Effectiveness of Physiotherapy Management of Meniscal Injuries of the Knee Joint: A Review for Clinical Practice and Research

Background: Meniscal tears are among the most common knee injuries in both active and older populations [1]. Historically managed surgically, accumulating evidence over the past decade has shifted practice toward conservative, exercise-based care for many tear types, with physiotherapy (PT) playing a central role in symptom control, functional recovery, and pre-/postoperative optimisation [2]. Objective: To review evidence (2015–2025) on the effectiveness of physiotherapy for meniscal injuries, including degenerative and traumatic tears, postoperative rehabilitation after meniscal repair or partial meniscectomy, and management of root tears [3]. Methods: A focused literature search of PubMed, PMC, and Google Scholar identified randomized trials, systematic reviews, consensus statements, and high-quality cohort studies (2015–2025) that evaluated physiotherapy, exercise therapy, or rehabilitation protocols for meniscal pathology [4]. Results: High-quality RCTs and meta-analyses demonstrate that structured, progressive, exercise-based physiotherapy provides clinically meaningful improvements in pain and function for many patients with degenerative meniscal tears and is often non-inferior to arthroscopic partial meniscectomy (APM) in the short to medium term [5]. For traumatic meniscal tears in young, active patients, repair (rather than conservative care) is often favoured when tears are in the vascular zone or associated with instability (e.g., ACL injury), but physiotherapy remains critical for prehabilitation and postoperative recovery [6]. For meniscal root tears, evidence is mixed: early repair may protect joint mechanics but conservative approaches can be reasonable in selected low-demand patients; data quality is limited and outcomes are heterogeneous [7]. Post-repair rehabilitation protocols vary, but staged programmes that emphasise protected weight bearing, gradual range-of-motion (ROM) progression, progressive strengthening, and neuromuscular control show acceptable healing rates and functional recovery [8]. Conclusions: Contemporary evidence supports physiotherapy as first-line management for many meniscal tears particularly degenerative lesions providing symptom relief and functional gains comparable to APM in many cases [9]. For traumatic tears amenable to repair and for root tears that threaten joint mechanics, surgical repair plus structured postoperative physiotherapy is often indicated. Future research should prioritise standardized rehabilitation protocols, stratified treatment algorithms to identify responders to conservative care, and adequately powered RCTs for root and complex tears [10].