Initially after meniscal transplantation surgery it is important to protect the knee and to offload the joint in order to protect the meniscal allograft and to give the graft the best possible chance of healing up successfully. With time, the patient’s blood vessels grow into the meniscal allograft and the new meniscus is seeded with new cells, and the graft becomes a living meniscus with the patient’s own living cells. However, this takes time, which is why initially it’s important to protect the joint.
If isolated meniscal transplantation is performed (i.e. there are no other additional concomitant procedures) then the patient is normally kept minimal toe-touch partial weight-bearing with two crutches for the 1st 6-week period. This means that you can put your toes to the ground and rest the weight of your leg through your toes, but avoiding putting body-weight through the foot. (This is far easier and less risky than trying to hop around constantly with your foot up in the air, completely off the ground.) At the same time, the knee is also kept in a knee brace locked at 0 to 90 degrees flexion for the same 1st 6-week period. (When the knee is flexed past 90 degrees a large force is placed on the back of the meniscus.)
During this 1st 6-week period you will inevitably develop stiffness in the knee joint and significant muscle wasting in the whole leg. You can (and should) mitigate against this by performing very regular gentle exercises, with the following:
In addition, it helps enormously to use a Game Ready machine for at least the first 1-month period, for regular icing and intermittent compression of the knee joint, which reduces post-op pain and swelling in the knee.
At the end of the first 6-week period, patients are then advised to then work on the following:
Very importantly, it is vital that during this rehab you avoid any:
From about the 3-month post-op mark, you should be able to start tailing off the frequency of your physio sessions and instead increasing the time that you spend in the gym on your own, doing the exercises that have been taught to you by your physio.
The important thing here to remember is that your new meniscus is still only part way through the process of healing in place, and therefore it still needs to be protected. This means sticking purely to just light non-impact cardio fitness work only, avoiding any heavy weights, loaded twisting or impact through the knee joint. The focus should very much be on just light fitness work only and not heavy strengthening work.