ARTICULAR CARTILAGE REPAIR REHABILITATION - THE NEED FOR CONSENSUS

Articular cartilage defects are not life-threatening but they can, and frequently do, threaten a person's quality of life. The treatment of articular cartilage defects has undergone a rapid and exciting evolution in recent years, especially in the field of advanced cell-based orthobiologic technologies. Rehabilitation is widely considered an important component for successful outcome and it is pertinent that articular cartilage repair surgery has one of the longest rehabilitation processes in the field of elective orthopaedic surgery. However, there is considerable international variation in postoperative care and this presents a significant challenge to the physical therapist working with people who are considering having, or have undergone, articular cartilage repair procedures.

There is an urgent need for basic scientists, surgeons and physical therapists to adopt a coordinated approach to the development of a consensus on clinical guidelines for rehabilitation following articular cartilage repair procedures. Therapists working within specialist cartilage repair centres have an exciting and important opportunity to build and contribute to an evidence base for articular cartilage repair rehabilitation. An initial comparative analysis of rehabilitation parameters for eleven cartilage repair centres across the world has highlighted key areas of variation in clinical practice. There are important implications for the design and implementation of rehabilitation programmes. Until an evidence base for rehabilitation practice is available physical therapists will have to rely on underpinning knowledge of the surgical techniques and the process of chondrocyte maturation to inform clinical practice. The need for a consenus on clinical guidelines for rehabilitation following articular cartilage repair has been recognised and an international rehabilitation consensus meeting is planned for mid-2007.