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 (Femoral Condyle)

Phase I (Weeks 0-12)

  • Weightbearing:
    • Weeks 0-2: Non-weightbearing
    • Weeks 2-4: Partial weightbearing (30-40 lbs)
    • Weeks 4-6: Continue with partial weightbearing (progress to use of one crutch at weeks 6-8)
    • Weeks 6-12: 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: Gradually open brace at 20° intervals as quad control is obtained
    • D/C brace when patient can perform straight leg raise without an extension lag
  • Range of Motion – Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 6 weeks
    • Set CPM to 1 cycle per minute – set initially at 0-30°
    • Increase flexion 5-10° per day until full flexion is achieved
      • Should be at 90° by week 4 and 120° by week 6
    • PROM/AAROM and stretching under guidance of PT
  • Therapeutic Exercises
    • Weeks 0-2: Straight leg raise/Quad sets, Hamstring isometrics
      • Perform exercises in the brace if quad control is inadequate
    • Weeks 2-6: Begin progressive isometric closed chain exercises** (see comments)
      • At week 6 can start weight shifting activities with operative leg in extension
    • Weeks 6-10: Progress bilateral closed chain strengthening, begin open chain knee strengthening
    • Weeks 10-12: Begin closed chain exercises using resistance (less than patient’s body weight), progress to unilateral closed chain exercises
    • At week 10 can begin balance exercises and stationary bike with light resistance 

Phase II (Weeks 12-24)

  • Weightbearing:  Full weightbearing with a normal gait pattern
  • Range of Motion – Advance to full/painless ROM
  • Therapeutic Exercises
    • Advance bilateral and unilateral closed chain exercises
      • Emphasis on concentric/eccentric control
    • Stationary bike/Treadmill/Stairmaster/Elliptical
    • 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 strength training
    • Start light plyometric exercises
    • Start jogging and sport-specific training at 6 months

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 – running/agility training at 9 months
  • Return to impact athletics – 16 months (if pain free)
  • Maintenance program for strength and endurance

 Comments:

**Weeks 2-6 – need to respect the repair site: if anterior lesion avoid loading in full extension, if posterior lesion avoid loading in flexion > 45°**

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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