AANA Lab Course 913 - Advanced Knee Course-Rehab and Return to Sport Timelines Following Cartilage Surgery Faculty Lecture

Rehab and Return to Sport Timelines Following Cartilage Surgery Faculty Lecture_ Mary K. Mulcahey, MD

Pdf Summary

This presentation by Dr. Mary K. Mulcahey addresses rehabilitation and return-to-sport (RTS) timelines following cartilage surgery in athletes. Key principles include individualized rehab protocols based on patient factors (age, BMI, health), lesion characteristics (location, size, depth, containment), and surgery type (e.g., ACI, osteochondral allograft, microfracture). Rehabilitation progresses through four biological cartilage maturation phases: proliferation (0-6 weeks post-op with protection and controlled motion), transitional (4-12 weeks with gradual weightbearing and strengthening), remodeling (3-6 months with moderate-impact activities), and maturation (4-18 months with gradual return to sport).<br /><br />Specific post-op protocols differ by procedure. Debridement allows early weightbearing and moderate activity by 4 weeks; microfracture requires 6 weeks non-weightbearing, gradual progression to full activity by 3-4 months; mosaicplasty/OATS involve partial weightbearing early and full return around 12 weeks; osteochondral allograft uses a slower regimen with protected weightbearing up to 6-8 weeks and return to activity up to 6-12 months; MACI entails non-weightbearing initially, progressive motion, and return to running/jumping between 6-12 months.<br /><br />Return-to-sport rates vary: overall cartilage restoration RTS is ~76% at mid-term follow-up, highest with OAT (~93%), followed by osteochondral allograft (~88%), ACI (~82%), and microfracture (~58%). Time to RTS ranges from 5 months for OAT to 11-12 months for ACI. Studies of athletes indicate 54-80% return to previous levels, with some social factors (e.g., graduation) affecting return.<br /><br />Low-to-moderate impact sports may resume by 6-8 months, higher-impact activities take longer (~12-18 months). Rehabilitation and RTS timelines must be customized based on lesion, patient, and sport demands. Despite challenges, structured rehab can enable many athletes to successfully resume sports post cartilage surgery.

Keywords

cartilage surgery

rehabilitation protocols

return to sport

athlete recovery

microfracture

osteochondral allograft

ACI (autologous chondrocyte implantation)

mosaicplasty/OATS

postoperative timelines

cartilage maturation phases