{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:34:55Z","timestamp":1789544095122,"version":"build-2803163510"},"reference-count":31,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate levels of consensus in rehabilitation practices following MACI (autologous cultured chondrocytes on porcine collagen membrane) treatment based on the experience of an expert panel of U.S. orthopedic surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A list of 24 questions was devised based on the current MACI rehabilitation protocol, literature review, and discussion with orthopedic surgeons. Known areas of variability were used to establish 4 consensus domains, stratified on lesion location (tibiofemoral [TF] or patellofemoral [PF]), including weightbearing (WB), range of motion (ROM), return to work\/daily activities of living, and return to sports. A 3-step Delphi technique was used to establish consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus (&gt;75% agreement) was achieved on all 4 consensus domains. Time to full WB was agreed as immediate (with bracing) for PF patients (dependent on concomitant procedures), and 7 to 9 weeks in TF patients. A progression for ROM was agreed that allowed patients to reach 90\u00b0 by week 4, with subsequent progression as tolerated. The panel estimated that the time to full ROM would be 7 to 9 weeks on average. A range of time was established for release to activities of daily living, work, and sports, dependent on lesion and patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Good consensus was established among a panel of U.S. surgeons for rehabilitation practices following MACI treatment of knee cartilage lesions. The consensus of experts can aid surgeons and patients in the expectations and rehabilitation process as MACI surgery becomes more prevalent in the United States.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1947603520968876","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T05:26:03Z","timestamp":1604035563000},"page":"1782S-1790S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Consensus on Rehabilitation Guidelines among Orthopedic Surgeons in the United States following Use of Third-Generation Articular Cartilage Repair (MACI) for Treatment of Knee Cartilage Lesions"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8876-7043","authenticated-orcid":false,"given":"David C.","family":"Flanigan","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth L.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Stanford University Medical Center, Redwood City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Chilelli","sequence":"additional","affiliation":[{"name":"Sports Medicine and Arthroscopy, Cartilage Restoration, Regional Medical Group Orthopaedics, Medical Group Northwestern Medicine, Evanston, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Gersoff","sequence":"additional","affiliation":[{"name":"Advanced Orthopedic and Sports Medicine, Orthopedic Centers of Colorado, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deryk","family":"Jones","sequence":"additional","affiliation":[{"name":"Sports Medicine and Cartilage Restoration, Ochsner Sports Medicine Institute, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra A.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California at Davis, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Toth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University, Durham, NC, USA"},{"name":"North Carolina Central University, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caryn","family":"Cramer","sequence":"additional","affiliation":[{"name":"Vericel Corporation, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Zaporojan","sequence":"additional","affiliation":[{"name":"Vericel Corporation, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Carey","sequence":"additional","affiliation":[{"name":"Penn Center for Advanced Cartilage Repair and Osteochondritis Dissecans Treatment, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"bibr1-1947603520968876","unstructured":"US Food and Drug Adminstration. FDA approves first autologous cellularized scafford for the repair of cartilage defects of the knee. Available from: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-autologous-cellularized-scaffold-repair-cartilage-defects-knee"},{"key":"bibr2-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199410063311401"},{"key":"bibr3-1947603520968876","unstructured":"MACI. MACI\u00ae rehabilitation manual. Available from: https:\/\/www.maci.com\/healthcare-professionals\/about-the-procedure\/rehab.html"},{"issue":"1","key":"bibr4-1947603520968876","first-page":"60","volume":"2","author":"Ebert JR","year":"2011","journal-title":"et al"},{"key":"bibr5-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2008.03.010"},{"key":"bibr6-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513495637"},{"key":"bibr7-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1123\/JSR.2014-0159"},{"key":"bibr8-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517724761"},{"key":"bibr9-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1177\/1947603510362907"},{"key":"bibr10-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512445167"},{"issue":"5","key":"bibr11-1947603520968876","volume":"8","author":"Toonstra JL","year":"2013","journal-title":"Int J Sports Phys Ther"},{"key":"bibr12-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4262-3"},{"key":"bibr13-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2008.02.001"},{"issue":"1","key":"bibr14-1947603520968876","doi-asserted-by":"crossref","DOI":"10.1016\/j.arthro.2006.08.024","volume":"23","author":"de Jong SN","year":"2007","journal-title":"Arthroscopy"},{"key":"bibr15-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1016\/j.orthres.2004.01.007"},{"key":"bibr16-1947603520968876","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3665"},{"key":"bibr17-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1287\/mnsc.9.3.458"},{"key":"bibr18-1947603520968876","doi-asserted-by":"publisher","DOI":"10.1576\/toag.7.2.120.27071"},{"key":"bibr19-1947603520968876","unstructured":"Linstone HA. 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