Passive ROM 0-120
  • No effusion
  • Appropriate quadriceps control
  • Continue exercises as outlined above
  • Partial weightbearing progress to full weightbearing as tolerated with brace set 0-90 degrees
  • Progress to passive and active-assist full flexion
  • Low-resistance closed-chain strengthening exercises, including mini-squats and leg presses (90→0° arc)
  • Underwater treadmill system (gait training)
  • Retrograde treadmill ambulation
  • Proprioception/Balance training: proprioception board, contralateral theraband exercises, balance systems
  • Straight leg raises with progressive resistance
  • Open-chain knee extension 40° to 0° (as long as there is pain-free /crepitus-free arc)

Phase III (Weeks 12 to 17)

Criteria for progression to Phase III:

  • Full ROM
  • No pain
  • Straight leg raise without extensor lag
  • Full active range of motion
  • Full weight-bearing with brace unlocked; may discontinue brace once adequate quadriceps control
  • Progressive-resistance closed-chain strengthening exercises (leg press 90º to 0° emphasizing eccentrics)
  • Resistance bicycling, swimming
  • Initiate “step down” program
  • Open-chain knee extension
  • Advanced proprioception training (Perturbations)
  • Agility exercises (sport cord)
  • Elliptical Trainer
  • Hamstring curls and proximal strengthening

Plyometrics, sport-specific drills

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