Osteochondral Allograft Implantation

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 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
3. Range of Motion
   • Continuous Passive Motion (CPM) machine for 6–8 hours per day for 6–8 weeks
   • 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
4. Therapeutic Exercises
   • Patellar mobilization
   • Quad / Hamstring / Adductor / Gluteal sets – Straight leg raises / Ankle pumps

Phase II (Weeks 6-8)

1. Weightbearing: Partial weightbearing (25% of body weight)
2. Range of Motion – Advance to full / painless ROM (patient should obtain 130° of flexion)
3. Therapeutic Exercises
   • Continue with Quad / Hamstring / Core strengthening
   • Begin stationary bike for ROM

Phase III (Weeks 8-12)

1. Weightbearing: Gradually return to full weightbearing
2. Range of Motion – Full / painless ROM
3. Therapeutic Exercises
   • 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)

1. Weightbearing: Full weightbearing with a normal gait pattern
2. Therapeutic Exercise
   • 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