Femoral Articular Chondrocyte Implantation Rehab Protocol (ACI)

Femoral implant Guideline

Post-op weeks 1 – 6:

Wear brace locked in full extension; wear at night for 4 wks. Unlock for exercise and CPM.
Cryotherapy, electrical stim. biofeedback.
Non-weight bearing for 2 weeks, toe touch WB @ 3 wks, 1/4 body WB @ 5 wks.
PROM with 90 degrees flexion @ 2 wks, 120 @ wk 6.
Patellar mobilizaton
Ankle pumps, Quad / hamstring isometric sets, Four direction SLRs.
Aquatherapy @ wk 4 -6.

Goal: @ 6 weeks full extension, flexion of 120, Quadriceps control.

Post-op weeks 7 – 12:

Discontinue brace.
Progress WB to full WB @ 8 – 9 wks.
Begin Closed chain exercises. Stationary bicycle with low resistance.
Mini-squats, toe-calf raises.
Continue patellar, soft tissue mobilization as needed.
Initiate balance and proprioceptive drills.
@ 10 wks begin step-ups, treadmill, open chain extension(0 – 45),Progress 1 lb/wk).

Goal: full ROM, regain strength (70 – 80 % contralateral Quads/hamstring), Endurance (Walk 1 -2 miles, cycle 30 min).

Post-op weeks 13 – 26:

Begin planning for transition to HEP.
Begin, leg press (to 90), Squats (to 60), Knee extensions (0 – 90), Forward lunges.
Initiate Stairmaster, Elliptical work.
Progress with walking program, swimming, cycling.

Goal: Full non-painful ROM, strength 80 -90% contralateral side, improved balance.

Post-op weeks 27 – 52:

Continue maintenance program.
Progress strengthening as tolerated.
Begin sports specific drills.
Return to low impact activities (cycling,swimming) @ 6 months, Running @ 8 – 12 months.
High impact sports (tennis, football, basketball) @ 12 – 18 months.