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• W2018171219 abstract "This randomized controlled study demonstrated that an ‘accelerated' rehabilitation program following matrix-induced autologous chondrocyte implantation (MACI) was not detrimental to graft development up until 24 months post-surgery, and may accelerate patient return to normal function, whilst reducing post-operative muscle loss, intra-articular adhesions and associated gait abnormalities. Policies on post-operative load bearing rehabilitation following autologous chondrocyte implantation (ACI) are varied and the subject remains controversial. This study aims to determine the safety and efficacy of an ‘accelerated' post-operative weight bearing (WB) regime following matrix-induced autologous chondrocyte implantation (MACI). A randomized controlled study design was used to assess clinical and radiological outcome in 70 patients (45 males, 25 females) who underwent MACI to the medial or lateral femoral condyle, in combination with either ‘traditional' or ‘accelerated' approaches to post-operative WB rehabilitation. Apart from the gradient and time to full WB, components of both rehabilitation interventions were the same. Under the ‘accelerated' protocol, patients reached full WB at eight weeks post-surgery, compared to 11 weeks for the ‘traditional' group. Clinical outcomes were undertaken pre-surgery and at 3, 6, 12 and 24 months post-surgery. These included the Knee Injury and Osteoarthritis Outcome Score (KOOS), the visual analogue pain scale (VAS), the six-minute walk test, knee range of motion and activity level. High resolution magnetic resonance imaging (MRI) was undertaken at 3, 12 and 24 months post-surgery. A significant effect (p<0.05) for time existed for all clinical measures, demonstrating improvement up until 24 months in both groups. A significant interaction effect (p<0.05) existed for pain severity and the six-minute walk test, with accelerated group patients reporting significantly less severe pain and demonstrating superior six-minute walk distance over the period. While there was a significant group effect (p<0.05) for maximal active knee extension range in favor of the accelerated regime, no further significant differences existed. Both groups significantly improved (p<0.05) in an MRI composite score and pertinent descriptors of graft repair throughout the post-operative timeline, up until 24 months post-surgery, while there were no differences (p>0.05) observed between the two groups. The ‘accelerated’ WB approach was not detrimental to graft development at any stage throughout the post-operative assessment timeline up until 24 months post-surgery, and may accelerate patient return to normal function, whilst reducing post-operative muscle loss, intra-articular adhesions and associated gait abnormalities." @default.
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• W2018171219 date "2011-10-01" @default.
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• W2018171219 title "Paper # 159: A Randomized Comparison of Traditional and Accelerated Approaches to Post-operative Rehabilitation following Matrix-induced Autologous Chondrocyte Implantation (MACI)" @default.
• W2018171219 doi "https://doi.org/10.1016/j.arthro.2011.08.159" @default.
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