Objective: There are no reports describing in detail postoperative rehabilitation after double-level osteotomy (DLO). Consequently, the establishment of a safe and effective rehabilitation protocol is required.

Methods: This retrospective study included 26 patients with varus knees who underwent DLO. No patient had obvious fracture around the femoral osteotomy sites, as evaluated using computed tomography (CT) 3 weeks postoperatively. From 3 days postoperatively, gait training with early weight bearing was performed using our parallel bar protocol. Range of motion exercises were permitted as tolerated. Radiological evaluation was performed to confirm the presence or absence of fracture around the femoral osteotomy sites using CT at 3 weeks and X-ray at 6 weeks postoperatively. X-ray imaging 6 months postoperatively indicated no femoral correction loss. Additionally, the time from initiation to completion of the protocol and the time from initiation to achievement of independent gait were recorded.

Results: No fractures around the femoral osteotomy sites in any patient were found using CT 3 weeks postoperatively and X-rays 6 weeks postoperatively. There was no correction loss at the femoral osteotomy site according to X-ray findings 6 months postoperatively. The mean time until completion of the parallel bar protocol was 19.8 ± 6.2 (7–30) days, and that from the initiation of rehabilitation to the achievement of independent gait was 26.8 ± 7.1 (16–45) days.

Conclusion: Patients without fracture around the femoral osteotomy site during the rehabilitation period could achieve independent gait within an average of <1 month using the parallel bar protocol. Early weight-bearing walking and independent walking could be achieved using this protocol.