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 (discontinue crutches at 4 weeks post-op if gait normalized)
2. Hinged Knee Brace
   • Worn for 6 weeks post-op
   • Locked 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
3. Range of Motion – PROM → AAROM → AROM as tolerated
   • Weeks 0–2: Non-weightbearing 0–90°
   • Weeks 2–8: Full non-weightbearing ROM as tolerated – progress to flexion angles greater than 90°
4. Therapeutic Exercises
   • Weeks 0–2: Quadriceps sets, heel slides, straight leg raises, patellar mobilizations, co-contractions
   • Weeks 2–8: Add heel raises and terminal knee extensions
   • Activities in brace for first 6 weeks – then without brace
   • No weightbearing with flexion > 90° during Phase I
   • 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 Exercises
   • Progress to closed chain extension exercises; begin hamstring strengthening
   • Lunges – 0–90°, Leg press – 0–90° (flexion only)
   • Proprioception exercises
   • 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 Exercises
   • Continue with quad and hamstring strengthening
   • Focus on single-leg strength
   • Begin jogging / running
   • Plyometrics and sport-specific drills
   • Gradual return to athletic activity as tolerated (6 months post-op)
   • Maintenance program for strength and endurance