Multi-Procedure Knee Reconstruction — Femoral Osteotomy with ACL Reconstruction (Peroneus Longus Allograft) + OATS + Lateral Meniscus Allograft Transplant + Microfracture

Mammoth Orthopedic Institute / Sierra Park PT · Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Ariel Duvall…

Weight-Bearing

NWB x6 weeks with crutches; WB progression 25%/week from 6 weeks (MD/X-ray clearance required); DC crutches at 10 weeks when quad control returns

Key Restrictions

NWB x6 weeks; brace locked 0° for ambulation, open 0-90° at rest x6 weeks; AROM/PROM 0-90° x6 weeks; no downhill activity x4.5 months; X-ray clearance required before WB progression; monitor for DVT/infection signs; earliest RTS 9 months

Timeline & Phases

4 phases: Phase I (0-6 wks, NWB, brace locked 0° ambulation, PROM 0-90°, DVT/infection monitoring), Phase II (6-12 wks, WB 25%/wk to FWB at 10 wks with MD/X-ray clearance, CKC once FWB), Phase III (3-5 months, running at 75%, agility), Phase IV (5-8 months, plyometrics, RTS testing at 9 months)

Notes

Complex combined surgery: femoral osteotomy + ACL with peroneus longus allograft + open allograft OATS + lateral meniscus allograft transplant + microfracture; X-ray evidence of healing required before WB progression at wk 6; Ariel Duvall PT 1/24/17; Gilmer MD January 2017; RTS criteria: quad/hamstring ≥90%, SL hop/vertical jump ≥90%, no effusion

Surgeon / Author

Brian B. Gilmer MD (US Ski Team Physician); Karly M. Dawson PA-C; Ariel Duvall PT

Published

January 2017