Combined Osteochondral Allograft Meniscal Allograft Transplantation High Tibial Osteotomy

phase I

0-2 weeks

Heel-touch only

Locked in full extension at all times*

Off for hygiene and home exercise only

Gentle passive 0-90°

CPM 0-90°

Heel slides, quad sets, patellar mobs, SLR, calf pumps at home

phase II

2-8 weeks

2-6 weeks: Heel-touch only

6-8 weeks: Advance 25% weekly until full

2-6 weeks: Locked 0-90°

Discontinue brace at 6 weeks

Advance as tolerated w/caution during flexion >90° to protect post horn of meniscus

2-6 weeks: Add side-lying hip and core, advance quad set and stretching**

6-8 weeks: Addition of heel raises, total gym (closed chain), gait normalization, eccentric quads, eccentric hamstrings

Advance core, glutes and pelvic stability

phase III

8-12 weeks

Full

None

Full

progress closed chain activities

Advance hamstring work, lunges/leg press 0-90° only, proprioception/balance exercies

Begin stationary bike

phase IV

12-24 weeks

Full

None

Full

Progress Phase III Exercises and functional activities: walking lunges, planks, bridges, swiss ball, half-bosu exercises

Advance core/glutes and balance

phase V

6-9 months

Full

None

Full

Advance all activity w/o impact such as running, jumping, pivoting, sports until cleared by MD