Patel Snehal, Marrone William
Sports Rehabilitation Center Hospital for Special Surgery.
Int J Sports Phys Ther. 2023 Jun 1;V18(3):551-557. doi: 10.26603/001c.77508. eCollection 2023.
Rehabilitation after knee cartilage repair or restoration can be a challenging and nuanced process. Historically, conservative rehabilitation protocols have been characterized by limited weightbearing and restricted range of motion (ROM) were created to primarily protect the repaired cartilage but did little for progression into higher level activity. Recent literature has supported accelerated protocols in a variety of cartilage procedures ranging from osteochondral allograft (OCA) Osteochondral autograft surgery (OATS) to matrix-based scaffolding procedures such as Matrix Induced Chondrocyte Implantation (MACI) or Denovo procedures. Advances in technology such as blood flow restriction (BFR) and testing equipment with progressive rehabilitation from the acute phase through the return to sport continuum have made it possible to return to a higher level of activity and performance than first thought of for these procedures. This clinical viewpoint discusses the evolution of knee cartilage rehabilitation characterized by early but progressive weightbearing and early ROM while maintaining early homeostasis in the knee, and then its progression to return to sport and performance in the higher-level athlete.
V.
膝关节软骨修复或重建后的康复可能是一个具有挑战性且微妙的过程。从历史上看，保守的康复方案的特点是负重受限和活动范围（ROM）受限，其目的主要是保护修复的软骨，但对向更高水平活动的进展作用不大。最近的文献支持在从骨软骨异体移植（OCA）、骨软骨自体移植手术（OATS）到基于基质的支架手术（如基质诱导软骨细胞植入术（MACI）或Denovo手术）等各种软骨手术中采用加速方案。诸如血流限制（BFR）等技术的进步以及从急性期到恢复运动连续过程的渐进性康复测试设备，使得这些手术能够比最初设想的恢复到更高水平的活动和表现成为可能。本临床观点讨论了膝关节软骨康复的演变，其特点是早期但渐进性的负重和早期的ROM，同时保持膝关节的早期内环境稳定，然后进展到在高水平运动员中恢复运动和表现。
V。
