knee osteotomy

Rehabilitation Guideline

Introduction

A High Tibial Osteotomy (HTO) and Distal Femoral Osteotomy (DFO) are surgical procedures designed to correct knee alignment and reduce pressure on damaged cartilage. These procedures are commonly performed in patients with knee osteoarthritis or malalignment conditions.

Rehabilitation is crucial to achieving the best outcomes, ensuring pain relief, mobility restoration, and return to daily activities.

Recovery Timeline

Phase 1: Immediate Post-Operative (0-2 Weeks)

✅ Goals:

  • Pain and swelling management

  • Protect surgical site

  • Begin gentle mobility exercises

📌 Key Instructions:

  • Weight-Bearing: Typically non-weight-bearing (NWB) or partial weight-bearing (PWB) with crutches for 6-8 weeks (follow surgeon’s advice). Dr Damasena may later this depending on your specific individual case.

  • Knee Brace: Often required to maintain stability.

  • Pain Control: Use prescribed medications and ice therapy (15-20 min every 2 hours). We recommend the RE ice brace. We will provide this for you at a discounted price

  • Elevation: Keep the leg elevated above heart level to reduce swelling.

🦵 Exercises:

  • Ankle Pumps (Prevents blood clots)

  • Quadriceps Sets (Tighten thigh muscle, hold for 5 sec, repeat 10 times per hour)

  • Gentle Passive Knee Bends (Only as tolerated, within allowed range)

Phase 2: Early Recovery (2-6 Weeks)

✅ Goals:

  • Increase range of motion (ROM)

  • Start weight-bearing progression (if cleared by surgeon)

  • Maintain muscle activation

📌 Key Instructions:

  • Weight-Bearing: Progress gradually with crutches and assistive devices.

  • Knee Movement: Aim for 45-90° knee flexion by week 6.

  • Physical Therapy Begins: Supervised rehab sessions may start.

🦵 Exercises:

  • Straight Leg Raises (Strengthens quadriceps, 10 reps x 3 sets)

  • Seated Knee Bends (Aim for controlled flexion)

  • Hamstring Stretches

Phase 3: Strength & Mobility (6-12 Weeks)

✅ Goals:

  • Improve knee bending & strength

  • Reduce reliance on crutches

  • Increase functional movement

📌 Key Instructions:

  • Weight-Bearing: Gradually transition to full weight-bearing as tolerated.

  • Continue Physical Therapy: Focus on controlled strengthening and balance.

  • Monitor Swelling & Pain: Adjust activity levels accordingly.

🦵 Exercises:

  • Mini Squats (Partial squats to strengthen quads, 10 reps x 3 sets)

  • Step-Ups (Controlled stepping onto a low platform)

  • Stationary Cycling (Low Resistance)

Phase 4: Return to Activity (12-24 Weeks)

✅ Goals:

  • Full weight-bearing without discomfort

  • Restore functional mobility

  • Gradual return to sports/impact activities (if applicable)

📌 Key Instructions:

  • Continue Strengthening: Advance exercises include leg presses, single-leg balancing, and core strengthening.

  • Monitor Knee Stability: Avoid high-impact activities until cleared by surgeon.

  • Return to Sports: Low-impact sports like swimming and cycling can begin after 4-6 months, while running/jumping is delayed until 6-12 months.

🦵 Exercises:

  • Lunges (Controlled forward lunges, 10 reps x 3 sets)

  • Single-Leg Balancing (Hold for 30 sec, repeat 3 times)

  • Light Jogging (as advised by PT)

Signs to Watch For & When to Seek Medical Help

🚨 Contact Dr Damasena if you experience:

  • Severe pain or swelling that does not improve with rest/ice.

  • Signs of infection (redness, warmth, pus from incision, fever).

  • Sudden inability to move the knee or bear weight.

  • Blood clot symptoms (calf pain, swelling, shortness of breath).

Final Notes & Long-Term Care

✔ Rehabilitation is a gradual process—stay committed to exercises. ✔ Listen to your body—avoid pushing through significant pain. ✔ Maintain a healthy weight—reduces stress on the knee joint. ✔ Follow-up visits are essential—attend all scheduled appointments with your surgeon and physiotherapist.