Accuracy of partial weight bearing after autologous chondrocyte implantation

Arch Phys Med Rehabil. 2008 Aug;89(8):1528-34. doi: 10.1016/j.apmr.2008.02.019.

Abstract

Objective: To determine whether patients can accurately replicate and retain weight-bearing restrictions in both stationary (static) and dynamic conditions after autologous chondrocyte implantation (ACI).

Design: Case series.

Setting: Rehabilitation clinic.

Participants: A consecutive sample of patients (N=48) who had undergone ACI to a medial or lateral femoral condylar defect in the knee.

Interventions: Patients were trained to partially weight bear using bathroom scales and forearm crutches prior to assessment.

Main outcome measures: A force platform was used to measure peak vertical ground reaction forces in patients during static and dynamic conditions immediately after weight-bearing instruction and training, and again during gait 7 days after training.

Results: Immediately after instruction and weight-bearing practice on a set of scales, patients exerted a mean of 15.8% body weight more than expected during walking for 20% weight-bearing trials, 8.3% more for the 40% trials, 11.9% more for the 60% trials, and 1.2% less for the prescribed 80% trials. Accuracy of weight-bearing replication improved across all weight-bearing levels when assessed 7 days later, when patients exerted a mean of 6.6% body weight more than expected during walking for 20% weight-bearing trials (9.2% body weight improvement), 4.2% more for the 40% trials (4.1% body weight improvement), 9.9% more for the 60% trials (2% body weight improvement), and 0.2% more for the 60% trials (1% body weight improvement).

Conclusions: Patients were unable to follow weight-bearing restrictions after instruction and practice on a set of scales, and patients were unable to replicate weight-bearing levels in both static and dynamic conditions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cartilage, Articular / injuries*
  • Cartilage, Articular / surgery*
  • Chondrocytes / transplantation*
  • Female
  • Gait
  • Humans
  • Knee Injuries / rehabilitation*
  • Knee Injuries / surgery*
  • Male
  • Pain Measurement
  • Transplantation, Autologous
  • Treatment Outcome
  • Weight-Bearing*