OCD Allograft Rehabilitation Protocol

PHASE I:

Week 0-2

Weight Bearing

  • NWB

Brace

  • Hinged knee brace locked in extension– remove for CPM and rehab with PT

ROM

  • Continuous Passive Motion (CPM) Machine for 6-8 hours per day for 8 weeks
  • Set CPM to 1 cycle per minute – set at 0-30° for first 3 weeks
  • PROM/AAROM and stretching under guidance of PT

Therapeutic Exercise

  • Weeks 0-4: Straight leg raise/Quad sets, Hamstring isometrics
  • Perform exercises in the brace if quad control is inadequate

Week 2-4

Weight Bearing

  • Partial WB (30-40 lbs)

Brace

  • Locked in extension for weight bearing – Can open brace for NWB ROM 0-30°

ROM

  • Starting at week 3 increase flexion 5-10° per day until full flexion is achieved

Therapeutic Exercise

  • Weeks 0-4: Straight leg raise/Quad sets, Hamstring isometrics
  • Perform exercises in the brace if quad control is inadequate

Week 4-8

Weight Bearing

  • Continue with partial WB (progress to use of one crutch at weeks 6-8)

Brace

  • Open brace to 30° for ambulation
  • D/C brace at week 6 post-op

ROM

  • Should be at 90° by week 6 and 120° by week 8

Therapeutic Exercise

  • Weeks 4-10: Begin isometric closed chain exercises
  • At week 6 can start weight shifting activities with operative leg in extension

Week 8-12

Weight Bearing

  • Progress to full WB with discontinuation of crutch use

Brace

  • None

ROM

  • Advance to full/painless ROM

Therapeutic Exercise

  • Weeks 4-10: Begin isometric closed chain exercises
  • At week 8 can begin balance exercises and stationary bike with light
  • Weeks 10-12: hamstring strengthening, theraband resistance exercises 0-30°, light open-chain knee isometrics

Phase II:

Week 12-24

Weight Bearing

  • Full WB with normal gait pattern

Brace

  • None

ROM

  • Advance to full/painless ROM

Therapeutic Exercise

  • Gait training/treadmill use at slow-moderate pace
  • Progress balance/proprioception exercises
  • Start sport cord lateral drills

Phase III:

Month 6-9

Weight Bearing

  • Full WB with normal gait pattern

Brace

  • None

ROM

  • Advance to full/painless ROM

Therapeutic Exercise

  • Advance closed chain strengthening/Start unilateral closed chain exercises
  • Progress to fast walking and backward walking on treadmill (add incline at 8 months)
  • Start light plyometric training

Phase IV:

Month 9-18

Weight Bearing

  • Full WB with normal gait pattern

Brace

  • None

ROM

  • Full/painless ROM

Therapeutic Exercise

  • Continue closed chain strengthening exercises and proprioception activities
  • Emphasize single leg loading
  • Sport-specific rehabilitation – jogging/agility training at 9 months
  • Return to impact athletics – 6 months (if pain free)
  • Maintain program for strength and endurance

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