A Prospective, Randomized Comparison of Traditional and Accelerated Approaches to Postoperative Rehabilitation following Autologous Chondrocyte Implantation

Ebert JR, Robertson WB, Lloyd DG, Zheng MH, Wood DJ, Ackland T · Cartilage

Both groups improved on every clinical measure to 24 months. The accelerated group reported significantly less severe pain and walked further in six minutes over the follow-up period, and had greater maximal active knee extension range. No graft delamination up to 24 months resulted from the three-month rehabilitation programme in either arm.

Population

Seventy patients after matrix-induced autologous chondrocyte implantation of the knee

Intervention

An accelerated weight-bearing protocol reaching full weight bearing at 8 weeks after surgery

Comparator

A traditional protocol reaching full weight bearing at 11 weeks

Limitations

Seventy patients at a single centre, and the two protocols differ by three weeks of crutches rather than representing the range of what is done — so it shows this acceleration is safe, not that faster is generally better. Surgeons and patients could not be blinded to which protocol they were following. Twenty-four months is short for a cartilage graft.