Ostoarticular Transfer Rehab Protocol

The lesion size and location are important in determining a rehabilitation program for each patient.
The autograft (tissue from your own body) is normally implanted into either the femoral condyle or the trochlea.

Femoral Condyle autograft Rehabilitation:

Post op week one – two:
Ice, cryotherapy for swelling, other modalities as indicated.
Brace: locked in extension
ROM: PROM to tolerance out of brace; patellar mobilzation
CPM: Used for 2 – 4 hr blocks of time for 6 – 8 hours / day for 3 – 4 wks; initially limit flexion to 40 degrees, add 5 – 10 degrees / day as tolerated to a maximum of 90 degrees at 3 weeks
Weight-bearing: toe-touch only
Strengthen: isometric quadriceps, hamstring, hip ab/aduction; SLRs in brace, calf pumps.

Postop weeks three – four:
Continue modalities as indicated.
Brace: opened to 30 degrees after 2 weeks,90 degrees at 3 wks Postop, 120 degreesat 4 wks. postop.
Weight-bearing: toe-touch only
ROM: PROM and AAROM to tolerance, continue patellar mobilization
Strengthen: isometric quadriceps, hamstring, hip ab/aduction; SLRs in brace, calf pumps.

Post op weeks five- eight:
Brace: wean out with progressive WB
Weight-bearing: beginat 1/4 body wt. 5 wks post op, progress to full WBat 8 wks
ROM: PROM, AROM with a goal of 120 degrees flexionat 6 wks
Strengthen: continue as above, add stationary bike with low resistance

Post op weeks nine – twelve:
Strengthen: begin closed chain exercises, add gait training, proprioceptive exercises, at week 10 begin light leg press, small step ups as tolerated.

Postop weeks thirteen – twentyfour:
Strength: step-ups on larger step, begin running in place, progress to light running at 16 wks
Function: progress to sports specific training at 20 wks, return to sporting activities @ 24 wks