Rehab Knee ACL with Meniscus Repair Protocol
  • Sports Medicine

  • Knee Surgery

  • Shoulder Surgery

  • Elbow Surgery

  • Hip Surgery

  • Ankle Surgery

  • Arthroscopic Surgery

Rehab Knee ACL with Meniscus Repair Protocol

Phase I: (0-6 weeks)


  • Alleviate acute pain and swelling
  • Increase ROM 0-90° (emphasize 0° extension)
  • Increase hamstring and quadriceps strength
  • Promote comfortable ambulation TDWB with brace and crutches
  • Maintain cardiovascular conditioning

Plan: (0-2 weeks)

  • Patellar mobilization
  • PROM positioning for knee extension
  • Quad isometrics with knee in full passive extension
  • Ankle AROM as much as possible
  • Knee ROM: Supine heel slides with terminal stretch to increase flexion to 90 degrees by 4 weeks postop; do not exceed
  • ROM goal prior to 4 full weeks postop
  • Gait training TDWB with brace locked in full extension
  • Sit and allow knee flexion over edge of table to facilitate flexion to 90
  • Hamstring and quadriceps co-contraction
  • 4-Quad (hip flexion, abduction, adduction, extension) brace locked ext
  • Modalities for pain and edema control
  • Sleep in Brace

Plan: (3-4 weeks)

  • Soft tissue/scar mobilization
  • Emphasis on increasing ROM(full extension, flexion to 90 degrees)
  • Continue crutches with brace locked at 0, TDWB
  • Add supine SLR out of brace when able to do so with no extensor lag
  • Side lying SLR begins
  • EMS co-contraction at VMO and hamstrings’
  • Theraband ankle exercises – progress to standing as WB dictates
  • General conditioning
  • Aquatic therapy (when incisions healed) No whip kick
  • Continue sleep in brace

Plan: (5-6 weeks)

  • ½ revolution non-resisted bike for knee flexion – progress to full rev. when patient reaches 110°
  • Weight shifting in standing, 0-30° ROM mini squats
  • Prone/standing knee flexion to 90 degrees
  • Proprioceptive training/ balance — BAPS, trampoline
  • Progress ROM to 110
  • Rehab brace open 0 to 90, may wean from nighttime brace use as tolerated
  • More aggressive patellar mobilization
  • Progress to full WBAT

Phase II (7-12 weeks)


  • Decrease swelling and prevent atrophy
  • Increase ROM -125°
  • Increase quadriceps and hamstring strength
  • Increase hip strength
  • Stimulate collagen healing
  • Independent ambulation without crutches
  • Continue general conditioning


  • Continue phase I exercises
  • Continue patellar mobilization and ROM activities
  • Standing ½ squat
  • Joint and soft tissue mobilization as needed
  • Isotonic hamstring NK table
  • Leg press
  • Begin stair master gradual increase in endurance
  • Continue closed chain, balance and proprioceptive activities
  • Continue EMS as needed for muscle re-ed and edema
  • Step-ups (controlled – forward and side)
  • *McConnell tapping as necessary)
  • General conditioning