Recovery from Knee Cartilage Restoration Surgery

There are two procedures: MACI – Matrix induced autologous Chondrocyte Implantation and Osteochondral Allografts.

Recovery from the MACI procedure

Matrix-induced autologous chondrocyte implantation (MACI) is an advanced surgical technique used for the repair of cartilage defects in the knee. It involves harvesting chondrocytes (cartilage cells) from the patient, culturing them in a laboratory to increase their numbers, and then implanting them back into the defect area within a special collagen matrix. The recovery process from MACI is purposefully stepwise and involves several stages:

1. Immediate Post-Operative Phase in the first few weeks – Pain management with medications, laser therapy, and cryotherapy (the application of ice). Weight-bearing may be restricted with crutches depending on the location of the cartilage defect; a knee brace will be utilized to protect the implant.  Early rehabilitation focuses on maintaining range of motion, and gentle exercises to prevent stiffness.
2. Early Rehabilitation (First 3 months) – Physical therapy focuses on restoring knee mobility, strengthening the muscles around the knee, and improving proprioception (sense of joint position).
3. Intermediate Rehabilitation (3-6 months) – This phase is focused on more advanced exercises to enhance strength and flexibility. Patients must avoid high-impact activities that may jeopardize the healing graft.
4. Late Rehabilitation and Return to Activity (6-12 months) – Now the focus is on returning to pre-injury levels of activity and when applicable, a gradual and structured return to sports-specific activities, starting with low-impact exercises and progressing to higher-impact activities as tolerated.

Full recovery from MACI can take anywhere from 6 to 12 months. The exact timeline varies based on the size and location of the cartilage defect, the patient’s overall health, adherence to rehabilitation protocols, and individual healing rates.

Recovery from Osteochondral Allografts

Osteochondral allograft transplantation is a surgical procedure used to treat large cartilage defects in the knee, often resulting from injury or degenerative joint diseases. This technique involves transplanting a piece of bone and cartilage from a donor (allograft) into the damaged area of the knee. The recovery process from osteochondral allograft transplantation is complex and can be broken down into several stages:

1. Immediate Post-Operative Phase (First Few Weeks) – Pain management with medications, laser therapy, and cryotherapy (the application of ice). The knee is immobilized with a brace to protect the graft. Weight-bearing may be restricted with crutches depending on the location of the cartilage defect; a knee brace will be utilized to protect the implant.
2. Early Rehabilitation Phase (First 3 Months) – Physical therapy focuses on restoring knee mobility, strengthening the muscles around the knee, and improving proprioception (sense of joint position).
3. Intermediate Phase (3-6 Months) – This phase is focused on more advanced exercises to enhance strength and flexibility. Patients must avoid high-impact activities that may jeopardize the healing graft.
4. Late Rehabilitation and Return to Activity (6-12 Months) – The focus is on enhancing knee strength and leg conditioning. Depending on the patient’s progress, they may start low-impact sports and gradually progress to more demanding activities.

The full recovery process can take anywhere from 6 to 12 months or longer, depending on various factors. Returning to high-impact sports or heavy physical labor might take over a year.

It’s important to remember that recovery from osteochondral allograft transplantation is highly individualized. The rate of graft incorporation and overall recovery can vary significantly from patient to patient. Regular follow-up with healthcare providers and a commitment to rehabilitation are vital for a successful outcome.

Dr. Ronak Patel is a double board-certified orthopedic surgeon and sports medicine physician. He specializes in the treatment of complex knee injuries. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life work. He serves teens and adults in Chicagoland and NW Indiana.