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I am having a cartilage transfer operation for my knee. A piece of cartilage has pulled clear away from the bone leaving a hole that won't heal. The surgeon is going to take some of the good cartilage out of the joint, use it to grow more normal cartilage, and put it back in the hole to help it heal. What's the rehab like for something like this?

For optimal healing, tissue must be protected and shouldn't be overloaded. This is very important after autologous chondrocyte implantation (ACI). Ideally, you would see a physical therapist before surgery to practice muscle contractions and weight-bearing loads. This is helpful since you will be progressing after surgery through a gradual increase in how much weight you can put on the joint. And it can be difficult to gauge how much weight is acceptable. There could be many other factors affecting the success of accurate weight-bearing. The role of pain, swelling, and muscle weakness may affect your ability to stand and move easily without putting too much weight on the joint. Mental state and physical fragility after surgery must also be taken into consideration. It does seem to help to use a forearm crutch (sometimes two crutches) at lower levels of allowed weight-bearing. The added weight is offloaded onto the arms. You can expect a five-to-eight week period of time during which you will gradually increase the amount of load until you are weight bearing fully on that leg. Muscle strengthening and training to improve motor control will be started during that time. Special exercises to restore normal joint proprioception (sense of position) will also be included.

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