Office Hours: M-F 8:30 AM - 5:00 PM
Physical Therapy Hours: M-F 7:00 AM - 8:00 PM
Rehab Protocols

Autologous Chondrocyte Implantation (ACI)/DeNovo NT Implantation (Trochlea/Patella)

Phase I (Weeks 0-12)

  • Weightbearing:
    • Weeks 0-2: Non-weightbearing
    • Weeks 2-4: Partial weightbearing (30-40 lbs)
    • Weeks 4-8: Continue with partial weightbearing (progress to use of one crutch at weeks 6-8)
    • Weeks 8-12: Progress to full weightbearing with discontinuation of crutch use
  • Bracing:
    • Weeks 0-2: Hinged knee brace locked in extension– remove for CPM and rehab with PT
    • Weeks 2-4: Locked in extension for weight bearing – Can open brace for NWB ROM 0-30°
    • Weeks 4-6: Open brace to 30° for ambulation
    • D/C brace at 6 weeks post-op
  • Range of Motion – Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 8 weeks
    • Set CPM to 1 cycle per minute – set at 0-30° for first 3 weeks
    • Starting at week 3 increase flexion 5-10° per day until full flexion is achieved
      • Should be at 90° by week 6 and 120° by week 8
    • PROM/AAROM and stretching under guidance of PT
  • Therapeutic Exercises
    • Weeks 0-4: Straight leg raise/Quad sets, Hamstring isometrics
      • Perform exercises in the brace if quad control is inadequate
    • Weeks 4-10: Begin isometric closed chain exercises
      • At week 6 can start weight shifting activities with operative leg in extension
    • At week 8 can begin balance exercises and stationary bike with light resistance
    • Weeks 10-12: hamstring strengthening, theraband resistance exercises 0-30°, light open-chain knee isometrics

Phase II (Weeks 12-24)

  • Weightbearing:  Full weightbearing with a normal gait pattern
  • Range of Motion – Advance to full/painless ROM
  • Therapeutic Exercises
    • Gait training/treadmill use at slow-moderate pace
    • Progress balance/proprioception exercises
    • Start sport cord lateral drills

 Phase III (Months 6-9)

  • Weightbearing:  Full weightbearing with a normal gait pattern
  • Range of Motion – Advance to full/painless ROM
  • Therapeutic Exercises
    • Advance closed chain strengthening/Start unilateral closed chain exercises
    • Progress to fast walking and backward walking on treadmill (add incline at 8 months)
    • Start light plyometric training

Phase IV (Months 9-18)

  • Weightbearing:  Full weightbearing with a normal gait pattern
  • Range of Motion – Full/Painless ROM
  • Therapeutic Exercises
    • Continue closed chain strengthening exercises and proprioception activities
      • Emphasize single leg loading
    • Sport-specific rehabilitation – jogging/agility training at 9 months
  • Return to impact athletics – 16 months (if pain free)
  • Maintenance program for strength and endurance

Orthopaedic Specialists of Connecticut, also known as Orthopedic Specialists of Connecticut, based in Brookfield, CT and Danbury, CT, provides comprehensive orthopaedic care, sports medicine, joint replacements, and interventional pain management to patients of all ages.

Orthopaedic Specialists of Connecticut, also known as Orthopedic Specialists of Connecticut, provides orthopedic care including: orthopedic examination, foot surgery, ankle surgery, hand surgery, hip surgery, hip replacement, hip resurfacing, knee surgery, knee replacement, orthopedic oncology, shoulder surgery, elbow surgery, and MAKOplasty.

Orthopaedic Specialists of Connecticut, also known as Orthopedic Specialists of Connecticut, also provides sports medicine, physical therapy, pain management, interventional pain management, radiology, x-ray, ultrasound, cortisone injection, and PRP injections.

Orthopaedic Specialists of Connecticut, also known as Orthopedic Specialists of Connecticut, treats sprains, fractures, ligament tears, arthritis, musculoskeletal pain, neurological pain, cancer pain, neck pain, and back pain.

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