This document, authored by Jared T. Lee, MD, outlines a rehabilitation plan for patients following a Trochlea Osteochondral Allograft Transplantation (OATS) procedure.
The protocol is divided into six phases, each with specific:
- **Restrictions:** Guidelines for weight-bearing status (partial weight-bearing, progressing to full weight-bearing), brace usage (locked at 0-30 degrees, then unlocked), range of motion limitations, and avoiding aggressive strengthening early on.
- **Therapeutic Exercises:** Prescribed activities for each phase, focusing on passive range of motion (PROM), active range of motion (AROM), active-assisted range of motion (AAROM), edema control, pain management, isometric quadriceps strengthening, hip ab/adduction strengthening, hamstring and calf stretching, ankle pumps, patellar mobilizations, closed-chain strengthening, progressive resistance exercises, balance exercises, stationary biking, aquatic therapy, and functional progressions (jogging, running, cutting).
- **Goals:** Objectives for each phase, such as reducing swelling and edema, minimizing pain, retarding muscle atrophy, protecting the surgical repair, restoring range of motion, increasing resistance exercises, restoring a normal gait pattern, improving lower extremity strength, and progressing to functional and sport-specific activities.
- **Criteria for Progression:** Benchmarks for transitioning to the next phase, including achieving range of motion goals, no valgus collapse, no femoral adduction/IR rotation, achieving specific strength indices (hamstring and quadriceps >90% compared to the contralateral limb), Y-Balance anterior reach measurement, and no complaints of pain or instability.
The phases progress from initial post-operative care with partial weight-bearing and a locked brace to full return to activity and sports, with increasing exercise intensity and functional demands. The document emphasizes achieving specific strength levels and functional test scores before discharge.
