Cartilage Restoration — MACI (Matrix-Induced Autologous Chondrocyte Implantation)

University of Virginia Orthopaedic Surgery

Weight-Bearing

WB varies by defect type/location: PF single = FWB locked; TF single/multiple = TTWB 20% increasing 10%/week; PF/TF combo = TTWB 20%; most types reach FWB by 6-8 weeks

Key Restrictions

WB and brace protocols individualized by defect location (PF vs TF) and number (single/multiple/combo); ROM starts 0-45° advancing 15°/week; avoid active knee extension against resistance early; avoid excessive load on graft site; physician clearance for high-impact and contact sports (9-12+ months per defect type); emphasis on goal-based rather than time-based progression

Timeline & Phases

Phase 1 (0-3 wks): protect implant, brace 0-30° (locked extension for ambulation/sleep), TTWB-20% WB (TF) or FWB locked (PF), passive ROM 0-45° (CPM encouraged), quad/HS/glute recruitment; Phase 2 (4-6 wks): 50% WB most types, brace 0-45° to 90°, ROM goal 90° by wk 6, recumbent cycling, hydrotherapy; Phase 3 (7-12 wks): gradual transition off crutches/brace, full ROM by wk 9, upright cycling, standing hip strengthening; Phase 4 (3-6 months): FWB off brace, low-impact recreation (cycling/swimming/elliptical), gradual running; Phase 5 (6-9 months): running/agility progression; Phase 6 (9+ months): return to contact sports 9-12+ months depending on defect type

Notes

6 phases; WB and brace individualized per defect location and number — clinician must follow defect-specific sub-protocol; CPM encouraged in Phase 1; avoid active knee extension against resistance early; avoid full WB without brace/crutches until advanced; return to contact sports: PF single 12+ months, TF single 10-12 months, TF multiple/combo 12+ months; source: MACI Rehabilitation Manual

Published

12/2024