Osteotomy for Alignment (HTO/DFO) — Rehabilitation Protocol

Dr Jobe Shatrov
MBBS (Hons), BSc. (Physio). Grad. Dip. (Surgical Anatomy), FRACS, FAOrthoA
Orthopaedic Surgeon, Knee Surgery
Important: Weight-bearing and range depend on the procedure and fixation. Follow your written plan and X-ray review schedule.
Phase 1: Weeks 0–2
Goals: Protect the osteotomy, manage pain and swelling, begin gentle range within limits.
Weight-bearing: Often partial with crutches.
Brace: As advised.
Exercises: Ankle pumps, quads sets, SLR, gentle heel slides if permitted.
Phase 2: Weeks 2–6
Goals: Maintain knee motion, protect healing bone, build early strength and hip control.
Exercises: Bridges, side-lying hip work, core training, bike with low resistance when permitted.
Phase 3: Weeks 6–12
Goals: Progress weight-bearing as cleared on X-ray, normalise gait, increase strength and balance.
Exercises: Leg press within comfort, step-ups, split squats, proprioception.
Phase 4: Months 3–6
Goals: Return to low and moderate impact as bone heals and strength symmetry improves.
Impact: Introduce gradually only after surgeon clearance.
Sport: Later return guided by imaging and functional testing.
Red flags: Fever, wound problems, calf pain or swelling, chest symptoms, new deformity, uncontrolled pain. Seek urgent review.
Your plan may differ. Follow the instructions you receive from Dr Shatrov.
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