Meniscus Allograft Transplantation

Meniscus Allograft Transplantation

Phase I (Weeks 0-8)

  1. Weightbearing:Weeks 0-2:  Partial Weightbearing (up to 50%)Weeks 2-6:  Advance to WBAT with crutches (d/c crutches at 4 weeks post-op if gait normalized)
  2. Weeks 0-2:  Partial Weightbearing (up to 50%)
  3. Weeks 2-6:  Advance to WBAT with crutches (d/c crutches at 4 weeks post-op if gait normalized)
  4. Hinged Knee Brace:  worn for 6 weeks post-opLocked in full extension for ambulation and sleeping – remove for hygiene (Week 1)Locked in full extension for ambulation– remove for hygiene and sleeping (Week 2)Set to range from 0-90° for ambulation- remove for hygiene and sleeping (Weeks 3-6)Discontinue brace at 6 weeks post-op
  5. Locked in full extension for ambulation and sleeping – remove for hygiene (Week 1)
  6. Locked in full extension for ambulation– remove for hygiene and sleeping (Week 2)
  7. Set to range from 0-90° for ambulation- remove for hygiene and sleeping (Weeks 3-6)
  8. Discontinue brace at 6 weeks post-op
  9. Range of Motion – PROM -> AAROM -> AROM as toleratedWeeks 0–2:  Non-weightbearing 0-90°Weeks 2–8:  Full non-weightbearing ROM as tolerated – progress to flexion angles greater than 90°
  10. Weeks 0–2:  Non-weightbearing 0-90°
  11. Weeks 2–8:  Full non-weightbearing ROM as tolerated – progress to flexion angles greater than 90°
  12. Therapeutic ExercisesQuadriceps sets, heel slides, straight leg raises, patellar mobilizations, co-contractions (Weeks 0-2)Add heel raises and terminal knee extensions (Weeks 2-8)Activities in brace for first 6 weeks – then without braceNo weightbearing with flexion > 90° during Phase IAvoid tibial rotation for first 8 weeks to protect the meniscal allograft
  13. Quadriceps sets, heel slides, straight leg raises, patellar mobilizations, co-contractions (Weeks 0-2)
  14. Add heel raises and terminal knee extensions (Weeks 2-8)
  15. Activities in brace for first 6 weeks – then without brace
  16. No weightbearing with flexion > 90° during Phase I
  17. Avoid tibial rotation for first 8 weeks to protect the meniscal allograft

Phase II (Weeks 8-12)

  1. Weightbearing:  As tolerated
  2. Range of Motion –  Full active ROM
  3. Therapeutic ExercisesProgress to closed chain extension exercises, begin hamstring strengtheningLunges – 0-90°, Leg press – 0-90° (flexion only)Proprioception exercisesBegin use of the stationary bicycle
  4. Progress to closed chain extension exercises, begin hamstring strengthening
  5. Lunges – 0-90°, Leg press – 0-90° (flexion only)
  6. Proprioception exercises
  7. Begin use of the stationary bicycle

 Phase III (Months 3-6)

  1. Weightbearing:  Full weightbearing with normal gait pattern
  2. Range of Motion – Full/Painless ROM
  3. Therapeutic ExercisesContinue with quad and hamstring strengtheningFocus on single-leg strengthBegin jogging/runningPlyometrics and sport-specific drills
  4. Continue with quad and hamstring strengthening
  5. Focus on single-leg strength
  6. Begin jogging/running
  7. Plyometrics and sport-specific drills
  8. Gradual return to athletic activity as tolerated (6 months post-op)
  9. Maintenance program for strength and endurance