High Tibial Osteotomy (HTO) — HTO or Distal Femoral Osteotomy (DFO)

Saint Louis University (SLUCare)

Weight-Bearing

NWB in brace 2 weeks; 25-50% PWB in brace locked wks 2-6; WBAT wks 6-14; running at 4 months if criteria met

Key Restrictions

NWB in brace wks 1-2; brace locked in extension; no running/sport until week 14+; running criteria: extensor LSI >70%, AROM 0->125 deg, hop test >70%; no descending stairs reciprocally until adequate quad control

Timeline & Phases

Wks 1-6: NWB then 25-50% PWB brace locked, SLR/quad sets, patellar mob; Wks 6-14: WBAT, normalize gait, bike (short crank then standard at >115 deg), leg press, step program, elliptical, retro treadmill; Wks 14-22: running, lunges, agility, plyometrics; discharge: hop test >85% and isokinetic test >85% limb symmetry

Notes

SLU Sports Medicine; covers both HTO and DFO; 4-month protocol 2-3 visits/week