Meniscus Surgery Rehabilitation Program Initial Period (0-1 week after surgery) 1. Day of Surgery: After anesthesia subsides, begin to move toes and ankle joints. (1) Ankle pump – forceful, slow, full range flexion and extension of the ankle joint. Zheng Peng, Department of Orthopedic Surgery, Fushun Central Hospital (2) Quadriceps isometric exercises – i.e., tensing and relaxing the thigh muscles. It should be done as much as possible without increasing pain. (3) N cord muscle isometric exercises – the affected leg is pressed down hard on the pillow, so that the muscles of the back of the thigh are tensed and relaxed. The requirements are the same as above. Do as many exercises as possible without increasing pain! (4) After 24 hours, you can walk on the ground with the help of crutches, but only to go to the toilet and other necessary activities. (2) Postoperative day 2: (1) Continue the above exercises. (2) Change the ankle pump to anti-gravity exercises. (3) Begin to lift the leg straight – straighten the leg after extending the knee and lift it up to 40M from the bed, hold it for 5 seconds. 30 times/group, 3-4 groups/day. (4) Start lateral leg raising exercises. Requirements and number of times as above. (5) Begin the back leg raising exercise, lie down, stretch the knee and then raise the straight leg until the toe of the foot is 40M away from the bed, hold for 5 seconds. Requirements and repetitions are the same as above. (6) Weight bearing and balance: Separate the feet under protection and move the center of gravity alternately from side to side within the range of slight pain. 5 minutes/times, 2 times/day; Separate the feet anteriorly and posteriorly and move the center of gravity. If the pain and swelling are not obvious, you can go down to the ground with a single crutch or without crutches, but more walking is not encouraged. Postoperative day 3: (1) Continue the above exercises. (2) Start flexion exercises. Flexion exercises should be performed to the extent that it is slightly painful, and the angle should be as large as possible. 4. Postoperative day 4: (1) Continue the above exercises. (2) Begin one-legged standing balance exercises. 5 minutes/times, 2-3 times/day. (3) Start prone position “leg hooking exercise”, 30 times/set, 2-4 sets/day. (4) Active knee flexion up to 90 degrees. 5. Postoperative day 5: (1) Continue and strengthen the above exercises. (2) Begin active extension and flexion exercises in the range of 0-45 degrees with weight bearing in the standing position. 30 repetitions/group, 2-3 groups/day, and apply ice packs for swelling and pain after the exercises. 6. Postoperative week 1: (1) Active flexion greater than 90 degrees. (2) Can stand on one foot and walk short distances without crutches. (3) Start squatting against the wall. Static squatting exercises: back against the wall, feet shoulder-width apart, toes and knee joints forward, no “inside and outside eights”, gradually increase the angle of squatting with the increase in strength (less than 90 °), 2 minutes / times, interval of 5 seconds, 5-10 consecutive / group. 2-3 groups / day. (4) Begin standing “hook leg” exercise, resisted flexion to pain-free maximum angle for 10-15 seconds. 30 repetitions/set, 4 sets/day. Early stage: (2 weeks – 1 month after surgery) Objective: to strengthen mobility and muscle strength exercises: to improve joint control and stability; to start resuming daily activities. As the level of muscle strength increases, exercises to improve absolute strength are the main focus in this period. Choose a medium load (the load of fatigue when completing 20 movements), 20 times/group, 2-4 consecutive sets of exercises, rest 60 seconds between sets, until fatigue. Attention should be paid to control the amount of exercise to avoid joint swelling and fluid accumulation. If there is swelling and warmth in the joints after the exercise, ice packs should be applied in time! 1. Postoperative week 2: (1) Active flexion to 120-130°. (2) Strengthening muscle strength exercises. (A straight leg lift can last up to 6 minutes.) (3) If there is no obvious swelling or pain in the joint, you should walk with a normal gait as much as possible. (4) Begin instructing thigh band resistance exercises in the straight knee position. The load, angle, number and time of the exercises should be determined according to your own conditions. Generally 30 times/set, 2-4 sets/day. Thigh Band Resistance Exercises 2. Postoperative week 3: (1) Passive flexion to 140°. (2) Strengthening muscle strength exercises. (3) Begin anterior-posterior and lateral stride exercises with gradual transitions and increasing loads. 30 repetitions/set, 4 sets/day. Mid-term: (1 month-2 months after surgery) Objective: To strengthen the joint mobility training to the same level as the healthy side; to strengthen the muscle strength training to improve the joint stability; to restore the ability of daily life activities and light exercise. Postoperative week 5: (1) Active flexion up to 150° (full range, same as the healthy leg), and basically painless. (2) Start half squatting exercise with the affected leg in 45 degree position. 5 minutes/time, 4 times/day. (3) Start stationary bicycle exercise. 30 minutes/times, 2 times/day. (2) Postoperative weeks 6-8: (1) Active flexion and extension angles reach the same as the healthy side, and there is no pain. (2) Can complete daily activities, such as going up and down the stairs, riding a bicycle, walking more than 5000 meters without swelling and pain in the joints. (3) Start kneeling exercises. (4) Start pedaling exercises. (5) Start swimming, jumping rope and jogging. Post-operative period: (2 months-3 months after surgery) Purpose: Full recovery of daily life activities. Strengthen muscle strength and joint stabilization. Gradually resume exercise. Increase the maximum strength, use a large load of 70% 1RM (the load of fatigue when completing 12 movements), 8-12 times/set, 2-4 sets of continuous exercises, rest 90 seconds between sets, until fatigue. 1. Begin the knee loop exercise. 2. Start jumping up and down exercises. 3. Start lateral jumping exercises. 4. Mobilize and start the basic movements of special sports. If necessary, you can wear knee pads for protection. Recovery exercise period: (3 months after surgery) Purpose: full recovery of sports or strenuous activities. 1. Gradually resume strenuous activities or specialized training. 2. Strengthening muscle strength and joint stability during running and jumping. 3. Muscle strength test, the muscle strength of the affected side reaches more than 85% of the healthy side, and there is no pain or obvious swelling during exercise, then you can fully resume sports. Department of Orthopaedics, Fushun Central Hospital