Medical Information

Explore detailed information about a range of joint problems and treatments, including medications, surgery, physiotherapy and rehabilitation. Reading this will help you understand more about your own condition. There is also a glossary with explanations of many medical terms used in orthopaedics. You can find out even more by following the links page to other related websites, journals or professional medical associations.

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Articular Cartilage injuries and their Treatment: Rehabilitation

Following any surgery to reconstruct the articular weight bearing surface a period of protected motion is necessary. This involves undertaking gentle exercised to mobilise the joint and to ensure that the joint does not become stiff. However crutches are often used to ensure that the operated area is not damaged during the healing phase by the action of walking or bearing weight through the joint. This usually involves using crutches for a period of time. Commonly this may be at least a week and can be up to as long as six weeks duration. Thereafter gentle activities of daily living are undertaken with a return to twisting activities and sport as much as three months following surgery.
Success of Articular Cartilage Reconstruction
The success is very dependant on the individual circumstances. In particular the age of the patient, the size, site, depth and nature of the damaged area of articular surface. In many of the reported studies the assessment of the results is confused by the fact that many patients have undergone several different operations so the effect of the reconstruction of the articular surface is difficult to assess.

As a generalisation microfracture can be successful in small localise areas of damage in particular where the damage is not to the convex weight bearing surface of the femur or patella. Osteochondral transplantation has been reported (D Johnson) to be successful in up to 96% of patients with localised lesions of less than 2cm in diameter. Osteocyte transplantation has been reported to result in an improvement in 72% of patients over a two year period. Many of the lesions in these cases were of considerable size.

Complications of the procedure are in general relatively small. These complications may include general complications such as infection, thrombosis, joint stiffness, continued symptoms and pain or a failure of the procedure. Specific complications may include an unresolved defect in the articular surface continued symptoms or progression over the course of time to arthritis.

It should however be remembered that general wear in any joint may progress and become worse and even arthritic over the course of time. Surgical reconstruction may improve the symptoms and provide a good result in the short term but the long term outlook remains to be defined. – patient information – Tendonitis and Tenosynovitis
Editor: David P Johnson MD. St Mary’s Hospital. Clifton Bristol. BS8 1JU.
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