Knee rehabilitation following arthroscopic meniscectomy

Guidelines for knee rehabilitation after conventional open meniscectomy are generally well known. Less agreement exists on rehabilitation following arthroscopic meniscectomy. The program is sometimes arbitrary. Rehabilitation should follow a logical progression regardless of the type of surgery performed. Rehabilitation following knee surgery can be divided into four phases: immediate post-operative period, early healing phase, late healing phase, and conditioning for return to preinjury activity. Following arthroscopic surgery, the overall recovery time can be significantly shortened compared to conventional arthrotomy, primarily by decreasing the length of the early postoperative phases. A smaller incision causes less soft-tissue injury to skin, capsule, synovium, and other periarticular structures, resulting in less quadriceps inhibition and a more rapid recovery. The rate of tissue healing is not altered, however, and the knee must still heal completely before the patient can return to a full functional level. Not all patients are rehabilitated uniformly, and a great deal of variability exists following arthroscopic surgery. Factors that affect the speed of rehabilitation and return to normal function are the extent of meniscectomy performed, the coexistence of additional intra- or extra-articular pathology, and individual patient differences. Therefore, an arbitrary time frame for rehabilitation following arthroscopic meniscectomy is not recommended. Rather, each patient should progress from one stage of rehabilitation to the next, based on objective knee findings.