Important
Shared principles
Pain and swelling control, safe movement, restoration of strength and functional progression are reviewed at each stage. Fever, wound discharge, spreading redness, chest pain, breathlessness, sudden calf swelling or a new neurological deficit require prompt medical assessment.
Guidance framework
Selective partial meniscectomy
Recovery is usually rapid and symptom-led because there is no repair that needs biological protection.
Weeks 0–2
- weight bear as tolerated with crutches until gait is no longer antalgic;
- control swelling, regain full extension, progress flexion and restore quadriceps activation;
- patellar mobility, ankle pumps and thrombosis prevention according to individual risk.
Weeks 2–6
- normal gait, cycling, progressive strength, balance and single-leg control;
- do not run while effusion, pain or loss of extension persists.
Return
- run and pivot only with no effusion, full movement and strength/control close to the other limb;
- sport often resumes within 4–8 weeks, but cartilage damage or additional procedures may extend this.
Guidance framework
Meniscal repair
Protection depends on tear pattern and repair stability; a longitudinal repair is not rehabilitated in the same way as a radial or root repair.
Weeks 0–6
- brace, weight-bearing status and flexion limit exactly as stated in the operative instructions;
- early full extension, swelling control and quadriceps activation;
- complete radial and root repairs commonly require stricter early weight-bearing and flexion limits.
Weeks 6–12
- progress weight bearing and movement after review;
- closed-chain strength, cycling and neuromuscular control without a reactive effusion.
Return
- running is commonly considered after 3–4 months only when criteria are met;
- pivoting sport is often delayed to 4–6 months or longer after radial/root repair.
Guidance framework
ACL reconstruction
Progress is criterion-based: extension, effusion, strength, movement quality and psychological readiness matter more than the month number alone.
Weeks 0–6
- full extension, control of effusion, quadriceps activation and progressive normal gait;
- progress flexion and patellar mobility; any meniscal repair or additional procedure sets further restrictions.
Months 2–6
- progressive strength and neuromuscular work; run only after movement, swelling and strength criteria are met;
- introduce jumping and change of direction gradually with qualitative movement assessment.
Return
- strength and hop testing, good control, no instability and psychological readiness;
- pivoting sport is usually no earlier than 9 months and often later according to reinjury risk.
Guidance framework
MCL reconstruction
The medial structures need protection from valgus stress while movement is recovered without creating stiffness.
Weeks 0–6
- hinged brace and valgus protection; weight bearing depends on associated injuries;
- progressive movement, full extension and quadriceps activation without stressing the reconstruction.
Weeks 6–16
- wean from the brace after stability review;
- strength, balance, frontal-plane control and stairs without valgus collapse.
Return
- run, cut and contact only after clinical stability and functional criteria;
- multiligament reconstructions commonly require 9–12 months before sports return.
Guidance framework
LCL / posterolateral corner reconstruction
Lateral reconstruction must be protected from varus, hyperextension and excessive external rotation.
Weeks 0–6
- brace and restricted weight bearing according to the construct; avoid varus and hyperextension;
- controlled movement, quadriceps activation and peroneal nerve protection when relevant.
Weeks 6–16
- progress weight bearing and movement after stability review;
- closed-chain strength; isolated hamstring work may be delayed depending on the reconstruction.
Return
- run and progress agility only with good strength, alignment and control;
- pivoting/contact sport is usually delayed for 9–12 months or longer.
Guidance framework
PCL reconstruction
Rehabilitation aims to avoid posterior tibial translation while the graft integrates.
Weeks 0–6
- a brace supporting the tibia anteriorly when prescribed and avoidance of posterior sag;
- controlled flexion, quadriceps activation and weight bearing according to associated procedures.
Weeks 6–16
- progress flexion and loading with quadriceps emphasis;
- resisted knee flexion/hamstring work is introduced later according to the operative protocol.
Return
- run after stability, strength and joint-response criteria;
- pivoting and contact commonly require 9–12 months and functional testing.
Guidance framework
Rotator cuff repair
Pace depends on tear size, tendon quality, number of tendons and fixation.
Weeks 0–6
- sling as prescribed with hand, wrist and elbow movement;
- protected passive movement as directed; no active arm elevation and no pushing through the arm.
Weeks 6–12
- gradual active-assisted then active movement without scapular substitution;
- restore scapular control and movement before loading.
After week 12
- progress strength when tendon healing and movement permit;
- heavy work and overhead sport commonly require 6–9 months and functional criteria.
Guidance framework
Arthroscopic shoulder stabilisation
The capsulolabral repair is protected from forced abduction and external rotation early on.
Weeks 0–4/6
- sling, wound care and hand/wrist/elbow movement;
- protected shoulder motion within prescribed limits; avoid apprehension positions and weight bearing through the arm.
Weeks 6–12
- progress active movement, scapular control and cuff strength;
- graded exposure to apprehension-provoking positions without force.
Return
- strength, stability, confidence and control in sport-specific positions;
- sport may require 4–6 months, with contact and overhead activity often 6 months or longer.
Guidance framework
Biceps tenotomy, subacromial decompression and distal clavicle excision
Without a tendon repair, movement is generally quicker; any associated repair changes the protocol.
Weeks 0–2
- sling for comfort, early tolerated motion and pain control;
- avoid early resisted elbow flexion/supination after tenotomy; biceps tenodesis follows a different, more protective protocol.
Weeks 2–6
- restore movement, scapular control and progressive strength without a painful reaction;
- avoid sudden loading and repetitive overhead work.
Return
- daily activity as pain and movement allow;
- manual work or sport often resumes within 6–12 weeks when no repair was performed.
Guidance framework
Acromioclavicular joint stabilisation
Coracoclavicular reconstruction must be protected from arm weight, lifting and forced cross-body adduction.
Weeks 0–6
- sling almost continuously, no lifting and no weight bearing through the arm;
- protected motion within operative limits plus hand and elbow exercises.
Weeks 6–12
- gradually discontinue the sling, restore active motion and scapular control;
- start strength only once stability and healing are confirmed.
Return
- progress overhead work and sport gradually;
- contact sport commonly requires 5–6 months or longer and functional criteria.
Guidance framework
Total hip replacement
Early mobilisation supports safe gait, complication prevention and strength recovery without overload.
Days 0–14
- early standing and walking with a frame/crutches; weight bearing as prescribed;
- circulatory work, gluteal and quadriceps activation, wound care and thromboprophylaxis;
- dislocation precautions depend on approach and individual stability.
Weeks 2–6
- normalise gait, increase distance and gradually reduce walking aids;
- abductor/extensor strength and balance within any movement precautions.
Weeks 6–12+
- endurance, balance and low-impact activity;
- driving and work depend on side, limb control and stopping opioids; high-impact sport is discussed individually.
Guidance framework
Total knee replacement
Full extension, swelling control and quadriceps activation are priorities from the first days.
Days 0–14
- early mobilisation and weight bearing with support, circulation exercises and fall prevention;
- full extension, progressive flexion, quadriceps activation and wound care;
- thromboprophylaxis and red-flag advice according to the medical plan.
Weeks 2–6
- longer walking, gradual reduction of aids and stair practice;
- strength, movement and cycling once wound and flexion permit.
Weeks 6–12+
- strength, endurance, balance and low-impact activity;
- flexion develops individually; aggressive forcing that sustains swelling is not helpful.
Guidance framework
Unicompartmental knee replacement
Recovery can be quicker than after total replacement, but wound care, thromboprophylaxis and functional control remain equally important.
Days 0–14
- early weight bearing with crutches, swelling control, full extension and quadriceps activation;
- safe gait and wound care.
Weeks 2–6
- normalise gait, cycle, strengthen and retrain balance;
- wean from crutches when gait is not antalgic and control is adequate.
Weeks 6–12+
- endurance and low-impact activity;
- running or impact sport is an individual discussion considering the implant and other compartments.
Guidance framework
Corrective osteotomy around the knee
Weight-bearing progression is governed by osteotomy type, fixation, union and associated procedures.
Weeks 0–6
- restricted or progressive weight bearing exactly as prescribed;
- extension, controlled flexion, quadriceps activation and patellar mobility;
- monitor wound, calf and neurovascular warning signs.
Weeks 6–12
- increase loading only after clinical/radiographic review;
- gait, cycling and progressive strength without bone or joint reaction.
Months 3–9+
- run after union and adequate movement and strength;
- pivoting sport often resumes at 6–9 months or later, especially with meniscal, ligament or cartilage procedures.