After the Procedure

will i need physical therapy following carticel?

Yes. All patients undergoing Carticel (Autologous Chondrocyte Implantation) will need to follow a prescribed rehabilitation program. Although specific exercises and length of the rehabilitation period may differ from patient to patient, your surgeon and physical therapist will recommend a program for you based on the size, location, severity of your cartilage injury and the extent of your operative repair.

when does physical therapy start?

Within 6-24 hours of your surgery you will begin using a CPM (continuous passive motion) machine. You will use the CPM machine 6-8 hours per day non-sequentially. That means you may use it in two-hour time intervals rather than the six to eight hours all at once. You will also begin home exercises the next day. This will include isometrics, straight leg raises, and contracting your quadriceps muscle several times per day. (Please review the post-operative exercises program on this web site.) Physical therapy starts one week following surgery. Therapy runs approximately 2-3 times per week for 8 to 12 weeks. You will not be allowed to put weight on your leg for the first 3 weeks. By week 4 or 5 you will be allowed to gradually increase weight on your leg. By week 6 or 8, you will be progressed to full weight bearing/walking. Specific therapy programs may vary from patient to patient. Your surgeon will be able to discuss your particular program with you.


how long will i be on crutches?

Crutches are used for the first 6 to 8 weeks. Too much pressure initially on the cultured cells can damage them or inhibit their growth. After that you may switch to a cane on an as needed basis, though many patients do not need any further assistance. Consult with your surgeon or physical therapist for specific recommendations regarding the use of crutches or a cane.

what is the recovery period of the operation?

This can vary. Immediately after surgery, you will begin decreasing your swelling, increasing motion and strength. Single injuries improve faster, while multiple injuries and the Patella-Femoral joint implants tend to be protected longer. If you require concurrent operative procedures such as a knee reconstruction or an osteotomy (bone cut for realignment), the length of time is influenced. However, in general, the cells mature over many months. Regardless of how much better you may feel after the operation, it takes time just for the cells to grow. Most surgeons will not let you run until at least 9 months from date of surgery.


what will the scar look like?

The second stage of Carticel is done through an open procedure that requires an incision and will leave a scar. The scar will vary depending on the exposure needed to perform the operation. Single lesions require relatively small incisions. If you require an osteotomy (bone cutting procedure), especially a patellar elevation osteotomy, your incision will be larger. It is very important that your surgeon have enough exposure to perform an adequate implantation.


what should i expect following my surgery?

As with most surgeries, there will be some pain following surgery. However, physicians at the Joint Preservation Center use special nerve blocks and local injections to make the pain very manageable. Speak to your physician about the appropriate ways to manage your pain.


when can i start playing sports again?

This depends upon the size and location of your lesion, numbers of lesions, and the specific sport you are playing. Generally, low-level activity such as swimming, biking, walking, or skiing, may be resumed as early as 6 months following treatment. More strenuous activity involving pivoting or twisting, such as basketball, soccer, or tennis may compromise the durability of the new cultured cells and generally should be attempted until 12-16 months post treatment. Individual results may vary. Not all patients return to full activity.