Knee arthroscopy with osteochondral autograft transplant (OATS)

ost-op recovery	First 2 weeks	Date
Goals	Protect the knee and surgical incision Recover from swelling and inflammation Control of post-surgical pain
Precautions	Non-weight bearing on crutches
Recommendations	Rest and elevate as required Ice the knee up to 3 times a day – particularly in the first 72 hours Range of motion exercises of ankle Range of motion exercises of hip Gentle movement of the knee from full extension to 90 degrees of flexion as pain and swelling allows
Suggested exercises	Static quads contraction Supine straight leg raise Ankle pumps Supine bed supported knee bend Sitting supported knee bend Supine knee extension – foot elevated/supported

Phase 1	Week 2 to week 6
Goals	Increase range of motion Begin strengthening hip and core
Precautions	Touch-weight bearing on crutches The foot may rest on the ground when stationary
Recommendation	Hip and gluteal muscle strengthening Gentle movement of the knee from full extension to 90 degrees of flexion Ankle range of motion
Suggested exercises	Static quads contraction Supine straight leg raise Ankle pumps Supine bed supported knee bend Sitting supported knee bend Sitting knee extension stretch – foot on floor Supine knee extension – foot elevated/supported Side leg raise – knee straight, knee flexed

Phase 2	Week 7 to week 12
Goals	Comfortably walk normally Gain full range of motion
Precautions	No running No deep squats
Recommendations	Gradually begin taking weight through your leg when you walk. Fully weight bear as able Discard crutches when walking safely Achieve full range of motion of knee – passive and active Hip and gluteal muscle strengthening Ankle and calf strengthening Balance and control of the leg Short walks
Suggested exercises	Wall slide mini squat Double leg squats (0-60) Sitting unsupported knee extension and flexion Single leg stance – knee straight, knee flexed Straight leg raise Step ups Double calf raises – progress to single calf raise Side leg raise – knee straight, knee flexed Gluteal band exercises Bridging with gluteal contraction Exercycle – low resistance, short interval

Phase 3	3 Months – 6 months
Goals	Gain full function and strength
Precautions	Avoid collision sports or high risk recreational activity Return to vigorous athletic activity as physiology allows (rapid return to rigorous strength training or endurance and speed training can lead to tendinopathies or injury)
Recommendations	Concentrated full rehab program that includes strengthening of core, hip flexors, gluteal muscles, external rotators of the hip, quadriceps, hamstrings and calves. Gain in confidence during athletic activity. Neuromuscular control and co-ordination of leg Long walks Return to running in sensible progressive time frame
Suggested exercises	Double leg squats (0-90) Single leg squats Single leg hop Step ups – increase height Hop ups Step downs Resisted quads and hamstring weight training Gluteal band exercises Bridging Exercycle – increase resistance and training length