Accelerated rehabilitation following opena nd arthroscopic matrix-induced autologous chondrocyte implantation (MACI)

[Truncated abstract] Articular, or hyaline cartilage, possesses unique properties that help protect joints from the harsh load bearing and movement demands of daily activity. However, the incidence of concurrent injury to human articular cartilage remains extremely common with the knee being the most common injury site, and it is well known that once traumatic cartilage injury does occur, it is unable to regenerate the same hyaline matrix. Without the ability to regenerate this biomechanically favourable hyaline cartilage, knee function will progressively deteriorate, subsequently leading to end-stage osteoarthritis (OA). Although a number of cartilage repair techniques have been proposed to address this issue, none produces a repair tissue with the same biomechanical characteristics as hyaline cartilage. The development of cell regenerative therapies such as autologous chondrocyte implantation has proven a successful method in treating these chondral defects. Although cell culturing and surgical procedures for ACI continue to improve, rehabilitation remains conservative, and best patient (and graft) outcome seems limited by a lack of knowledge regarding how to progressively increase weight bearing (WB) post-surgery and what are the best adjunct rehabilitation exercises. Nonetheless, most surgeons and therapists agree that post-operative rehabilitation is crucial in achieving optimal patient outcomes. While the current post-operative WB progression and exercise rehabilitation regime followed by patients who undergo ACI has been formulated on opinion, it has also been based on early ACI surgical techniques. Matrixinduced ACI (MACI) is the third and current generation of ACI, removing a number of debilitating side effects associated with earlier forms of the surgical procedure.