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Arthroscopic Meniscal Repair

Rehabilitation clinical resource for Clinical Exercise Physiologists (CEPs)

Clinical Profile

Minimally invasive surgical repair of a torn meniscus. Commonly causes arthrogenic inhibition of the quadriceps2 and limits walking, squatting, stairs, kneeling, and pivoting.

CEP role: Using Te Whare Tapa Whā framework1, co-develop a personalised, evidence-based exercise plan with the client and whānau (taha whānau) to restore knee function and reduce atrophy2(taha tinana), increase movement confidence (taha hinengaro), and meet the client's own goals (taha wairua).

Rehabilitation Phases2

PhaseGoalsProgression
Recovery
~0–6 weeks

Follow surgeon restrictions: protect repair (avoid WB), joint nutrition, reduce pain / swelling, activate quadriceps.

Surgeon clearance + full TKE, 120° knee flexion, 20 reps straight leg raise, limited swelling.
Transition ~6–12 weeks

Transition off crutches, partial → full WB.

Full WB tolerated, minimal swelling.
Rebuild
~9–16 weeks

Full TKE, gradually increase knee flexion (WB limited to ≤ 70°), increase load, introduce balance & stability.

Green zone post-exercise (see Monitoring); quadriceps LSI ≥ 65%; normal gait after 15 min walk.3
Restore
~16–36+ weeks

Increase knee stability, strength and endurance; gradually introduce plyometrics + pivoting. Sport / work / ADL focus.

Green zone post-exercise; quadriceps LSI ≥ 80–90%; minimal kinesiophobia.

Recovery and Transition phases are usually physio-led. Timeframes vary depending on tear type and client characteristics.2

Assessment

Functional assessments selected for client's rehab phase + ADLs and goals. Examples: sit-to-stand, step down, single-leg balance, 15-min gait.

IKDC Subjective Knee Form:4 tracks knee function and ADL impact; use to identify functional limitations and improvements.

Quadriceps LSI: interpret with clinical judgement (unaffected leg may have weakened).5

TSK-11: tracks kinesiophobia; lower scores associated with less pain and better IKDC scores.6

Monitoring2

Continue
Pain ≤ 3/10, settles within 24 hours.
Modify
Pain 4–5/10 or increased joint-line tenderness, settles within 48 hours.
Stop & refer
Pain ≥ 6/10 or disrupting sleep; infection signs; instability or loss of function; catching, popping or locking; progressive neurological symptoms. Urgent review if suspected DVT/PE: calf pain/tightness, chest pain, rapid HR, breathlessness.

Acronyms: WB Weight-Bearing; TKE Terminal Knee Extension; ADLs Activities of Daily Living; LSI Limb Symmetry Index; IKDC International Knee Documentation Committee; TSK Tampa Scale of Kinesiophobia; DVT Deep Vein Thrombosis; PE Pulmonary Embolism; HR Heart Rate.

References

  1. Durie, M. (1994). Tirohanga Māori — Māori health perspectives. In Whaiora: Māori health development (pp. 67–81). Oxford University Press.
  2. Monson, J. K., Tollefson, L. V., LaPrade, C. M., & LaPrade, R. F. (2025). Current rehabilitation principles following meniscus repairs. Current Reviews in Musculoskeletal Medicine, 18(9), 331–343. https://doi.org/10.1007/s12178-025-09967-6
  3. Joreitz, R., Lynch, A., Popchak, A., & Irrgang, J. (2020). Criterion-based rehabilitation program with return to sport testing following ACL reconstruction: A case series. International Journal of Sports Physical Therapy, 15(6), 1151–1173. https://doi.org/10.26603/ijspt20201151
  4. Shephard, L., Abed, V., Nichols, M., Kennedy, A., Khalily, C., Conley, C., Jacobs, C., & Stone, A. V. (2023). International Knee Documentation Committee (IKDC) is the most responsive patient reported outcome measure after meniscal surgery. Arthroscopy, Sports Medicine, and Rehabilitation, 5(3), e859–e865. https://doi.org/10.1016/j.asmr.2023.02.005
  5. Wellsandt, E., Failla, M. J., & Snyder-Mackler, L. (2017). Limb symmetry indexes can overestimate knee function after anterior cruciate ligament injury. Journal of Orthopaedic & Sports Physical Therapy, 47(5), 334–338. https://doi.org/10.2519/jospt.2017.7285
  6. Hsu, C. J., George, S. Z., & Chmielewski, T. L. (2020). Fear-avoidance and self-efficacy psychosocial factors are altered after partial meniscectomy and associated with rehabilitation outcomes. International Journal of Sports Physical Therapy, 15(4), 557–570. https://doi.org/10.26603/ijspt20200557