Phase I: Protection and Early Recovery (0–2 Weeks)

Immobilisation:

• Hinged knee brace locked in extension for ambulation for 2 weeks

• Brace unlocked for prescribed exercises and hygiene

Precautions:

• Weight bear as tolerated with brace protection

• Avoid lateral patellar loading and twisting activities

• Avoid deep knee flexion

• Avoid impact activities

Therapy:

• Oedema management and elevation

• Gait retraining

• Patella mobilisation

• Active knee range of motion to approximately 90°

• Quadriceps activation and straight leg raises

• Active ankle and hip range of motion

Criteria to Progress:

• Wound healed

• Pain controlled

• Minimal swelling

• Independent mobilisation

• Good quadriceps activation

Phase II: Restore Motion and Early Strength (2–6 Weeks)

Immobilisation:

• Wean hinged knee brace

Precautions:

• Continue weight bearing as tolerated

• Avoid twisting and pivoting activities

• Avoid loaded knee flexion

• Avoid impact activities

Therapy:

• Progress knee range of motion

• Continue quadriceps strengthening

• Commence closed-chain strengthening

• Balance and gait retraining

Criteria to Progress:

• Functional knee ROM

• Minimal swelling

• Improving quadriceps control

• Normalising gait

Phase III: Strength and Functional Recovery (6–12 Weeks)

Precautions:

• Avoid running and pivoting activities initially

• Progress loading gradually

• Avoid abrupt increases in training volume

Therapy:

• Progressive strengthening

• Functional lower limb rehabilitation

• Balance and proprioception exercises

• Endurance exercises

Criteria to Progress:

• Functional ROM restored

• Improved lower limb strength

• Good dynamic control

• Normalising function

Phase IV: Return to Function and Endurance (3–6 Months)

Precautions:

• Gradual return to unrestricted activity

• Avoid abrupt progression into pivoting and impact activities

Therapy:

• Progressive strengthening

• Functional rehabilitation

• Occupation-specific rehabilitation

• Sport-specific rehabilitation

Criteria to Progress:

• Functional strength restored

• Stable patella

• Symmetrical lower limb function

• Return to unrestricted activity

General Recommendations

Work:

• Desk-based work may resume after 2–4 weeks.

• Manual labour is typically deferred until 3–6 months depending on job demands and recovery progression.

Driving:

• It is important that you are medically fit to return to driving and you feel safe to control the vehicle and take evasive action if needed.

• In general, for left knee surgeries in vehicles with automatic transmission, return to driving may be sooner.

Sports and Leisure:

• Low-impact activities may resume from 8-12 weeks.

• Running may commence at approximately 3–4 months if strength and control permit.

• Pivoting, jumping, and contact sports are typically delayed until 4–6 months or longer with surgeon clearance.

Thromboprophylaxis

Routine postoperative pharmacological thromboprophylaxis is not generally required following arthroscopic meniscal surgery. In selected cases – particularly where weight bearing is restricted (e.g. meniscal root repair) or patient-specific risk factors are present – A/Prof Ernstbrunner and his medical team may consider thromboprophylaxis based on individual risk assessment.

Disclaimer: This protocol is intended as a general rehabilitation guide only. Rehabilitation progression should always be individualised and may be modified by A/Prof Ernstbrunner and the treating rehabilitation team based on the patient’s clinical progress, surgical findings, and individual circumstances.