Rehabilitation before regenerative cartilage knee surgery : a new prehabilitation guideline based on the best available evidence

Hirschmüller, Anja; Schoch, Wolfgang; Baur, Heiner; Wondrasch, Barbara; Konstantinidis, Lukas; Sudkamp, Nobert P.; Niemeyer, Philipp (2019). Rehabilitation before regenerative cartilage knee surgery : a new prehabilitation guideline based on the best available evidence Archives of Orthopaedic and Trauma Surgery, 139(2), pp. 217-230. Springer 10.1007/s00402-018-3026-6

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Introduction Focal cartilage defects are an increasingly relevant clinical problem especially in athletes. Cartilage regenerative surgery (CRS) including microfracture and autologous chondrocyte implantation (ACI) to treat such isolated cartilage defects in the knee joint has been well established in the last two decades. In contradiction to high-level evidence concerning the surgical technique, cell-related issues, and clinical results, the knowledge about the optimal rehabilitation process is still sparse although the importance of optimizing the rehabilitation process has recently led to new research focus in this field. The preoperative time frame may be used to start rehabilitation which may fasten the postoperative recovery and optimize clinical outcome (“Prehabilitation”—PREHAB). The aim of this article, therefore, was to review the available literature on prehabilitation concepts and to present a prehabilitation guideline for CRS patients based on the best evidence available. Methods A systemic literature research was conducted on rehabilitation for cartilage regenerative surgery as well as prehabilitation in knee joint procedures. From the available literature a prehabilitation concept was generated and tested in 10 ACI patients. Results As the literature search found no studies addressing prehabilitation in CRS patients, an evidence-based PREHAB program has been compiled based on the available evidence from (a) studies addressing postoperative rehabilitation in CRS patients and (b) PREHAB studies on other knee procedures including TKA. This presented prehabilitation guideline has been tested in > 50 CRS patients and was found to be feasible as all of the patients showed a good compliance and were able to perform the protocol as suggested. Conclusion The presented PREHAB regimen may serve clinicians as a guideline for early rehabilitation of their CRS patients. Obviously, further research is mandatory to quantify its clinical effect and to demonstrate its cost-effectiveness and benefits in surgically treated patients. Keywords Knee injuries Knee osteoarthritis Articular cartilage Rehabilitation Resistance training

Item Type:	Journal Article (Original Article)
Division/Institute:	School of Health Professions School of Health Professions > Physiotherapy School of Health Professions > Physiotherapy > Neuromuscular Control
Name:	Hirschmüller, Anja; Schoch, Wolfgang; Baur, Heiner0000-0002-4780-225X; Wondrasch, Barbara; Konstantinidis, Lukas; Sudkamp, Nobert P. and Niemeyer, Philipp
ISSN:	1434-3916
Publisher:	Springer
Language:	English
Submitter:	Service Account
Date Deposited:	13 Nov 2019 11:13
Last Modified:	16 Aug 2023 11:19
Publisher DOI:	10.1007/s00402-018-3026-6
ARBOR DOI:	10.24451/arbor.6776
URI:	https://arbor.bfh.ch/id/eprint/6776