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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