PURPOSE: The aim of part one of this EU-US consensus was to combine literature research and expertise to provide recommendations for the usage of rehabilitation (including physical therapy) of patients undergoing surgical treatment for degenerative meniscus lesions or acute meniscus tears (including meniscectomy, repair, or reconstruction). Prevention programmes, non-operative treatment of acute tears and degenerative lesions, return to sports and patient-reported outcome measures will be presented in a part II article. METHODS: This consensus followed the European Society for Sports Traumatology and Arthroscopy (ESSKA)'s 'formal consensus' methodology. For this combined ESSKA, American Orthopedic Society for Sports Medicine and American Academy of Sports Physical Therapy initiative, 67 experts (26 in the steering group and 41 in the rating group) from 14 countries (US and 13 European countries), including orthopaedic surgeons, sports medicine doctors and physiotherapists were involved. Steering group members established guiding questions, searched the literature and proposed statements. Rating group members assessed the statements according to a Likert scale and provided grades of recommendations, reaching a final agreement about rehabilitation of the knee after meniscus surgery. Final documents were then assessed by a peer review group to address the geographical adaptability. RESULTS: The overall level of evidence in the literature was low. Of the 19 questions (leading to 29 statements), 1 received a Grade A of recommendation, 2 a Grade B, 9 a Grade C and 17 a Grade D. Nevertheless, the mean median rating of all questions was 8.2/9 (9 being the highest rating on a scale of 1-9). The global mean rating was 8.4 ± 0.2, indicating a high agreement. Rehabilitation depends on the type of lesion, the treatment performed and is the same after medial or lateral meniscus surgery. Rehabilitation after meniscectomy should follow a criterion-based rehabilitation protocol, based on milestones rather than a time-based protocol. After meniscus repair and reconstruction, rehabilitation should be progressed according to both time and criterion-based milestones. CONCLUSION: Rehabilitation after meniscus surgery is a debated topic that may influence surgical outcomes if not optimally performed. This international formal consensus established clear, updated and structured recommendations for both surgeons and physiotherapists treating patients after meniscus surgery. LEVEL OF EVIDENCE: Level I, consensus.

Center of Evidence based Education and Arts Therapies A JBI Affiliated Group Faculty of Education Palacký University Olomouc Prague Czech Republic

Cochrane Czech Republic Czech CEBHC JBI Centre of Excellence Czech GRADE Network Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Department of Health and Rehabilitation Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Department of Orthopaedic Surgery University of California San Francisco California USA

Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia USA

Department of Orthopedic and Trauma Surgery Centre Hospitalier de Versailles Le Chesnay Rocquencourt France

Department of Orthopedics and Traumatology Brandenburg Medical School Theodor Fontane University Hospital Brandenburg Havel Brandenburg Germany

Department of Orthopedics and Traumatology Hospital del Mar Barcelona Spain

Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA

Department of Physical Therapy and Human Movement Sciences Northwestern University Chicago Illinois USA

Department of Physical Therapy University of Delaware Newark Delaware USA

Department of Physical Therapy University of Pittsburgh School of Health and Rehabilitation Sciences Pittsburgh Pennsylvania USA

Division of Occupational Therapy and Physical Therapy Division of Sports Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

Division of Physical Therapy School of Health and Rehabilitation Sciences and OSU Sports Medicine Research Institute Ohio State University Columbus Ohio USA

Education and Research Department Isokinetic Medical Group FIFA Medical Centre of Excellence Bologna Italy

ESSKA Office Centre Médical Fondation Norbert Metz Luxembourg Luxembourg

Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Potsdam Germany

Faculty of Health Sciences Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany

Institute of Physiotherapy of Saint Etienne Saint Michel Campus Saint Etienne France

Knee and Arthroscopy Unit Institut Català de Traumatologia i Medicina del'Esport Hospital Universitari Dexeus Universitat Autònoma de Barcelona Barcelona Spain

Landspitali University Hospital of Iceland Reykjavik Iceland

Mayo Clinic Department of Orthopedic Surgery Rochester Minnesota USA

Medical Faculty University of Iceland Reykjavik Iceland

Michigan Medicine Department of Orthopaedic Surgery Ann Arbor Michigan USA

MS Knee Specialists Bristol UK

Osteon Orthopedics and Sports Medicine Clinic Mostar Bosnia and Herzegovina

Physiotherapy Research Laboratory University Centre of Physiotherapy and Rehabilitation Faculty of Physiotherapy Wroclaw Medical University Wroclaw Poland

Rehasport Clinic and Sport Medicine Lab Department of Spine Disorders and Pediatric Orthopedics University of Medical Sciences Poznań Poland

Sports and Orthopedics Research Center Anna TopSupport Eindhoven the Netherlands

Twin Cities Orthopedics Eagan Minnesota USA

Twin Cities Orthopedics Edina Minnesota USA

Wichita State University Ascension Via Christi Wichita Kansas USA

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The formal EU-US Meniscus Rehabilitation 2024 Consensus: An ESSKA-AOSSM-AASPT initiative. Part II-Prevention, non-operative treatment and return to sport