Cartilage Restoration — Osteochondral Fracture ORIF / Cartiform / DeNovo / MACI — Patella and Trochlea

Sutter Health / Palo Alto Medical Foundation · Kevin Roth MD

Weight-Bearing

FWB with hinged knee brace wks 0-6 (remove for CPM and exercise only); FWB no brace wks 6+

Key Restrictions

Brace locked full extension wks 0-2; CPM 6 hrs/day wks 0-6; brace unlocked daytime only wks 2-4, d/c when quad controls SLR; RTS with MD clearance at 8+ months

Timeline & Phases

Phase I (wks 0-6): FWB in brace, locked 0° wks 0-2 (CPM 0-30°), unlocked daytime wks 2-4 (CPM 0-60°), d/c when quad adequate (CPM 0-60° wks 4-6) — quad/hamstring/glute sets, SLR, calf pumps, passive leg hangs to 45°, PROM/AAROM, patellar/tibiofibular mobs; Phase II (wks 6-8): FWB, no brace, full ROM — advance Phase I; Phase III (wks 8-12): FWB — gait training, CKC (wall sits, mini-squats, toe raises, stationary bike), unilateral stance, balance training; Phase IV (wks 12 to 6 months): FWB — advance Phase III, maximize core/glutes/pelvic stability, eccentric hamstrings, elliptical/bike/pool; Phase V (months 6-12+): FWB — advance functional activity, RTS with MD clearance at 8+ months

Notes

Covers ORIF of osteochondral fracture, Cartiform scaffold, DeNovo, and MACI at patella and trochlea; CPM 6 hrs/day wks 0-6; RTS requires MD clearance at 8+ months

Surgeon / Author

Kevin Roth MD

Published

2024