Cartilage Injuries: A Guide for Physical Therapists

By dpope2020

March 7, 2025

ACI, articular cartilage, articular cartilage injury, Autologous Chondrocyte Implantation, cartilage injury, dan pope, evidence based practice, evidence-based medicine, fitness pain free, Knee, knee arthritis, knee cartilage, knee injury, knee pain, knee surgeon, knee surgery, MACI, Matrix-Induced Autologous Chondrocyte Implantation, Microfracture, OATs, orthopedic surgery, orthopedics, Osteochondral autologous transplantation, physical therapist, physical therapy, sports injury

Cartilage Injuries: A Guide for Physical Therapists

To go along with today's video I have a nice infographic to share...

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In today's video we go over Cartilage Injuries: A Guide for Physical Therapists - FPF Show Episode 163

  • 0:00 Introduction
  • 2:19 Can cartilage injuries be managed with physical therapy? (Conservative Management)
  • 7:10 Does a cartilage injury increase the risk of knee osteoarthritis (or speed it up) over the course of time?
  • 9:16 How long should you perform physical therapy before deciding to go for surgery?
  • 11:02 When is surgery indicated for articular cartilage injuries?
  • 16:59 Why would you consider conservative management over surgery?
  • 19:34 What should non-operative physical therapy look like for these patients?
  • 30:45 What are the different types of cartilage surgeries? (Microfracture, OATs, ACI, MACI)
  • 32:06 What are the return to sport rates after articular cartilage surgeries?
  • 37:48 What factors influence the ability of an athlete to return to sport after articular cartilage injuries?
  • 44:17 How does a cartilage surgery compare to other knee surgeries from a return to sport perspective?
  • 48:37 Nine principles of post-operative rehab
  • 57:14 Weight bearing guidelines and criteria for progression after articular cartilage surgery
  • 1:01:03 12 Keys to Post-Operative ACL-Reconstruction Physical Therapy

Cartilage Breakdown!!!

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Wagner KR, Kaiser JT, DeFroda SF, Meeker ZD, Cole BJ. Rehabilitation, Restrictions, and Return to Sport After Cartilage Procedures. Arthrosc Sports Med Rehabil. 2022 Jan 28;4(1):e115-e124. doi: 10.1016/j.asmr.2021.09.029. PMID: 35141543; PMCID: PMC8811518.

  2. Salzmann GM, Niemeyer P, Hochrein A, Stoddart MJ, Angele P. Articular Cartilage Repair of the Knee in Children and Adolescents. Orthop J Sports Med. 2018 Mar 13;6(3):2325967118760190. doi: 10.1177/2325967118760190. PMID: 29568785; PMCID: PMC5858627.

  3. Cicuttini F, Ding C, Wluka A, Davis S, Ebeling PR, Jones G. Association of cartilage defects with loss of knee cartilage in healthy, middle-age adults: a prospective study. Arthritis Rheum. 2005 Jul;52(7):2033-9. doi: 10.1002/art.21148. PMID: 15986359.

  4. Hanaoka C, Fausett C, Jayabalan P. Nonsurgical Management of Cartilage Defects of the Knee: Who, When, Why, and How? J Knee Surg. 2020 Nov;33(11):1078-1087. doi: 10.1055/s-0040-1713813. Epub 2020 Jul 14. PMID: 32663885; PMCID: PMC7606792.

  5. Mithoefer K, Hambly K, Della Villa S, Silvers H, Mandelbaum BR. Return to sports participation after articular cartilage repair in the knee: scientific evidence. Am J Sports Med. 2009 Nov;37 Suppl 1:167S-76S. doi: 10.1177/0363546509351650. Epub 2009 Oct 27. PMID: 19861696.

  6. Reinold MM, Wilk KE, Macrina LC, Dugas JR, Cain EL. Current concepts in the rehabilitation following articular cartilage repair procedures in the knee. J Orthop Sports Phys Ther. 2006 Oct;36(10):774-94. doi: 10.2519/jospt.2006.2228. PMID: 17063839.