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Author Topic: 2 wks post Patella ACI w/TTO - different protocol  (Read 3045 times)

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Offline denanderson

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2 wks post Patella ACI w/TTO - different protocol
« on: August 20, 2012, 11:14:43 PM »
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.

« Last Edit: August 21, 2012, 02:36:53 AM by denanderson »

Offline randomlife

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Re: 2 wks post Patella ACI w/TTO - different protocol
« Reply #1 on: October 17, 2012, 04:51:15 AM »
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!

03/10: Lateral tibial plateau fx
05/11: Chondroplasty of lateral tibial plateau and patella w/ extensive synovectomy
02/12: Grade III lesions on patella, new Grade II fissure on medial femoral condyle
09/12: DeNovo and Elmslie-Trillat TTT
01/14: Hardware removal and arthroscopy