Criterion-based rehabilitation and return-to-sport decision-making after arthroscopic partial medial meniscectomy in an elite athlete

Abstract

Background:
Arthroscopic partial meniscectomy is commonly performed in athletes with mechanically symptomatic meniscal tears. Contemporary EU–US consensus recommendations advocate criterion-based rather than time-based rehabilitation following partial meniscectomy; however, descriptions of how these principles are operationalised in elite athletes remain limited.

Case presentation:
An elite male athlete in his mid-20s sustained a non-contact twisting injury resulting in a mechanically unstable medial meniscal tear. Persistent locking and functional limitation despite conservative management prompted arthroscopic partial medial meniscectomy. Postoperatively, the athlete undertook an accelerated, criterion-based rehabilitation programme with immediate weight bearing and unrestricted range of motion. Rehabilitation progression was guided by objective clinical milestones, including pain, effusion, neuromuscular control, and functional performance, rather than predefined timelines. Progressive loading and sport-specific drills were introduced in response to symptom tolerance, with wearable-derived workload metrics used as an adjunct to clinical assessment.

Outcome:
The athlete met all rehabilitation criteria and returned to unrestricted full-contact competitive sport 19 days postoperatively. At six-month follow-up, he remained asymptomatic, had fully returned to pre-injury training and competition, and demonstrated excellent patient-reported outcomes (IKDC 100, KOOS 99–100, Tegner–Lysholm 100, VAS pain 0).

Conclusion:
This case demonstrates the practical application of criterion-based return-to-sport decision-making following partial medial meniscectomy in a selected high-demand athlete, illustrating that return-to-sport timelines may be shortened when progression is guided by objective clinical recovery rather than fixed time-based protocols.