The articular cartilage repair rehabilitation story

How did a UK physiotherapist working in sports medicine who five years ago had never even heard of half of the available articular cartilage repair procedures end up working with some of the top orthopaedic surgeons in the cutting-edge area of articular cartilage repair? Where to start? As the white rabbit told Alice in - 'Alice in Wonderland' - "I've always found it's helpful to start at the beginning." So that is where I'm going to start - at the beginning!

Well, I suppose it won't be too much of a surprise to most people to hear that it was initially through experiencing the problems of knee cartilage damage first hand. I was diagnosed with 'chondromalacia patallae' in 1992 back when this was an acceptable diagnosis for articular cartilage damage. I was a very active person so that didn't stop me participating in all sorts of sports which probably didn't help to preserve the cartilage! After switching to lower and lower impact sports enough was enough and I did some homework and sought out an orthopaedic consultant who specialised in articular cartilage repair. After several MRIs and an arthoscopy I eventually ended up having autologous chondrocyte implantation surgery in July 2003.

Before my operation I must have been every surgeon's worst nightmare - someone who worked in an allied health field who had lots, and lots, and lots of questions, especially about the rehabilitation. Well, my surgeon actually welcomed and encouraged me and he even emailed medical journal articles on the latest research in the area (I hope he doesn't regret that now!). After getting more of an insight into the cartilage repair field what struck me was how well the surgical techniques were described and detailed but how poorly the rehabilitation was outlined. No one really seemed to know the best way to go about it and it was all rather confusing. It didn't stop me going ahead with having the surgery as I had to got to the point where I needed to get it sorted but it did serve to highlight to me the inadequacies and unknowns of the rehabilitation for many of these new cartilage repair procedures. From that point onwards, as they say, the rest is history and since 2003 I have been actively engaged in the development of better rehabilitation programmes for people who undergo articular cartilage repair procedures.

I will be developing this blog into a rolling commentary on what's happening in cartilage repair rehabilitation once I have brought the story up to date. These first few blogs will set the scene and provide you with a bit of a historical perspective to it all.

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