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Radiological Assessment of Accelerated versus Traditional Approaches to Postoperative Rehabilitation following Matrix-Induced Autologous Chondrocyte Implantation.

Ebert JR, Fallon M, Robertson WB, Lloyd DG, Zheng MH, Wood DJ, Ackland T - Cartilage (2011)

Bottom Line: Both groups significantly improved (P < 0.05) in the MRI composite score and pertinent descriptors of graft repair throughout the postoperative period until 24 months postsurgery.Patient age, body mass index, chondral defect size, and duration of preoperative symptoms were significantly correlated (P < 0.05) with several MRI-based outcomes at 24 months, whereas there were no significant pertinent correlations (P > 0.05) observed between clinical and MRI-based outcomes.The accelerated WB approach was not detrimental to graft development at any stage throughout the postoperative assessment timeline from baseline to 24 months postsurgery and may potentially accelerate patient return to normal function, while reducing postoperative muscle loss, intra-articular adhesions, and associated gait abnormalities.

View Article: PubMed Central - PubMed

Affiliation: School of Sport Science, Exercise and Health, University of Western Australia, Crawley, Perth, Western Australia.

ABSTRACT

Objective: To assess the safety and efficacy of accelerated compared with traditional postoperative weightbearing (WB) rehabilitation following matrix-induced autologous chondrocyte implantation (MACI) of the knee, using MRI.

Methods: A randomized controlled study design was used to assess MRI-based outcomes of MACI grafts in 70 patients (45 men, 25 women) who underwent MACI to the medial or lateral femoral condyle, in combination with either traditional or accelerated approaches to postoperative WB rehabilitation. High-resolution MRI was undertaken and assessed 8 previously defined pertinent parameters of graft repair, as well as a combined MRI composite score at 3, 12, and 24 months postsurgery. The association between clinical and MRI-based outcomes, patient demographics, chondral defect parameters, and injury/surgery history was investigated.

Results: Both groups significantly improved (P < 0.05) in the MRI composite score and pertinent descriptors of graft repair throughout the postoperative period until 24 months postsurgery. There were no differences (P > 0.05) observed between the 2 groups. Patient age, body mass index, chondral defect size, and duration of preoperative symptoms were significantly correlated (P < 0.05) with several MRI-based outcomes at 24 months, whereas there were no significant pertinent correlations (P > 0.05) observed between clinical and MRI-based outcomes.

Conclusion: The accelerated WB approach was not detrimental to graft development at any stage throughout the postoperative assessment timeline from baseline to 24 months postsurgery and may potentially accelerate patient return to normal function, while reducing postoperative muscle loss, intra-articular adhesions, and associated gait abnormalities.

No MeSH data available.


Related in: MedlinePlus

Change in the MRI composite score over time for the accelerated and traditional patient groups, throughout the postoperative timeline.
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fig2-1947603510380902: Change in the MRI composite score over time for the accelerated and traditional patient groups, throughout the postoperative timeline.

Mentions: Both rehabilitation groups demonstrated an increased MRI composite score over time that significantly improved (P < 0.0001) from 3 to 24 months postsurgery (Figs. 2 and 3; Table 6). Although a minor fall (not significant) in the MRI composite score was observed between 12 and 24 months, the 24-month outcome still rated significantly better (P < 0.05) than 3 months postsurgery (Fig. 2). There was no significant group or interaction effect (P > 0.05) for the MRI composite score over time. With regard to the 8 individual MRI scoring parameters, a significant time effect (P < 0.05) was observed for signal intensity, graft infill, subchondral lamina, subchondral bone, and effusion, although there were no significant group or interaction effects (P > 0.05) for all variables (Table 6).


Radiological Assessment of Accelerated versus Traditional Approaches to Postoperative Rehabilitation following Matrix-Induced Autologous Chondrocyte Implantation.

Ebert JR, Fallon M, Robertson WB, Lloyd DG, Zheng MH, Wood DJ, Ackland T - Cartilage (2011)

Change in the MRI composite score over time for the accelerated and traditional patient groups, throughout the postoperative timeline.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4300786&req=5

fig2-1947603510380902: Change in the MRI composite score over time for the accelerated and traditional patient groups, throughout the postoperative timeline.
Mentions: Both rehabilitation groups demonstrated an increased MRI composite score over time that significantly improved (P < 0.0001) from 3 to 24 months postsurgery (Figs. 2 and 3; Table 6). Although a minor fall (not significant) in the MRI composite score was observed between 12 and 24 months, the 24-month outcome still rated significantly better (P < 0.05) than 3 months postsurgery (Fig. 2). There was no significant group or interaction effect (P > 0.05) for the MRI composite score over time. With regard to the 8 individual MRI scoring parameters, a significant time effect (P < 0.05) was observed for signal intensity, graft infill, subchondral lamina, subchondral bone, and effusion, although there were no significant group or interaction effects (P > 0.05) for all variables (Table 6).

Bottom Line: Both groups significantly improved (P < 0.05) in the MRI composite score and pertinent descriptors of graft repair throughout the postoperative period until 24 months postsurgery.Patient age, body mass index, chondral defect size, and duration of preoperative symptoms were significantly correlated (P < 0.05) with several MRI-based outcomes at 24 months, whereas there were no significant pertinent correlations (P > 0.05) observed between clinical and MRI-based outcomes.The accelerated WB approach was not detrimental to graft development at any stage throughout the postoperative assessment timeline from baseline to 24 months postsurgery and may potentially accelerate patient return to normal function, while reducing postoperative muscle loss, intra-articular adhesions, and associated gait abnormalities.

View Article: PubMed Central - PubMed

Affiliation: School of Sport Science, Exercise and Health, University of Western Australia, Crawley, Perth, Western Australia.

ABSTRACT

Objective: To assess the safety and efficacy of accelerated compared with traditional postoperative weightbearing (WB) rehabilitation following matrix-induced autologous chondrocyte implantation (MACI) of the knee, using MRI.

Methods: A randomized controlled study design was used to assess MRI-based outcomes of MACI grafts in 70 patients (45 men, 25 women) who underwent MACI to the medial or lateral femoral condyle, in combination with either traditional or accelerated approaches to postoperative WB rehabilitation. High-resolution MRI was undertaken and assessed 8 previously defined pertinent parameters of graft repair, as well as a combined MRI composite score at 3, 12, and 24 months postsurgery. The association between clinical and MRI-based outcomes, patient demographics, chondral defect parameters, and injury/surgery history was investigated.

Results: Both groups significantly improved (P < 0.05) in the MRI composite score and pertinent descriptors of graft repair throughout the postoperative period until 24 months postsurgery. There were no differences (P > 0.05) observed between the 2 groups. Patient age, body mass index, chondral defect size, and duration of preoperative symptoms were significantly correlated (P < 0.05) with several MRI-based outcomes at 24 months, whereas there were no significant pertinent correlations (P > 0.05) observed between clinical and MRI-based outcomes.

Conclusion: The accelerated WB approach was not detrimental to graft development at any stage throughout the postoperative assessment timeline from baseline to 24 months postsurgery and may potentially accelerate patient return to normal function, while reducing postoperative muscle loss, intra-articular adhesions, and associated gait abnormalities.

No MeSH data available.


Related in: MedlinePlus