Rehabilitation after meniscus repair: protecting the repair while the knee recovers

The NHS notes that severe meniscus damage may be treated with arthroscopic surgery to repair or remove the damaged cartilage. These are different operations with different recoveries. When damaged tissue is trimmed away, the knee can usually be used again fairly quickly. When tissue is repaired with stitches, it has to be allowed to heal, so the surgeon may protect it for a period.

That is why two people who both had a meniscus operation can be given very different instructions. Before you leave hospital, ask which of the two was done, because it determines almost everything about your rehabilitation.

Protocols after a repair commonly limit how far the knee bends, how much weight goes through the leg, or both, for a set period decided by the surgeon, sometimes using crutches or a brace. The reasons are practical: deep bending and twisting place stress on the stitched tissue.

No official page retrieved for this guide gives numbers for those limits, and they differ with the type and position of the tear. Treat any figures from friends or online forums with caution and follow the sheet you were given.

The NHS says a meniscus tear can get better on its own without treatment but it can take a while to heal. That slow healing is the underlying reason repaired menisci are not rushed. The practical message is patience: a knee that feels better quickly is not necessarily ready for twisting or deep squatting.

The NHS says physiotherapy may be recommended to help reduce pain and improve movement and strength in the knee, and notes that in many areas you can reach community musculoskeletal services without a GP referral.

After a repair, physiotherapy usually starts gently and focuses on swelling, regaining straightening and activating the thigh muscles, then progresses to strengthening and balance as the repair allows. The physiotherapist needs to know exactly what was done, so take your discharge summary or operation note to the first appointment.

For keyhole surgery in general, the NHS advises applying a wrapped ice pack for 20 minutes every 2 to 3 hours, keeping the leg raised when sitting, wearing a compression stocking if given one and keeping dressings dry. On driving, it says you should be able to drive when you can perform an emergency stop, usually at least 2 weeks after an arthroscopy. If you have a brace or restricted movement, discuss driving with your surgeon before you try.

• Ask whether you can bend the knee fully, and if not, how far.

• Ask how much weight you can put through the leg, and whether you need crutches.

• Ask when you can go back to work, and whether your job involves kneeling or squatting.

• Ask when running, cycling and swimming are acceptable.

No retrieved official page gives a return-to-sport date after meniscus repair, and this guide does not invent one. Because the repair depends on healing, surgeons usually allow twisting and impact activities later than straight-line activities such as walking or cycling. Your surgeon or physiotherapist can say when each is acceptable for you.

The NHS meniscus page lists symptoms that need urgent attention. They are written for the injured knee, but they apply as a sensible guide while you are recovering.

• Very bad knee pain after a fall or injury.

• Being unable to walk or put weight on the leg.

• Hot, swollen skin around the knee, or a fever.

• Being unable to bend or straighten the leg.

• Tingling or numbness in the knee, leg or toes.

• A knee that has moved out of place, changed shape or points at an odd angle: go to A&E.