Cartilage repair rehabilitation chart

In any cartilage repair, postoperative management is critical to ensure optimal results; such management includes a careful return to weight-bearing activities. The rehabilitation guidelines for 4 different repair procedures each recommend the patient return to full weight-bearing activity at approximately 8 weeks. 

 


CARTICEL1
(autologous cultured chondrocytes)


 

Microfracture1

Osteochondral Autograft1

Allograft2

CPM

 

begin post-operative
8-12 hours on day 1;
6-8 hours/day
up to 6 weeks

begin post-operative
8-12 hours on day 1; 6-8 hours/day
up to 6 weeks

begin post-operative
8-12 hours on day 1; 6-8 hours/day
up to 6 weeks

not specified

Non-Weight Bearing

weeks 1-2

weeks 0-2

weeks 2-4

weeks 6-12

Partial Weight Bearing


weeks 2-8

weeks 0-4

weeks 3-7

weeks 8-16

Full Weight Bearing

by week 6-9

weeks 4-8

weeks 8-14

weeks 12-16

Low Impact Sports

at 6 months

2-3 months

6-8 months

at 6 months

Higher Impact Sports
(running, aerobics)

at 8-12 months

4-5 months

8-10 months

not specified

High Impact Pivotal Sports

at 12-18 months

6-8 months

12-18 months

6 months

1. Reinold MM, et al. Journal of Orthopaedic and Sports Physical Therapy. vol 36. no 10. October 2006: 715-833.
2. Cole BJ, Malek MM. Articular Cartilage Lesions: A Practical Guide to Assessment and Treatment. 2004: 89-90.

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Important Safety Information

CARTICEL is for autologous use and is indicated for the repair of symptomatic, cartilage defects of the femoral condyle (medial, lateral or trochlea), caused by acute or repetitive trauma, in patients who have had an inadequate response to a prior arthroscopic or other surgical repair procedure (e.g., debridement, microfracture, drilling/abrasion arthroplasty, or osteochondral allograft/autograft). CARTICEL should only be used in conjunction with debridement, placement of a periosteal flap and rehabilitation. The independent contributions of the autologous cultured chondrocytes and other components of the therapy to outcome are unknown. It is not indicated for the treatment of cartilage damage associated with generalized osteoarthritis. It is not recommended for patients whose knee meniscus has been surgically removed unless the patient has undergone surgical reconstruction prior to or concurrent with CARTICEL implantation.

Pre-existing conditions including meniscal tears, joint instability or malalignment of the joint should be corrected prior to or concurrent with CARTICEL implantation. It should not be used in patients with a known history of hypersensitivity to gentamicin, other aminoglycosides or materials of bovine origin. CARTICEL is not routinely tested for transmissible infectious diseases and may transmit disease to the healthcare provider handling CARTICEL. In addition, it should not be used in patients who have previously had cancer in the bones, cartilage, fat or muscle of the treated limb. Use in children, patients over age 65, or in joints other than the knee has not yet been assessed.

The occurrence of subsequent surgical procedures (SSPs), primarily arthroscopy, following CARTICEL implantation is common. In the Study of the Treatment of Articular Repair (STAR), forty-nine percent (49%) of patients underwent an SSP on the treated knee, irrespective of their relationship to CARTICEL, during the 4-year follow up. The most common serious adverse events (≥5% of patients), derived from STAR, include arthrofibrosis/joint adhesions, graft overgrowth, chondromalacia or chondrosis, cartilage injury, graft complication, meniscal lesion, graft delamination, and osteoarthritis.

For more information on CARTICEL, please see the Package Insert (PDF).