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    High Tibial Osteotomy Rehabilitation Protocol

    Uploaded by

    Illene Mooi
    This document outlines a 6 phase rehabilitation protocol for patients who have undergone a high tibial osteotomy surgery. Phase I focuses on pain/effusion control and range of motion from 0 to 90 degrees. Phase II aims to improve range of motion to 0-120 degrees with no extensor lag. Phase III targets full range of motion. Phase IV emphasizes normal gait and walking 2 miles. Phase V has a goal of jogging 2 miles at an easy pace. Phase VI is return to all activities with no contact sports until 6 months post-op. Exercises progressively advance from range of motion to strengthening, proprioception, and sport-specific drills.

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    High Tibial Osteotomy Rehabilitation Protocol

    Uploaded by

    Illene Mooi
    46 views2 pages
    This document outlines a 6 phase rehabilitation protocol for patients who have undergone a high tibial osteotomy surgery. Phase I focuses on pain/effusion control and range of motion from 0 to 90 degrees. Phase II aims to improve range of motion to 0-120 degrees with no extensor lag. Phase III targets full range of motion. Phase IV emphasizes normal gait and walking 2 miles. Phase V has a goal of jogging 2 miles at an easy pace. Phase VI is return to all activities with no contact sports until 6 months post-op. Exercises progressively advance from range of motion to strengthening, proprioception, and sport-specific drills.

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    High tibial osteotomy

    Original Title

    HIGH-TIBIAL-OSTEOTOMY

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    This document outlines a 6 phase rehabilitation protocol for patients who have undergone a high tibial osteotomy surgery. Phase I focuses on pain/effusion control and range of motion from 0 to 90 degrees. Phase II aims to improve range of motion to 0-120 degrees with no extensor lag. Phase III targets full range of motion. Phase IV emphasizes normal gait and walking 2 miles. Phase V has a goal of jogging 2 miles at an easy pace. Phase VI is return to all activities with no contact sports until 6 months post-op. Exercises progressively advance from range of motion to strengthening, proprioception, and sport-specific drills.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    46 views2 pages

    High Tibial Osteotomy Rehabilitation Protocol

    Uploaded by

    Illene Mooi
    This document outlines a 6 phase rehabilitation protocol for patients who have undergone a high tibial osteotomy surgery. Phase I focuses on pain/effusion control and range of motion from 0 to 90 degrees. Phase II aims to improve range of motion to 0-120 degrees with no extensor lag. Phase III targets full range of motion. Phase IV emphasizes normal gait and walking 2 miles. Phase V has a goal of jogging 2 miles at an easy pace. Phase VI is return to all activities with no contact sports until 6 months post-op. Exercises progressively advance from range of motion to strengthening, proprioception, and sport-specific drills.

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    University Orthopedics, Inc.

    Sports Medicine Division

    HIGH TIBIAL OSTEOTOMY REHABILITATION PROTOCOL

    This protocol was developed for patients who have had a high tibial osteotomy. Please note this
    protocol is a guideline. Patients with additional surgery will progress at different rates. Achieving the
    criteria of each phase should be emphasized more than the approximate duration.

    PHASE I: ~0-2 WEEKs POSTOPERATIVE PHASE II: ~2-4 WEEKS POSTOPERATIVE


    GOALS: GOALS:
    • Pain/effusion control • ROM 0-120 degrees
    • ROM—0 to 90 degrees • No extensor lag

    AMBULATION, BRACING, AND DRESSING: AMBULATION AND BRACE USE:


    Dressing – POD 1: Debulk dressing, TED Hose in place Brace – Open to available range
    – POD 2: Change dressing, keep wound covered, Crutches – NWB
    continue TED Hose
    – POD 7-10: Sutures out, D/C TED Hose when EXERCISES:
    effusion is resolved Scar mobilization when incision healed
    Brace – 0-90 degrees Co-contractions quads/hamstring at 0, 30, 60, 90
    Crutches – Non weight bearing (NWB) x 6 weeks degrees
    SLR x 4 on mat, no brace – Add weight above knee if
    EXERCISES: good quad control
    CPM in hospital – 0-90 degrees Stationary bike for ROM
    AROM, AAROM 0-90 degrees
    Patellar mobilization (teach patient) PHASE III: ~4-8 WEEKS POSTOPERATIVE
    Calf pumping GOAL: FULL ROM
    Passive extension with heel on bolster or prone
    hangs AMBULATION AND BRACE USE:
    Electrical stimulation with quad sets and SLR Brace – Open to available range
    Quad sets, Co-contractions quads/hams Crutches – NWB x 6wks then Partial weight bearing
    Straight leg raise (SLR) x 4 on mat, in brace (parallel (PWB)
    bars if poor quad control) Continue appropriate previous exercises
    Stretches – Hamstring, Hip flexors, ITB PROM, AAROM, AROM to regain full motion
    Ice pack with knee in full extension after exercise SLR x 4 on mat, no brace – Light weight below the
    knee
    Weight shifts, Mini squats – In parallel bars
    Leg press with light resistance
    Hamstring curls – Carpet drags or rolling stool
    (closed chain)
    Double leg heel raises
    Stationary bike – Progressive resistance and time
    Pool therapy – Chest deep exercises in sagittal plane
    only
    PHASE IV: ~8-12 WEEKS POSTOPERATIVE
    GOALS: PHASE VI: ~4-6 MONTHS POSTOPERATIVE
    • Normal gait GOAL: Return to all activities
    • Walk 2 miles at 15min/mile pace
    EXERCISES:
    AMBULATION AND BRACE USE: Continue appropriate previous exercises
    Brace – Continue until 12 weeks post-op Agility drills / Plyometrics
    Crutches – Weight bearing as tolerated (WBAT) (D/C Sit-up progression
    when gait is normal) Progressive weight training program
    Running progression to track
    EXERCISES: Transition to home / gym program
    Continue appropriate previous exercises
    Forward, lateral and retro step downs – No flexion > No contact sports until 6 months post-op
    45 degrees (small step)
    SLR x 4 with Theraband bilaterally
    Wall squats – No knee flexion past 45 degrees
    Single leg heel raises
    Proprioceptive training – Single leg standing in
    parallel bars
    – Double leg BAPS for weight shift
    – Progress to single leg BAPS, ball toss and body
    blade
    Treadmill – Forwards and backwards walking
    – Walking progression program
    Elliptical trainer
    Pool therapy – Walk in waist deep water
    **This protocol is designed to be administered by a
    licensed physical therapist and/or certified athletic trainer.
    PHASE V: ~3-4 MONTHS POSTOPERATIVE Please do not hesitate to contact our office should you
    GOAL: Jog 2 miles at easy pace have any questions concerning the rehabilitation process.

    AMBULATION AND BRACE USE:


    D/C crutches and brace

    EXERCISES:
    Continue appropriate previous exercises with
    progressive resistance
    Forward, lateral and retro step downs – Medium to
    large step
    Hamstring curl weight machine
    Knee extension weight machine
    Hip weight machine x 4 bilaterally
    Fitter
    Slide board
    Stairmaster
    Swimming
    Treadmill – Running progression program

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