[Research progress of rehabilitation after autologous chondrocyte implantation on knee]

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Jun 15;32(6):758-763. doi: 10.7507/1002-1892.201801034.
[Article in Chinese]

Abstract

Objective: To summarize the research progress of rehabilitation after autologous chondrocyte implantation (ACI).

Methods: The literature related to basic science and clinical practice about rehabilitation after ACI in recent years was searched, selected, and analyzed.

Results: Based on the included literature, the progress of the graft maturation consists of proliferation phase (0-6 weeks), transition phase (6-12 weeks), remodeling phase (12-26 weeks), and maturation phase (26 weeks-2 years). To achieve early protection, stimulate the maturation, and promote the graft-bone integrity, rehabilitation protocol ought to be based on the biomechanical properties at different phases. Weight-bearing program, range of motion (ROM), and options or facilities of exercise are importance when considering a rehabilitation program.

Conclusion: It has been proved that the patients need a program with an increasingly progressive weight-bearing and ROM in principles of rehabilitation after ACI. Specific facilities can be taken at a certain phase. Evidences extracted in the present work are rather low and the high-quality and controlled trials still need to improve the rehabilitation protocol.

目的: 总结膝关节自体软骨细胞移植术(autologous chondrocyte implantation,ACI)术后康复的研究进展。.

方法: 查阅近年来国内外 ACI 术后康复相关的基础及临床研究,并进行总结分析。.

结果: 研究表明,ACI 术后移植物成熟分为 4 个阶段:增生期(术后 0~6 周)、过渡期(术后 6~12 周)、重塑期(术后 12~26 周)、成熟期(术后 26 周~2 年)。为了避免早期移植物损伤,适当刺激移植物和骨骼的整合过程,更快恢复关节功能,临床需针对术后不同阶段移植物的生物力学特性设计康复锻炼方案,主要体现在术后负重、运动范围、康复训练方式的过渡和调整。.

结论: 膝关节 ACI 术后应科学地逐步增加负重和运动范围,在不同阶段可借助相应的康复锻炼手段。但目前相关研究的证据等级较低,仍需更高质量、更大样本量的随机对照试验,进一步探讨完善康复方案。.

Keywords: Knee; autologous chondrocyte implantation; cartilage defect; cartilage repair; rehabilitation.

Publication types

  • Review

MeSH terms

  • Chondrocytes*
  • Humans
  • Knee
  • Knee Injuries* / therapy
  • Knee Joint
  • Transplantation, Autologous

Grants and funding

国家自然科学基金资助项目(31741046);中央高校基本科研业务费资助项目(2015SCU04A40);四川省科技支撑计划项目(2017SZ0017);四川大学华西医院“135”工程项目(ZY2017301)