Orthopaedic Surgeon
Osteochondral Graft Transplant Surgical Rehabilitation (OATS)
Phase I (0 - 6 weeks)
Appointments
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Home exercise program will begin after surgery
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2-3xwk or as designated by rehabilitation specialist
Rehabilitation Goals
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Protection of healing tissue from load and shear forces
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Decrease pain and effusion
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Restoration of full passive knee extension
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Gradual improvement of normal knee flexion
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Regaining quadriceps control and patella mobility
Brace/Weight bearing
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Locked in extension
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Sleep in locked brace
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Non-weight bearing
Suggested Therapeutic Exercise
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Immediate motion exercises, full passive knee extension
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CPM 4-6 hours per day 0-40 degrees, increase by 5-10 degrees
per day as tolerated
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Range of motion goals: 90 degrees by 2 weeks and 115 by four
weeks and 125 by six weeks
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Patellar and soft tissue mobilization
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Hamstring, calf, and quadriceps stretching
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Ankle pumps, quad sets, multi-angle isometrics, active knee
extension 90-40 degrees, SLR 4 directions, stationary bike, biofeedback and EMS,
Cardiovascular exercise
• Upper body circuit training or upper body ergometer (UBE)
Progression Criteria
• Progress two weeks post-operatively
Phase II (6-12 weeks)
Appointments
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Rehabilitation appointments are 1-3 times per week
Rehabilitation Goals
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Gradually increase ROM and WB to full
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Gradually improve quadriceps strength/endurance
Brace/Weight Bearing Status
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Discontinue use of brace
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Progress weight bearing as tolerated by increasing 25%/week
until full WB
• Discontinue crutches at 12 weeks
Suggested Therapeutic Exercise
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Range of motion: 125-135 degrees
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Continue patellar mobilization and soft tissue mobilization as
needed
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Continue stretching program
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Week 6: initiate weight shifts
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Week 8: Initiate mini-squats 0-45 degrees, closed chain
activities
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Week 10: toe-calf raises, open kinetic chain knee extension,
stationary bike, balance and proprioception, front and lateral step ups, continue biofeedback and EMS,
Cardiovascular exercise
• Upper body circuit training or UBE, bike as range of motion allows
Progression Criteria
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Full range of motion
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Acceptable strength level, quadriceps within 15% of
contralateral leg and hamstrings within 10% of contralateral
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Balance testing within 30% and single leg balance >15 seconds
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Able to bike for 30 minutes
Phase III (3-6 months post-operatively)
Appointments
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Rehabilitation appointments are once every 1-2 weeks
Rehabilitation Goals
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Improve muscular strength and endurance
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Increase functional activities
Precautions
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Avoid post-activity swelling
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Post activity soreness should resolve after 24 hours
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Avoid pain with knee strengthening activities
Suggested Therapeutic exercises
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Range of motion: no restrictions – obtain full motion
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Leg press 0-90 degrees, Bilateral squats 0-60 degrees
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Unilateral step-ups progressing from 2-8”step
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Forward lunges
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Walking on treadmill
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Open kinetic chain extension 0-90 degrees
Cardiovascular exercise
• Upper body circuit training or UBE, non-impact lower body exercises including bike, elliptical, swimming, stair climber
Progression criteria
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Full non painful ROM
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Strength within 90%
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Balance and/or stability within 75%
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No pain, inflammation or swelling
Phase IV (6 months post-operative)
Appointments
Rehabilitation appointments are once every week
Rehabilitation Goals
Proprioceptive and muscular control with work and sport specific activities
Precautions
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Post activity soreness should resolve in 24 hours
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Avoid post activity swelling
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Avoid knee pain with higher impact activities
Suggested Therapeutic exercises
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Continue maintenance program progression 3-4x/wk.
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Progress resistance as tolerated
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Emphasis on entire lower extremity with strength and
flexibility
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Progress agility and balance drills
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Impact loading program should be specialized to the patient’s
demands
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Progress sport/work program
Cardiovascular exercise
• Replicate sport/work
Return to sport/work criteria
• Patient may return to various sport activities as progression in rehabilitation and cartilage healing allows. Generally, low impact sports such as skating, rollerblading, and cycling are permitted at about 8 months. Higher impact sports such as jogging, running, and aerobics may be performed at 8-10 months. High impact sports such as tennis, basketball, soccer and baseball are allowed at 10-12 months.