An estimated 850,000 meniscus surgeries are done each year in the U.S. Previously, we reviewed the keys to recovery after menisectomy surgery.  Menisectomy is the most common type of surgery for meniscus tears.  With this procedure, your surgeon removes the torn portion of your meniscus.  Recovery is quick and straightforward.  However, this type of surgery is associated with accelerated knee arthritis and knee replacement surgery.  Therefore, the preferred surgery is a meniscus repair.

With a meniscus repair, the torn edges of your cartilage are sewn back together.  Repair of your meniscus leads to a decreased risk for arthritis.  It also leads to improved outcomes compared to meniscectomy.  An individualized rehabilitation program is crucial for the best results after a meniscus repair.  This article highlights who should get their meniscus repaired and how to best recover.

Who Gets a Meniscus Repair?

Your surgeon considers many different factors to determine if you are a candidate for a meniscus repair.  This includes the following factors:

• Younger (usually < 40 but not always) active person
• No significant medical problems
• Excessive bodyweight
• Smaller tears
• Tears located in areas with good blood flow (for healing)
• Tears < 3 months old
• Minimal to no arthritis in your knee
• Willingness to comply with a slower rehabilitation (read on for more about this)

Meniscus Repair Recovery: Slow or Fast Rehab?

Historically, there has been very little consensus on how to best rehabilitate after a meniscus repair.  Now, this is changing. Recent research offers guidance on how to best get back to your favorite activities.

The key questions to consider after surgery are:

• How much weight is safe to put through your healing meniscus?
• How much knee bending is safe for your healing meniscus?
• When can you progress through your strengthening program?
• When can you safely return to sports?

Conservative rehabilitation restricts knee range of motion and weight through your injured leg.  Restrictions last for 4 to 6 weeks.  With this slower approach, you will wear a locked knee brace.  Also, you will walk with crutches until cleared by your surgeon.

Prolonged time in a brace with restricted weight-bearing leads to stiffness and weakness.  Accelerated rehabilitation avoids these problems.  However, some question the safety of this approach on the healing meniscus.

Accelerated Meniscus Repair Recovery: A Proven Approach

A systematic review done by physicians at the Rothman Institute investigated the safety and effectiveness of various rehab protocols after a meniscus repair. They looked at 15 different studies.

In their review, restricting the range of motion and weight-bearing showed no benefit over an accelerated approach.  Long-term results (1 to 2 years after surgery) are similar for the conservative and accelerated approaches.

Early weight-bearing and a full range of motion avoid the unnecessary decline in strength and function that happens with restricted rehabilitation.  We advocate for an accelerated approach.  However, pain and swelling have to be respected during the process.  Your rehab is progressed based on meeting specific milestones.  These include full range of motion and walking without a limp.

3 Easy Exercises to Start Early After Your Meniscus Repair 

Regardless of which rehabilitation approach your surgeon allows, you want to begin exercising your knee right away.  Start non-weight-bearing exercises from your home the day after surgery.  Focus your efforts on straightening your knee fully, activating your quadriceps, and slowly progressing your knee bending.

3 Weight-Bearing Exercise Progressions

Weight-bearing and advanced exercises come in later during your rehab.  Your physical therapist walks you through these exercises.  Avoid deep squats or knee bends until your physical therapist clears you.  The following 3 exercises are a safe way to start.  Focus on improving your single leg balance and avoiding compensations with your other leg.

Don’t Delay Your Rehab After Surgery

Meniscus repair is preferred over meniscectomy surgery.  Rehab is slower after a repair.  However, if you start early and commit to your exercises, the long-term results will make it well worth it.  Early on it is important you minimize knee stiffness and loss of your muscle strength.  As you progress in your rehab, your physical therapist will specifically target your exercises towards your movement patterns and goals.

A progressive rehab program is so important for your recovery!  Some people ignore their surgeon and physical therapist recommendations.  Unfortunately, we see this too often.  This results in a rollercoaster rehab with inconsistent improvements.  More importantly, this also leads to a knee that continues to be painful years later.

If you are looking for help after your meniscus repair surgery, call our office to schedule an appointment.  Our doctors of physical therapy have been helping people in Southern Ocean County move without pain since 2007.