Osteochondral Allograft Implantation
Phase I (Weeks 0-6)
- Weightbearing: Non-weightbearing
- Bracing:Hinged knee brace locked in extension (week 1) – remove for CPM and rehab with PTWeeks 2-6: Gradually open brace in 20° increments as quad control is obtainedD/C brace when patient can perform straight leg raise without an extension lag
- Hinged knee brace locked in extension (week 1) – remove for CPM and rehab with PT
- Weeks 2-6: Gradually open brace in 20° increments 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 6-8 weeksSet CPM to 1 cycle per minute – starting at 40°of flexionAdvance 10° per day until full flexion is achieved (should be at 100° by week 6)PROM/AAROM and stretching under guidance of PT
- Set CPM to 1 cycle per minute – starting at 40°of flexion
- Advance 10° per day until full flexion is achieved (should be at 100° by week 6)
- PROM/AAROM and stretching under guidance of PT
- Therapeutic ExercisesPatellar mobilizationQuad/Hamstring/Adductor/Gluteal sets – Straight leg raises/Ankle pumps
- Patellar mobilization
- Quad/Hamstring/Adductor/Gluteal sets – Straight leg raises/Ankle pumps
Phase II (Weeks 6-8)
- Weightbearing: Partial weightbearing (25% of body weight)
- Range of Motion – Advance to full/painless ROM (patient should obtain 130° of flexion)
- Therapeutic ExercisesContinue with Quad/Hamstring/Core strengtheningBegin stationary bike for ROM
- Continue with Quad/Hamstring/Core strengthening
- Begin stationary bike for ROM
Phase III (Weeks 8-12)
- Weightbearing: Gradually return to full weightbearing
- Range of Motion – Full/Painless ROM
- Therapeutic ExercisesBegin closed chain exercises – wall sits/shuttle/mini-squats/toe raisesGait trainingContinue with Quad/Hamstring/Core strengtheningBegin unilateral stance activities
- Begin closed chain exercises – wall sits/shuttle/mini-squats/toe raises
- Gait training
- Continue with Quad/Hamstring/Core strengthening
- Begin unilateral stance activities
Phase IV (Months 3-6)
- Weightbearing: Full weightbearing with a normal gait pattern
- Therapeutic exerciseAdvance closed chain strengthening exercises, proprioception activitiesSport-specific rehabilitation – jogging at 4-6 monthsReturn to athletic activity – 9-12 months post-opMaintenance program for strength and endurance
- Advance closed chain strengthening exercises, proprioception activities
- Sport-specific rehabilitation – jogging at 4-6 months
- Return to athletic activity – 9-12 months post-op
- Maintenance program for strength and endurance