An autologous graft means taking tissue from your own body to use in surgical repair of another part of your body. Chondrocyte implantation is a new technique for repair of articular tissue in the knee -- the connective material that allows the knee to flex. It is especially useful for younger patients who would otherwise wear out a knee replacement in 10 to 15 years. Post-surgical rehabilitation protocols allow a gradual, safe return to exercise.
Before Surgery
At time of publication, the only FDA cleared product for articular cartilage replacement is Carticel, manufactured by Genzyme Corp. Your surgeon will take a biopsy of knee cartilage, send the cells to Genzyme, and several weeks later the Carticel graft will be available for your surgery. Carticel is not suitable for every patient; you and your surgeon will determine whether this is the right approach for you.
Surgery and Physical Therapy
During surgery the graft is stitched onto the cartilage defect. Within hours of surgery, you will need to start flexing the knee. Upon discharge from the surgery center, you will walk using crutches. After a few days you will have your first physical therapy appointment. The first few weeks will involve flexing your knee and extending your leg out, without any additional weight. Gradually walking in a water tank, using resistance bands, and eventually working on a leg weight machine will result in a strong and flexible joint.
Braces and Wraps
You will transition from crutches to a knee brace. This may take two months or more. When you have a knee brace on you can walk, do light resistance training, and perform non-impact cardio exercise. You cannot swim while the wound is still healing. After a month or more wearing a brace, physical therapy should strengthen the joint enough that a wrap will replace the knee brace.
Exercise
Walking and biking are the recommended low-impact exercises at three months. You also need to gradually increase the time spent exercising, working up to 30- to 45-minute sessions. Start by exercising just a few minutes, and take every third or fourth day off. According to Genzyme, swimming is indicated at six months, and a full return to impact sports involving pivoting is up to 18 months post-surgery.
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