The Consensus?
Meniscus surgery is common, but clear and consistent post-op rehabilitation guidelines have been lacking.
A formal EU-US consensus was developed by ESSKA, AOSSM & AASPT.
Who was involved?
- Orthopaedic Surgeons
- Physiotherapists
- Sports Medicine Doctors
How was it done?
- 395 papers reviewed
- Many recommendations were supported by low to moderate levels of evidence, highlighting the importance of clinical expertise when applying the guidelines.
Meniscus Repair
How Long?
- Vertical tears: minimum 4 months
- Complex, complete radial/root & horizontal tears: 6-9 months
Weight Bearing & ROM
- Vertical longitudinal tears: full weight bearing may be permitted. ROM restrictions may be required for up to 6 weeks
- Complex, horizontal, radial & root repairs: weight bearing & ROM restrictions generally reuqired for 4-6 weeks
What to Avoid
- Deep squats, jumping & rotational knee movements should be avoided for at least 4 months
Meniscus Reconstruction
How Long?
- Rehab commonly 9+ months
- Return to sport generally 12+ months
Weight Bearing & ROM
- Non-weight bearing for 6 weeks
- Progress towards full weight bearing by approx 8 weeks
- Weight bearing on knee flexion should be delayed
- Non-weight bearing knee flexion should not exceed 90 deg until 6 weeks post op
Bracing?
- No definitive recommendation
Key Messages
Time & Criteria
- Use recommended timeframes to protect healing tissue, but progression should also be guided by clinical milestones
One Size Doesn’t Fit All
- Consider the tear type, surgical procedure and individual factors when planning rehabilitation
Quads, Quads, Quads
- Prioritise quads activation, strength and neuromuscular control throughout rehab
The Bottom Line?
- There is no one-size-fits-all meniscus rehab protocol
Reference
Pujol N, et al. (2025).
The Formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT Initiative: Part I – Rehabilitation Management After Meniscus Surgery (Meniscectomy, Repair and Reconstruction).