The recovery process and rehabilitation requirements
vary significantly among the different operative procedures used
to repair articular cartilage damage. The patient's commitment
level to the rehabilitation process is an important factor in determining
which treatment may be the best choice.
Shaving or Debridement
Crutch
use is minimal.
Rehabilitation
is started immediately after surgery.
Regular
activities are often resumed within 4 - 6 weeks.
This procedure involves the growth
and remodeling of cartilage and a restrictive period of rehabilitation
and crutch use for 6-8 weeks, with only touch-down weight bearing
of approximately 30 pounds permitted. Continuous passive motion
(CPM) is suggested by some physicians. Recovery to full activity
that is pain free may require 6 months or longer.
Following is an example of a recommended
rehabilitation program. Programs may vary from doctor to doctor.
A
CPM machine is used for 6 - 8 hours in a 24 hour period (usually
at night) for 6-8 weeks.
Crutches
are required for 6 - 8 weeks following surgery
The
patient must put no more than 30 pounds of weight on the injured
leg for 6 - 8 weeks, depending on the physician's recommendation
(some physicians may recommend no weight at all).
Pool exercises can be started as
soon as the incisions have healed, usually two weeks after surgery.
Full activity resumes in 3 - 6 months,
depending on the size of the cartilage damage.
Osteochondral Autograft Resurfacing
The long-term effects on the harvested
area are still unknown, as is the long-term performance of the transplanted
cartilage.
Crutch use is required for 4 -
6 weeks after surgery.
Pool therapy and bicycling are
usually started within 2 weeks.
Recovery to full activity generally
takes 4 - 6 months.
Return to running and impact sports
depends on the number of grafts taken.
Autologous Chondrocyte Implantation
Rehabilitation is a very lengthy process
with this treatment.
Crutches and touch-down weight
bearing on the operative leg for 6 weeks, with increasing weight
bearing to full weight bearing at 12 weeks.
Pool therapy and bicycling can
be started within 6 weeks.
Weight can be put on the leg starting
about 6 weeks after surgery. The patient's exact rehabilitation
time frame set by the physician may vary as the time to full weight
bearing is dependent on the size of the area resurfaced. Progressive
strengthening continues as the patient's range of motion and muscle
strength permits.
Return to sports often takes 6
- 12 months.
Osteochondral Allograft Resurfacing
Crutches and limited weight bearing
for two weeks on the operative leg, followed by full weight bearing
in a long leg cast brace for one year.
Pool therapy and bicycling are
usually started within 2 weeks.
Recovery to full activity usually
occurs when the cast brace is discontinued.
Return to running and impact sports
depends on the number of grafts used.
