Cartilage Restoration — Osteochondritis Dissecans (OCD) Fixation — Pediatric

Massachusetts General Hospital · MGH Brigham Pediatric Sports Medicine

Weight-Bearing

TDWB with brace locked wks 0-4; PWB 25% wks 4-6; FWB wks 6-8

Key Restrictions

Brace always locked in extension wks 0-6; no knee flexion wks 0-2; flexion to 60 deg wks 2-4; flexion to 90 deg wks 4-6; surgeon clearance required to advance WB at 6-wk follow-up; no impact loading until Phase VI (6+ mo); patellar mobs in Phase I for condylar lesion only (patellar lesion requires surgeon clearance); Pedi-IKDC preferred over KOOS-child

Timeline & Phases

Phase I (0-2 wks): TDWB brace locked, patellar mobs (condylar lesion), low-load extension stretches, quad sets, hip ABD/ADD/extension, SLR; Phase II (2-4 wks): TDWB brace locked, flexion to 60 deg, heel slides, 4-way SLR, AAROM short arc quad; Phase III (4-6 wks): PWB 25% brace locked, flexion to 90 deg, stationary bike semi-revolutions, AROM knee flex/ext with light resistance; Phase IV (6-8 wks): FWB, wean brace/crutches, walking program 15-30 min, stationary bike moderate resistance, hamstring curls, leg press; Phase V (9-12 wks): progressive strengthening, walking to 45 min, bilateral plyometrics (LSI >75%); Phase VI (3-6 mo): return-to-run program, agility/plyometrics, full sport at 7 mo

Notes

Revised 03/2024; 6-phase protocol; Phase VI criteria: quad/HS/glut >=90%, H:Q >=66%, hop >=90%; no impact loading throughout Phases I-V; strict brace/WB protocol with surgeon clearance at 6 wks; machine sizing guidance for adolescents; Pedi-IKDC recommended; hard cutting/pivoting ~7 mo. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-02-16.]

Surgeon / Author

MGH Brigham Pediatric Sports Medicine

Published

2024-03