2 wks post Patella ACI w/TTO - different protocol

[denanderson]

Hi All,

I am two weeks post op right knee patella ACI (huge lesion, practically entire patella) with TTO. Since day 1 I have been weight bearing as tolerated in extension in brace and am allowed to do any ROM I can in CPM or otherwise. I am using CPM 0-90 degrees several hours a day and I have about 120 degrees of flexion. SLR's and quad sets I do all the time with no problems. I have gone to PT mostly for soft tissue work. I have significant swelling and heat, especially when I do alot, but after reading this site this seems relatively normal. Of course I ice like a mad woman.

I have read tons of posts on this site and protocols all seem to be non-WB for 6 wks and limited ROM. Has anyone else out there had such an aggressive rehab?

I kind of wish I had read this website pre-op, but it took two years and suing Anthem Blue Cross to authorize it, so I sort of jumped into it after I finally won the lawsuit.

Any input would be incredibly helpful.

Denise

[randomlife]

Hi Denise,

I had a similar surgery just 4 weeks ago, though it was with DeNovo, not ACI. I had a large lesion under my patella, and my OS said that he basically resurfaced the patella with the tissue transplant. Regardless, I've had a rather aggressive protocol as well. Not quite as aggressive as yours, but I was in the CPM 24/7 from about 2 hours post-op until the 3 week mark. I was going from 0-30 degrees, and 6 times a day would go to 90 degrees and hold for 10 minutes. I was told at my second post-op appointment (2.5 weeks) that I had no restrictions on flexion, as long as I wasn't bearing weight. I'm now at 142 degrees flexion, so pretty good.

I was weight bearing as tolerated (WBAT) immediately post-op. I couldn't tolerate a whole lot the first few days, but I'd worked up to about 50% by 8-9 days, and I completely stop using the crutches at 3 weeks. This was a week earlier than my OS predicted prior to surgery, but he doesn't seem concerned. I have been using a hinged brace locked in full extension the whole time. I'll be in that until my next appointment at the 6.5 week mark.

Hope your recovery is still going well!

Cheers,
lk