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Review
. 2025 Sep;18(9):331-343.
doi: 10.1007/s12178-025-09967-6. Epub 2025 May 9.

Current Rehabilitation Principles Following Meniscus Repairs

Jill K Monson  1   2 , Luke V Tollefson  3 , Christopher M LaPrade  3 , Robert F LaPrade  3
Affiliations
Review

Current Rehabilitation Principles Following Meniscus Repairs

Jill K Monson et al. Curr Rev Musculoskelet Med. 2025 Sep.

Abstract

Purpose of review: The purpose of this review is to synthesize current science on meniscus anatomy and biomechanics and repair techniques to create an empirical foundation for postoperative rehabilitation precautions and guidelines, including timelines, clinical and performance-based criteria for return to activity, to maximize both meniscal healing potential and patient recovery.

Recent findings: Recent literature has focused on meniscus repair rather than debridement, and rehabilitation protocols should be designed to optimize healing. Complex, unstable tears, like root and radial tears, disrupt hoop stress and warrant a more conservative protocol including 6 weeks of non-weightbearing; however, more stable tears, like ramp and vertical tears, can often weight bear immediately after surgery. All protocols should emphasize early protected joint motion. Return to activity guidelines remain ill-defined but this review explores evidence-based recommendations for timelines, strength and performance testing. Patients typically should wait ≥ 4 months for a return to activity and the presence of joint line tenderness or effusion could be a sign of delayed/failed healing. It is essential for therapists to know the size, type, and location of a meniscus repair to optimize patient outcomes. Guidelines for weight bearing, range of motion, strength training, and return to activity should vary per tear type and repair technique and recovery should be both time- and criteria-based. Return to activity should align with healing time, objective clinical and performance testing, and clinical and imaging exam findings. Future research should aim to optimize repair techniques and rehabilitation protocols, specifically further study on the timing to initiate weightbearing, early motion, and return to activity.

Keywords: Knee; Meniscus; Meniscus repair; Meniscus root tear; Radial tear; Rehabilitation.

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Conflict of interest statement

Declarations. Human and Animal Rights and Informed Consent: All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards(including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines). Conflict of Interest: Jill Monson, PT, OCS: Financial Disclosure and Conflict of Interest. —Consultant: Ossur, Smith & Nephew -Committees: AASPT Research Committee. Dr. Robert F. LaPrade, MD, PhD: Financial Disclosure and Conflict of Interest.—Consultant: Ossur, Smith & Nephew, Responsive Arthroscopy—Royalties: Ossur, Smith & Nephew, Elsevier, Arthrex—Research Grants: Ossur, Smith & Nephew, AANA, AOSSM—Committees: ISAKOS, AOSSM, AANA—Editorial Board: AJSM, JEO, KSSTA, JKS, JISPT, OTSM—Education: Foundation Medical. Luke Tollefson, BS: No Financial Disclosures and Conflict of Interest. Dr. Christopher M. LaPrade, MD: Financial Disclosure and Conflict of Interest. Educational support: Evolution Surgical, Inc, Foundation Medical, LLC, Arthrex, and Smith & Nephew. Speaker fees from DJO.

Figures

None
Clinical and physical performance testing criteria for return to run, jump and sport
Fig. 1
Fig. 1
Arthroscopic image of a radial tear of the medial meniscus in a left knee
Fig. 2
Fig. 2
Arthroscopic image of a posterior medial meniscus root tear in a right knee
Fig. 3
Fig. 3
Arthroscopic image of a vertical, longitudinal tear of the lateral meniscus in a right knee
Fig. 4
Fig. 4
Arthroscopic image of a horizontal cleavage tear of the medial meniscus in a left knee
None
Flow Diagram 1. Clinical and physical performance testing criteria for return to run, jump and sport
Fig. 5
Fig. 5
Early Quadriceps Training Options
Fig. 6
Fig. 6
Early Hamstring Training Options
See this image and copyright information in PMC

References

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