Rehabilitation protocol for knee cartilage transplantation using nasal chondrocytes in a RCT setting

S Seitz; A Wixmerten; C Schuster-Amft; M Mumme

doi:10.1055/s-0045-1812412

physioscience, Inhaltsverzeichnis

physioscience 2025; 21(S 03): S27
DOI: 10.1055/s-0045-1812412

Abstracts

Poster/Posters

Rehabilitation protocol for knee cartilage transplantation using nasal chondrocytes in a RCT setting

Autoren

S Seitz

¹Research Department, Reha Rheinfelden, Rheinfelden, Switzerland

²Physiotherapy, Physio Werk 19 GmbH, Magden, Switzerland
A Wixmerten

³Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
C Schuster-Amft

¹Research Department, Reha Rheinfelden, Rheinfelden, Switzerland

⁴Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland

⁵School of Engineering and Computer Science, Bern University of Applied Sciences, Biel, Switzerland
M Mumme

³Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland

⁶Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland

⁷Sportclinic Zürich, Klinik Hirslanden, Zürich, Switzerland

Abstract

Volltext

Introduction Knee osteoarthritis often starts in the patellofemoral compartment and is diagnosed in about 39% of people with knee pain aged above 30 years. Nasal chondrocyte Tissue Engineered Cartilage (N-TEC) has been successfully introduced in phase I and II clinical studies for the treatment of focal cartilage lesions, and in a pilot group of patients with osteoarthritis. However, no consensus for treatment recommendation for isolated patellofemoral osteoarthritis (PFOA) in clinical guidelines exist.

Objective To develop two physiotherapy-based postintervention rehabilitation protocols (PPRPs) following the implantation of N-TEC and the comparator platelet-rich plasma (PRP) injections in patients with PFOA.

Methods For a randomised controlled trial (RCT) involving 75 patients with PFOA from nine different clinical centres in Switzerland, Germany and Croatia two PPRPs based on the current literature on cartilage transplantation or PRP injections and osteoarthritis were developed. In addition, results from a pilot study and expert opinions from physiotherapist and physicians were incorporated. All physiotherapists involved in the study receive a 30-minute standardised training in the application of the protocols.

Results Our work explains the two different PPRPs, including the distinct rehabilitation phases with their respective goals, interventions, and milestones. Both PPRPs focus on pain reduction, muscle strengthening (knee and hip muscles), proprioceptive training, optimizing neuromuscular function and patient education but they will differ during the initial phase (12 weeks):

N-TEC group: The PPRP protects the implanted graft during the early postoperative phase. Protective measures include six weeks of partial weight-bearing with crutches and 12 weeks of restricted knee motion post-surgery.

PRP group: The primary objective is to prevent excessive loading of the painful knee joint. Therefore, therapeutic exercises involving knee movements against maximal resistance during extension and flexion, as well as those incorporating rotational components or performed in high-stress positions, such as kneeling, are not recommended. Additionally, physiotherapy is not advised within the first three days following injection.

Conclusion Both detailed PPRPs enable standardised treatment of study participants while accounting for individual patient-specific factors. In the future, both PPRPs aim to support optimal postintervention care for patients undergoing N-TEC transplantation or PRP injections in the patellofemoral joint.