Importance of Sports in Cartilage Regeneration after Autologous Chondrocyte Implantation

Kreuz, Peter; Steinwachs, Matthias; Erggelet, Christoph; Lahm, A.; Krause, Sonja; Ossendorf, Christian; Meier, Dirk; Ghanem, Nadir; Uhl, Markus

doi:10.1177/0363546507300693

Cited by 103 publications

(60 citation statements)

References 51 publications

(50 reference statements)

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“…119 Postoperative participation in sports improved the long-term functional results after ACI. 32,86,180 The timing of return to sports varies from 7 to 18 months, depending on the surgical technique. Average time to return to sport was longest for ACI (18-25 months) and shortest for OATS (6.5-7 months).…”

Section: Return To Sport After Knee Articular Cartilage Repairmentioning

confidence: 99%

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Mithoefer¹,

Hambly²,

Logerstedt³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

106

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Synopsis Articular cartilage injury is observed with increasing frequency in both elite and amateur athletes and results from the significant acute and chronic joint stress associated with impact sports. Left untreated, articular cartilage defects can lead to chronic joint degeneration and athletic and functional disability. Treatment of articular cartilage defects in the athletic population presents a therapeutic challenge due to the high mechanical demands of athletic activity. Several articular cartilage repair techniques have been shown to successfully restore articular cartilage surfaces and allow athletes to return to high-impact sports. Postoperative rehabilitation is a critical component of the treatment process for athletic articular cartilage injury and should take into consideration the biology of the cartilage repair technique, cartilage defect characteristics, and each athlete's sport-specific demands to optimize functional outcome. Systematic, stepwise rehabilitation with criteria-based progression is recommended for an individualized rehabilitation of each athlete not only to achieve initial return to sport at the preinjury level but also to continue sports participation and reduce risk for reinjury or joint degeneration under the high mechanical demands of athletic activity. J Orthop Sports Phys Ther 2012;42(3):254–273. doi:10.2519/jospt.2012.3665

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Section: Return To Sport After Knee Articular Cartilage Repairmentioning

confidence: 99%

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Mithoefer¹,

Hambly²,

Logerstedt³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

106

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“…41 The creation of stable vertical walls allows for easy placement of a synthetic patch over the lesion site (an off-label use of the Bio-Gide [Geistlich Biomaterials, Wolhusen, Switzerland], which has not been approved by the US Food and Drug Administration for cartilage repair, though many like it are on the market and used with indication for tendon reconstruction). 34 The patch is then carefully sewn into place and sealed using fibrin glue (FIGURE 4). A small opening toward the top of the patch is utilized to inject the cultured chondrocytes.…”

Section: Restorative Technique: Autologous Chondrocyte Implantationmentioning

confidence: 99%

The Basic Science and Surgical Treatment Options for Articular Cartilage Injuries of the Knee

Tetteh¹,

Bajaj²,

Ghodadra³

2012

Journal of Orthopaedic & Sports Physical Therapy

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Synopsis The complex structure of articular cartilage allows for diverse knee function throughout range of motion and weight bearing. However, disruption to the structural integrity of the articular surface can cause significant morbidity. Due to an inherently poor regenerative capacity, articular cartilage defects present a treatment challenge for physicians and therapists. For many patients, a trial of nonsurgical treatment options is paramount prior to surgical intervention. In instances of failed conservative treatment, patients can undergo an array of palliative, restorative, or reparative surgical procedures to treat these lesions. Palliative methods include debridement and lavage, while restorative techniques include marrow stimulation. For larger lesions involving subchondral bone, reparative procedures such as osteochondral grafting or autologous chondrocyte implantation are considered. Clinical success not only depends on the surgical techniques but also requires strict adherence to rehabilitation guidelines. The purpose of this article is to review the basic science of articular cartilage and to provide an overview of the procedures currently performed at our institution for patients presenting with symptomatic cartilage lesions. J Orthop Sports Phys Ther 2012;42(3):243–253. doi:10.2519/jospt.2012.3673

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“…Note that it was not only the selection of study time points that varied but also the range in data-collection times about those points, which in some instances was up to 5 years. 41,44 However, the majority of the studies did not report these range values. These inconsistences in reporting are pertinent to rehabilitation, as it is a time-based process.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the studies reported multiple assessments with a mean follow-up of 38.6 months. Four studies 33,34,37,39,41 reported mean followup periods of 5 years, 1 study 30 reported 7.5 years, and another study, 28 10 years. However, the majority of the studies only reported mean assessment time and did not report the minimum and maximum assessment time.…”

Section: Data Synthesismentioning

confidence: 99%

“…Where studies did report the range of time scales about the mean assessment time, a wide range of variation was found. 25,27,41,43,44 The self-report physical activity and sports participation instruments used in these studies were the Tegner Activity Scale (TAS), the Modified Baecke Questionnaire, and the Activity Rating Scale. The knee-specific instruments used were Lysholm Knee Function Scale, the International Knee documentation Committee Score (IKDC) Subjective Form, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Modified Cincinnati Knee Score, and the StanmoreBentley Functional Score; the only general health questionnaire applied was the Short Form-36 Health Survey.…”

Section: Data Synthesismentioning

confidence: 99%

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Measuring Physical Activity and Sports Participation After Autologous Cartilage Implantation: A Systematic Review

Santos-Magalhaes¹,

Hambly²

2014

Journal of Sport Rehabilitation

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Context:The assessment of physical activity and return to sport and exercise activities is an important component in the overall evaluation of outcome after autologous cartilage implantation (ACI). Objective: To identify the patient-report instruments that are commonly used in the evaluation of physical activity and return to sport after ACI and provide a critical analysis of these instruments from a rehabilitative perspective. Evidence Acquisition: A computerized search was performed in January 2013 and repeated in March 2013. Criteria for inclusion required that studies (1) be written in English and published between 1994 and 2013; (2) be clinical studies where knee ACI cartilage repair was the primary treatment, or comparison studies between ACI and other techniques or between different ACI generations; (3) report postoperative physical activity and sport participation outcomes results, and (4) have evidence level of I-III. Evidence Synthesis: Twenty-six studies fulfilled the inclusion criteria. Three physical activity scales were identified: the Tegner Activity Scale, Modified Baecke Questionnaire, and Activity Rating Scale. Five knee-specific instruments were identified: the Lysholm Knee Function Scale, International Knee Documentation Committee Score Subjective Form, Knee Injury and Osteoarthritis Outcome Score, Modified Cincinnati Knee Score, and Stanmore-Bentley Functional Score. Conclusions: Considerable heterogeneity exists in the reporting of physical activity and sports participation after ACI. Current instruments do not fulfill the rehabilitative needs in the evaluation of physical activity and sports participation. The validated instruments fail in the assessment of frequency, intensity, and duration of sports participation.

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Importance of Sports in Cartilage Regeneration after Autologous Chondrocyte Implantation

Abstract: Physical training improves long-term results after autologous chondrocyte implantation of the knee and should be carried out for at least 2 years after surgery.

Cited by 103 publications

References 51 publications

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

Current Concepts for Rehabilitation and Return to Sport After Knee Articular Cartilage Repair in the Athlete

The Basic Science and Surgical Treatment Options for Articular Cartilage Injuries of the Knee

Measuring Physical Activity and Sports Participation After Autologous Cartilage Implantation: A Systematic Review

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