Rehabilitation: Overview

Articular Cartilage Rehabilitation

Rehabilitation needs to take into account the underlying biological healing process of the new articular cartilage combined with the concept of protecting the repaired tissue while simultaneously trying to first maintain, and then improve, general function.

The main phases are as follows:

1. Preoperative phase: Reduction of joint inflammation.

  • Optimising the knee – re-establishing Joint Homeostasis (no swelling or pain).
  • Prevention of excessive loads on the joint surface

2. 0 – 6 weeks post surgery: Protection of graft. Reducing post-surgery joint inflammation and promotion cell proliferation.

  • Range of movement exercises without shear forces on the graft
  • Reduction of swelling. Re-establishment of joint homeostasis

3. 4 – 12 weeks post surgery: Cell differentiation and start of maturation phase.

  • Regain muscle control and normal gait
  • Strength within safe range, again avoiding shear forces on the graft

4. 10 – 26 weeks post surgery: Continuing cell differentiation, formation of tissue and maturation.

  • Low load activities to promote fitness
  • Rowing and cycling exercises are probably the best

5. 5 – 9 months post surgery: Tissue formation and maturation.

  • Increase muscle control Isometric control under high load
  • Eccentric exercise, keeping high impact within safe zones

6. 9 – 12 months post-surgery: Tissue formation and maturation.

  • Introduction of sports specific exercises
  • No high impact sports

7. >12 months post-surgery: Maturation.

  • Sport-specific exercises and low impact sports.


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