C A S E S T U D Y

General Principles
This protocol for rehabilitation after knee meniscus repair Meniscus Repair
surgery is designed to provide the rehabilitation professional
with a general guideline for patient care with the AlterG Stage 2: Weeks 2 through 4
Anti-Gravity Treadmill Anti-Gravity Treadmill. As such, it Continue use of ice and compression
should be stressed that this is only a protocol and should Brace locked for ambulation and sleeping, may unlock for
not be a substitute for professional clinical decision-making sleeping with a peripheral tear
regarding a patients progression. And it should be further ROM Guidelines
noted that progression should be individualized based upon Gradually increase PROM
each patients specific needs, surgical variables, pain level, the Week 2: 0-100 degrees
specific surgeons guidelines, physical examination, progress,
and presence of any complications.

PHASE I: MAXIMUM PROTECTION PHASE Weight Bearing

(Weeks 1-6) For peripheral tears:
Week 2: 50% WB
Week 3: FWB as tolerated
Goals For complex tears:
Control inflammation/effusion Week 2: 25-50% WB
Allow early healing Week 3: 50-75% WB
Full passive knee extension Week 4: FWB as tolerated
Gradually increase knee flexion *Discontinue crutches when safe and proper gait (usually 3-4 weeks in
Independent quadriceps control peripheral tears and week 4-5 in complex tears)complex tears)

Stage 1: Immediate post-surgery Gait training:

days 1 through 10 Gait training may be performed daily and begins at
Ice, compression, elevation 2.0 MPH with no incline. Gait training begins at
Brace locked at 0 degrees for ambulation and sleeping only 5 minutes per day and may progress to up to 20 minutes
Brace may be unlocked while sitting, etc. during this phase
ROM (passive 0-90) As the patient progresses to 50% WB, they may begin to
Patellar mobilizations increase the speed of the treadmill to a comfortable level
Stretch hamstrings and calf of ~3.0-3.5 MPH with no incline.
Strengthening exercises: As the patient progresses to 75% WB, they may begin to
Quad sets increase the speed of the treadmill to a comfortable level
SLR flexion of ~3.5-4.0 MPH with no incline.
Hip Abd/Adduction Monitor pain levels and gait mechanics during
Knee extension 60-0 degrees AlterG Anti-Gravity Treadmill training; body weight
Avoid active knee flexion support may be increased on the AlterG Anti-Gravity
Weight bearing: Treadmill to reduce pain and correct gait kinematics
For peripheral tears: 25-50% WB as tolerated during training
with 2 crutches Continue PROM exercises and stretching
For complex tears: toe touch with crutches Strengthening exercises
Gait training: Multi-angle quad isometrics
For complex tears: Avoid AlterG Anti-Gravity Treadmill SLR (all 4 planes)
training at this time Knee extension 90-0 degrees
For peripheral tears: CKC weight shifts
Ambulation on the AlterG Anti-Gravity Treadmill Peripheral tears may also progress to:
treadmill may begin as soon as the patient can begin CKC mini-squats 0-45 degrees
25% weightbearing. CKC wall squats
Gait training may be performed daily and begins CKC weight shifts (diagonal)
at 2.0 MPH with no incline. Gait training begins Balance training (cup walking)
at 5 minutes per day and may progress to up to Bicycle (once ROM appropriate)
*Avoid twisting, deep squatting and stooping
10 minutes during this phase *Avoid hamstring curls
Monitor pain levels and gait mechanics during
AlterG Anti-Gravity Treadmill training; body weight