Cartilage Restoration — Osteochondral Allograft Transplant

University of Virginia Orthopaedic Surgery

Weight-Bearing

25% WB weeks 0-2; 50% WB weeks 2-8; progress to WBAT after 8 weeks

Key Restrictions

Prolonged protected WB (50% for up to 8 wks); if graft involves patella/trochlea: brace locked in extension for ambulation, unlocked at all other times; physician clearance required before high-impact activities (confirm graft healing on X-ray)

Timeline & Phases

Phase 1 (0-6 wks): brace 0-90° then open to available ROM, 25% then 50% WB, quad/HS/glute strengthening, NMES, SLR 4-ways, stationary bike wks 3-4 low resistance; Phase 2 (6-12 wks): 50% WB until wk 8 then WBAT, discontinue brace at 6 wks, CKC quad/HS, pool program, leg press 0-60°, mini-squats, wall sits; Phase 3 (12-24 wks): FWB without crutches, balance/NM control, BOSU squats/lunges, elliptical/swimming/cycling, functional/sport-specific; Phase 4 (6+ months): sport-specific activities with physician clearance for high-impact (graft healing confirmed on X-ray)

Notes

4 phases; physician clearance required before any high-impact activities — graft healing must be confirmed on X-ray; if patella/trochlea graft, brace locked in extension for ambulation; 50% WB extended to 8 weeks (longer than typical); pool program begins phase 2; running and impact progression begins Phase 4 only after imaging clearance

Published

12/2024