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Traditional vs accelerated approaches to post-operative rehabilitation following matrix- induced autologous chondrocyte implantation (MACI): comparison of clinical, biomechanical and radiographic outcomes J.R. Ebert, Ph.D., W.B. Robertson, Ph.D., D.G. Lloyd, Ph.D., M.H. Zheng, D.M., Ph.D., F.R.CPath, D.J. Wood, B.Sc., M.B.B.S., M.S., F.R.C.S., F.R.A.C.S., T. Ackland, Ph.D., F.A.S.M.F. Osteoarthritis and Cartilage Volume 16, Issue 10, Pages (October 2008) DOI: /j.joca Copyright © 2008 Osteoarthritis Research Society International Terms and Conditions
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Fig. 1 The progression and proposed future of WB rehabilitation since the inception of the general ACI procedure; (A) WB gradient proposed by Minas and Peterson14, whereby loading is limited to toe-touch for 6 weeks, one third of BW permitted during weeks 7 and 8, two thirds of BW permitted through weeks 9 and 10, and full WB as tolerated through weeks 11 and 12, (B) WB gradient proposed by Robertson et al.7, whereby a much more graduated increase is permitted, progressing from 20% of patient BW within 2 weeks of the operation, through to full WB at 3–4 months post-surgery, removing the initial 6-week period of non-WB, and (C) proposed accelerated WB gradient following MACI designed to attain full WB at 8 weeks post-surgery. Osteoarthritis and Cartilage , DOI: ( /j.joca ) Copyright © 2008 Osteoarthritis Research Society International Terms and Conditions
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Fig. 2 Patient randomization and assessment throughout the trial.
Osteoarthritis and Cartilage , DOI: ( /j.joca ) Copyright © 2008 Osteoarthritis Research Society International Terms and Conditions
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Fig. 3 KOOS sub-scales for accelerated (Accel) and traditional (Trad) rehabilitation groups, at pre-surgery and 3 months post-surgery. Osteoarthritis and Cartilage , DOI: ( /j.joca ) Copyright © 2008 Osteoarthritis Research Society International Terms and Conditions
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Fig. 4 Summary of gait for both patient groups (accelerated and traditional) and their respective control groups, throughout the stance phase of gait. These included the following: (A) knee flexion angle; (B) vertical GRF; (C) external knee adduction–abduction moment; and (D) external knee flexion–extension moment. Osteoarthritis and Cartilage , DOI: ( /j.joca ) Copyright © 2008 Osteoarthritis Research Society International Terms and Conditions
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Fig. 5 Peak external knee adduction and flexion moments during stance (%BW×H) for both accelerated (Accel) and traditional (Trad) patient groups, and their respective control groups. Osteoarthritis and Cartilage , DOI: ( /j.joca ) Copyright © 2008 Osteoarthritis Research Society International Terms and Conditions
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