Table 4.

Rehabilitation Protocol for Medial Closing-Wedge Distal Femoral Osteotomy

Weight bearing

The patient is allowed only touch-down weight bearing for 4 wk.

The patient progresses to weight bearing as tolerated from week 4 to week 6.

Range of motion

CPM of 0°-30° is started and is advanced to 0°-90° as tolerated for the first 6 wk. The goal is to perform CPM for 3-4 h per day as able.

The patient progresses to full range of motion from 6-12 wk.

The patient should have full range of motion by 12 wk.

Brace wear

The patient wears a hinged knee brace locked in extension for the first 2 wk except when performing range-of-motion exercises.

An unlocked hinged knee brace is worn during the day after 2 wk. The patient keeps the brace locked in extension at night for the first 6 wk.

Bracing is discontinued at 6 wk.

Exercises

The patient may do heel slides, quadriceps sets, straight-leg raises, and hamstring and calf stretching for the first 6 wk.

Spinning on a stationary bicycle with no resistance is added at 6 wk.

Mini-squats, stationary bicycling with resistance, and swimming are added at 8 wk.

A treadmill and walking or running program are added at 12 wk.

The patient should progress to activities as tolerated over a period of 3-6 mo postoperatively.

CPM, continuous passive motion.