Cartilage Restoration — Patellofemoral Microfracture / OATS / ACI

Lahey Hospital & Medical Center · J. Baumfeld MD, M. Lemos MD

Weight-Bearing

NWB wks 0-4; partial (25%) WB with crutches wks 5-6; 50-75% WB wks 7-8; FWB wks 9-12 once muscle control throughout ROM

Key Restrictions

CPM from day 1, 8-12 hrs/day at 0-60°, progressing 5-10°/day, may continue 6-8 hrs/day up to 6 wks; PROM 0-60° wks 0-2, 0-90° wks 3-4, 0-110° wks 5-6; D/C brace at 6 wks if muscle control throughout ROM; no impact activities until 12 wks

Timeline & Phases

7 phases: Phase I (wks 0-2, NWB, CPM, PROM 0-60°), Phase II (wks 3-4, NWB with crutches, PROM 0-90°), Phase III (wks 5-6, 25% WB, PROM 0-110°, stationary bike when ROM allows, D/C brace at 6 wks), Phase IV (wks 7-8, 50-75% WB, AROM 0-120°), Phase V (wks 9-12, FWB, AROM 0-135°), Phase VI (wks 13-26, strength 80-90% of contralateral, leg press, partial lunges, step-ups, swimming), Phase VII (wks 27-52, gradual return to full unrestricted functional activities)

Notes

Specifically for patellofemoral lesions (vs tibiofemoral). Initial ROM restricted to 0-60°. Cultured ACI cells continue to grow for 9-12 months and can mature up to 24 months. Approved 2/2014 (J. Baumfeld MD, M. Lemos MD); compiled by K. DelPaine PT.

Surgeon / Author

J. Baumfeld MD, M. Lemos MD

Published

2014-02