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Return to Play After Knee Articular Cartilage Restoration: Surgical Options, Rehabilitation Protocols, and Performance Outcomes

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Abstract

Purpose of Review

Numerous cartilage restoration techniques have proven to be effective in the treatment of articular cartilage defects. The ultimate goal of these procedures is to improve pain and function, thereby increasing the likelihood of a patient’s return to physical activity. Postoperative rehabilitation is a key component for a successful and expedient return to activities. The purpose of this article is to review the current literature regarding common surgical options, rehabilitation protocols, and performance outcomes after operative treatment of articular cartilage defects.

Recent Findings

Studies have demonstrated improved short- to long-term outcomes in a majority of techniques. However, the clinical benefits of microfracture are short-lived, which has led to the use of alternative procedures. Rehabilitation protocols are not standardized, but emphasis has been placed on bracing, weightbearing, early continuous passive range of motion, and strengthening to improve function. There is growing evidence to suggest that accelerated rehabilitation after matrix-induced autologous chondrocyte implantation may result in superior outcomes compared to delayed rehabilitation. Overall, most techniques result in satisfactory rates of return to play, though existing comparative studies typically include patients with heterogeneous pathology, complicating effective synthesis of outcomes data.

Summary

In appropriately selected patients, cartilage restoration procedures after articular cartilage injury result in favorable patient-reported clinical outcomes and high rates of return to play. While studies emphasize the critical role that rehabilitation plays with respect to outcomes after surgery, there are substantial inconsistencies in protocols across techniques.

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  1. Department of Orthopedic Surgery, New York University Langone Health, 301 East 17th Street, New York, NY, 10016, USA

    Jairo Triana, Zachary I. Li, Naina Rao, Matthew T. Kingery & Eric J. Strauss

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Jairo Triana, Zachary I. Li, Naina Rao, and Matthew T. Kingery declare that they have no conflict of interest relevant to this article. Eric J. Strauss is a paid consultant to Subchondral Solutions and Vericel, and receives support from Cartiheal and Springer Publishing Company.

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Triana, J., Li, Z.I., Rao, N. et al. Return to Play After Knee Articular Cartilage Restoration: Surgical Options, Rehabilitation Protocols, and Performance Outcomes. Curr Rev Musculoskelet Med 16, 575–586 (2023). https://doi.org/10.1007/s12178-023-09872-w

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