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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.
Microfracture
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.
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