2023 ISAKOS Biennial Congress ePoster
A Systematic Review Of Rehabilitation Protocols Following Matrix-Assisted Autologous Chondrocyte Implantation
Jaydeep Dhillon, BS, Parker, CO UNITED STATES
Sydney M Fasulo, MD, Paterson, NJ UNITED STATES
Matthew J. Kraeutler, MD, Houston, TX UNITED STATES
John W. Belk, BA, Boulder, CO UNITED STATES
Patrick C. McCulloch, MD, Houston, TX UNITED STATES
Anthony Scillia, Birmingham, AL UNITED STATES
Rocky Vista University College of Osteopathic Medicine, Parker, CO, UNITED STATES
The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: Geistlich Pharma AG, Chondro-Gide; BioTissue Technologies GmbH, BioSeed®-C; Matricel, ACI-Maix
Summary
Currently, most rehabilitation protocols for third-generation ACI initiate CPM within 24 hours postoperatively and allow partial WB immediately following surgery with progression to full WB within 12 weeks.
ePosters will be available shortly before Congress
Abstract
Purpose
To perform a systematic review of postoperative rehabilitation protocols for third-generation autologous chondrocyte implantation (ACI) of the knee joint.
Methods
A systematic review was performed by searching PubMed, Cochrane Library, and EMBASE to locate randomized controlled trials that described a rehabilitation protocol following third-generation ACI of the knee joint. The search terms used were: “autologous” AND “chondrocyte” AND “randomized”. Data extracted from each study included various components of postoperative rehabilitation such as initial weight bearing (WB) status and time to full WB, the use of continuous passive motion (CPM), the time to return to sports, and physical therapy (PT) modalities used and the timing of their initiation.
Results
Twenty-five studies (22 level I, 3 level II) met inclusion criteria, including a total of 905 patients undergoing treatment with ACI. The average patient age ranged from 29.1 to 54.8 years and the mean follow-up time ranged from 3 months to 10.0 years. The average lesion size ranged from 1.9 to 5.8 cm2 and the most common lesion location was the medial femoral condyle (n = 494). Twenty studies allowed partial WB postoperatively with all studies permitting full WB within 12 weeks. Twenty studies used CPM in their rehabilitation protocols and initiated its use within 24 hours postoperatively. Among 10 studies which reported time to return to sport, 9 (90%) allowed return by 12 months. While most protocols used strength training as well as the inclusion of proprioceptive training, there was disagreement on the timing and inclusion of specific PT modalities used during the rehabilitation process.
Conclusions
Currently, most rehabilitation protocols for third-generation ACI initiate CPM within 24 hours postoperatively and allow partial WB immediately following surgery with progression to full WB within 12 weeks. There is variation of the PT modalities used as well as the timing of their initiation.