Osteochondral Autograft Transplant (OATS)

Phase I (Weeks 0-6)

1. Weightbearing:  Non-weightbearing
2. 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
3. Hinged knee brace locked in extension (week 1) – remove for CPM and rehab with PT
4. Weeks 2-6: Gradually open brace in 20° increments as quad control is obtained
5. D/C brace when patient can perform straight leg raise without an extension lag
6. 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
7. Set CPM to 1 cycle per minute – starting at 40°of flexion
8. Advance 10° per day until full flexion is achieved (should be at 100° by week 6)
9. PROM/AAROM and stretching under guidance of PT
10. Therapeutic ExercisesPatellar mobilizationQuad/Hamstring/Adductor/Gluteal sets – Straight leg raises/Ankle pumpsStationary bike for ROM 
11. Patellar mobilization
12. Quad/Hamstring/Adductor/Gluteal sets – Straight leg raises/Ankle pumps
13. Stationary bike for ROM 

Phase II (Weeks 6-8)

1. Weightbearing:  Advance to full weightbearing as tolerated — discontinue crutch use
2. Range of Motion – Advance to full/painless ROM (patient should obtain 130° of flexion)
3. Therapeutic ExercisesClosed chain exercises – wall sits, shuttle, mini-squats, toe raisesGait trainingPatellar mobilizationBegin unilateral stance activities
4. Closed chain exercises – wall sits, shuttle, mini-squats, toe raises
5. Gait training
6. Patellar mobilization
7. Begin unilateral stance activities

 Phase III (Weeks 8-12)

1. Advance closed chain strengthening exercises, proprioception activitiesSport-specific rehabilitation
2. Advance closed chain strengthening exercises, proprioception activities
3. Sport-specific rehabilitation
4. Therapeutic Exercises
5. Range of Motion – Full/Painless ROM
6. Weightbearing:  Full weightbearing
7. Gradual return to athletic activity as toleratedJogging — 3 monthsHigher impact activities – 4-6 months
8. Jogging — 3 months
9. Higher impact activities – 4-6 months
10. Maintenance program for strength and endurance