Article

The major aim of the study was (1) to compare the physiotherapy
management in patients treated with autologous chondrocyte implantation (ACI)
versus microfracture (MF) at the knee using a standardized rehabilitation
protocol; and (2) to investigate the effect of activities in low-load conditions
after surgery on the functional recovery was explored. Design: 95
physiotherapists received a standardized rehabilitation protocol that was used in
a randomized controlled trial. A secondary analysis on patients' outcome was
studied in a cohort design. Outcome measures: An electronic report form including
18 physiotherapy variables was used to compare physiotherapy management.
Patients' functional outcome was assessed using the KOOS (Knee Injury
Osteoarthritis Outcome Score) and the pooled symmetry index (SI) based on one
strength and three hop tests. Both subjective and objective outcomes were
evaluated pre-surgery, and at 1 and 2 years post-surgery. Results: 65
physiotherapists adhered very consistently to the protocol during the first 3
months and showed a similar preference and timing for the physiotherapy
modalities in both treatment groups. Patients with high amount of low-load
activities (LLA+, n=21) post-surgery performed significantly better compared to
patients with low amount of LLA (LLA?, n=17). At 24 months the mean pooled SI of
LLA+ cohort was 92.4 compared to 78.2 for LLA? cohort (95% confidence interval
[CI] 1.8 to 26.2). Conclusion: Overall, the compliance post-surgery with the
rehabilitation protocol was excellent and the applied rehabilitation was
comparable in both treatment groups. A high amount of low-load activities
post-surgery appears beneficial for the objective functional outcome.

Langue : ANGLAIS