Cartiform Patella Rehabilitation Protocol

Phase I WEEK 0-6:

Weight Bearing

  • Full with hinged knee brace

Brace

  • 0-2 weeks: Locked in full extension. Remove for CPM and exercise only.
  • 2-4 weeks: Unlocked and worn daytime only. Discontinue when quads can control SLR without extension lag

ROM

  • 0-6 weeks: Use CPM 6 hrs/day
  • 0-2 weeks: 0-30°
  • 2-4 weeks: 0-60°
  • 4-6 weeks: 0-60°

Therapeutic Exercise

  • 0-2 weeks: Quad sets, SLR, calf pumps, passive leg hangs to 45° at home
  • 2-6 weeks: PROM/AAROM to tolerance, patella and tibiofibular joint mobs, quad, hamstring, and glute sets, SLR, side-lying hip and core

Phase II WEEK 6-8:

Weight Bearing

  • Full

Brace

  • None

ROM

  • Full

Therapeutic Exercise

  • Advance Phase I exercise

Phase III WEEK 8-12:

Weight Bearing

  • Full

Brace

  • None

ROM

  • Full

Therapeutic Exercise

  • Gait training, begin closed chain activities: wall sits, mini-squats, toe raises, stationary bike
  • Begin unilateral stance activities, balance training

Phase IV WEEK 12-6 MONTHS:

Weight Bearing

  • Full

Brace

  • None

ROM

  • Full

Therapeutic Exercise

  • Advance Phase III exercises; maximize core/glutes, pelvic stability work, eccentric hamstrings
  • May advance to elliptical, bike, pool as tolerated

Phase V MONTHS 6-12+:

Weight Bearing

  • Full

Brace

  • None

ROM

  • Full

Therapeutic Exercise

  • Advance functional activity
  • Return to sport-specific activity and impact when cleared by MD after 8 mos

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