After MACI knee cartilage repair implantation has been completed, the road to recovery begins. With insight from Dr. Mike Essa, a physical therapist at Duke University, we gathered tips for planning a rehab program for your MACI patients.
Individualized Planning
As Dr. Essa likes to say: “rehab programs are not cookbooks — an individualized plan improves outcomes.” Individual factors like body weight, age, previous medical history, patient goals, and the individual’s operative note are essential to consider when developing any rehab plan and should be considered well-before the first physical therapy assessment.
Early Education and Goal Setting
Have an open and earnest conversation with patients about the MACI rehab timeline from the start of your consultations so patients know what to expect post-surgery. While MACI requires a 6–9-month rehab timeline to return to sport, patients will see incremental improvements throughout their recovery.
It is important to encourage patients to set small, attainable goals throughout their journey so they can observe their progress. A MACI patient who is solely focused on her long-term goal of her return to sprinting after surgery may become more frustrated than a patient who focuses on intermediary benchmarks like her ability to perform single leg balances by month three.
Emphasize Enjoyable Activities
Help patients find enjoyment and motivation during their recovery process by integrating the activities they love into rehab. For example, a soccer player might practice balance exercises on his involved leg while kicking a ball with his healthy leg. A basketball player might be encouraged to shoot free throws or work on her dribbling while balancing.
Adjust the Timeline
Because each patient heals at his or her own rate, rehab timelines will be unique to the individual. For example. sometimes range of motion or loading may be delayed because of increased swelling or pain, and you should adjust the patient’s rehab regimen to get the patient back on track. Likewise, patients who are exceeding expectations, particularly later in recovery, may be allowed to accelerate their activity.
Every patient is unique but there are certain benchmarks that signal a patient is ready to proceed to the next phase of activity:
- At 0-3 months: Full, pain-free range of motion (ROM), active knee hyper extension/SLR, minimal to no pain when walking without assistive devices.
- 3-6 months: Return to activities of daily living (prolonged walking, standing, stairs, low impact exercise), low to no pain with loaded strength training
- 6-9 months: Return to desired activity level (for lower impact activities) or jogging, hopping, low level agility exercises
- 9+ months: Return to unrestricted activity with minimal pain or swelling
My MACI App
Encourage patients to download the My MACI App to keep them motivated throughout the MACI rehab process. The app includes goal-setting sections, exercise tracker, and calendars to help patients monitor progress.
Download the My MACI App for rehab
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