PATIENT INFO

GENERAL INFORMATION
 
HIPS
 
KNEES
 
OSTEOARTHRITIS
 
SHOULDERS
 
ELBOW SURGERY
 
VISCOSUPPLEMENTATION

 

HIGH TIBIAL OSTEOTOMY (Opening wedge, Allograft/ICBG Autograft)
Dr. Patrick Chin | Ms. Timberly George, BScKin, BScPT

Post-operative rehabilitation protocol

  WEIGHT BEARING (WB) STATUS BRACE ROM GOALS (RANGE OF MOTION) THERAPEUTIC EXERCISES
0-3 weeks NWB (Non Weight Bearing), 2 crutches Locked in full extension for ambulation; unlocked to 90 when seated 0-90 degrees Ankle pumping; NWB calf, hamstring stretches; Heel slides (seated, supine); quads setting; SLR with brace locked; Knee cap mobility
3-6 weeks

Autograft: Progress to 50% partial WB*, 2 crutches

Allograft: Do NOT WB to 50% until AFTER 6wk X-ray has been reviewed by surgeon.

Unlocked for ambulation; unlocked to 90 when seated. Only use brace when wt. bearing. Discontinue at 6 weeks at surgeon's approval 0- 120 degrees As above plus: NWB Hip, ankle, core strengthening. Continue to work on ROM until full.
6-12 weeks

Autograft:

PWB progressed to full WBAT by 12 weeks.

Allograft: Kept on strict 50% partial WB x 3 mos. **

Discontinue brace at 6 weeks at surgeon's approval. Full ROM

Stationary bike; hydrotherapy exercises (no swimming until 9-12 weeks); elliptical once full WB.

Begin CKC shuttle, mini squats, calf raises, mini step up/down; Lateral movements; Progress as tolerated.

3 -6 months Full WB n/a Full ROM As above plus increasing walking distance; sport specific movement training as tolerated.
> 6 months       Return to full activity as tolerated.

* 50% partial WB = 50% of patient's total body weight when stepping on scale
** Full WB may not be possible until up to 3 months. Size of wedge and x-ray confirmation of bone incorporation is necessary. Consult with surgeon.

Patient will have follow-up with surgeon at 2, 6, 12 weeks and 6 months post-op for repeat x-rays to ensure healing.

A pre-operative physiotherapy appointment should be scheduled to teach correct use of crutches and early ROM exercises to be done immediately post-op.

Patient should begin physiotherapy once surgical wounds are healed and bandages removed (approx. 2 weeks).