This article is more than 5 years old. Information may no longer be current.
Accelerated approach to postoperative weightbearing safe, effective for patients who receive MACI
Click Here to Manage Email Alerts
Researchers have detailed a safe, effective accelerated rehabilitation protocol for patients who undergo matrix-induced autologous chondrocyte implantation, according to this study.
The researchers studied the clinical and radiological outcomes of 63 patients who underwent matrix-induced autologous chondrocyte implantation (MACI) in the medial or lateral femoral condyle. Patients received either an accelerated (31 patients) or traditional (32 patients) program with regard to postoperative weightbearing rehabilitation.
The accelerated protocol, according to the study abstract, involved patients reaching full weightbearing 8 weeks postoperatively. Patients in the traditional program reached full weightbearing 11 weeks postoperatively. Knee Injury and Osteoarthritis Outcome Score (KOOS), Short-Form Health Survey (SF-36), Visual Analog Scale (VAS), 6-minute walk test and knee range of motion were assessed preoperatively and at the 3-, 6-, 12- and 24-month postoperative marks, as well as 5 years.
According to the study results, VAS results revealed less frequent pain at the 5-year mark for patients in the accelerated group, with no other significant VAS differences between the accelerated and traditional groups. The sport and recreation subscale of KOOS revealed significant improvements in both groups between the 24-month and 5-year marks, as well as a decrease in active knee extension for the traditional group.
Further, the authors found no differences in MRI-based scores between the 24-month and 5-year marks.
“At 5 years after surgery, 94% and 95% were satisfied with the ability of MACI to relieve their knee pain and improve their ability to undertake daily activities, respectively,” the authors wrote.
Perspective
Back to TopMatthias Steinwachs, MD
How accelerated treatment influences clinical and radiological outcomes of matrix-induced autologous chondrocyte implantation (MACI) has been studied in a recently published level 1 study. Ebert and colleagues evaluated 63 patients in a randomized controlled trial with cartilage defects on the femoral condyle clinically using usual outcome scores and MRI with 5 years follow-up. After 5 years no significant differences in clinical outcomes and MRI results could be observed. More than 94% of patients were satisfied with the results.
The MACI technique is a safe and effective method. Good results can be achieved clinically and by MRI over 5 years. A shortened full weight bearing phase until the eighth postop week leads to equally good results. In most centers, an accelerated rehabilitation is already being implemented.
Collapse
Ebert JR. Am J Sports Med. 2012. doi: 10.1177/0363546512445167
Click Here to Manage Email Alerts