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Cartilage Repair Rehabilitation - Maximizing Recovery and Function

This article explores the maturation of cartilage repair and the importance of delivering a comprehensive rehabilitation program that promotes durable repair tissue and facilitates a return to optimal function while minimizing the risk of re-injury or long-term health problems. It highlights the factors influencing rehabilitation outcomes and the need for better knowledge translation in the field.

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Cartilage Repair Rehabilitation - Maximizing Recovery and Function

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  1. CARTILAGE REPAIR REHABILITATION - INTO PRACTICE Karen Hambly K.Hambly@kent.ac.uk School of Sport & Exercise Sciences University of Kent

  2. MATURATION OF CARTILAGE Days Weeks Months Years

  3. REHAB GOALS • Deliver a rehab programme that ... • ... provides the best environment to produce a durable repair tissue • ... enables the person to return to their optimal level of function in shortest time • … whilst minimising risk of re-injury or future long term health problems

  4. REHABILITATION KNOWLEDGE IS BEING CREATED

  5. Cartilage 2010, 1(4): 312-319 “The present study suggests that results from published RCTs may not be representative of the gross cartilage population”

  6. DEFECT & SURGERY • Type of repair • Number of defects • Size of defect(s) • Location of defect(s) • Concomitant procedures • Cartilage quality

  7. Age • Type & level of sport • Gender • Body mass index • Duration of symptoms • Baseline condition • Self-efficacy • Motivation • Social support • General health INDIVIDUAL FACTORS Mithoefer K, Hambly K, Logerstedt D, Ricci M, Silvers H, Della Villa S. Current concepts for rehabilitation and return to sport after knee articular cartilage repair in the athlete. J Orthop Sports Phys Ther 2012; 42: 254-273.

  8. “One of our consultants is now ready to perform the MACI cartilage repair–we would therefore value your thoughts on the rehab principles” Outpatient Lead Physiotherapist “Fortunately, this is our first experience of a player sustaining an articular cartilage injury for quite some time but this has meant we have had to do quite a bit of research in order to devise the most appropriate rehabilitation programme.” Physio - Premier Football Club “How do we get the message out to those undertaking rehab about loading on joint surfaces? There is data out there but not recognised it seems.” Specialist Knee Surgeon

  9. LESSONS LEARNED (SO FAR!) • Knowledge translation & mobilisation requires - • Interdisciplinary collaboration • Partnerships with researchers & knowledge users • Varied approaches to research dissemination • Time and resources to initiate & maintain • Planning & more recognition e.g. in REF • Doing the research & publishing is the easy bit!

  10. Thank you K.Hambly@kent.ac.uk

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