Rehabilitation

Rehabilitation after ChondroFiller, by defect site.

The manufacturer’s phased tables for load, mobilisation and activity after ChondroFiller® liquid implantation, transcribed by defect site, with the early post-operative regimen from the surgical technique guide.

Surgical technique Resources

A patient on a stationary bicycle in a physiotherapy studio with a physiotherapist alongside

Principles

Four things every protocol shares.

The joint is immobilised in an orthosis for 48 hours after wound closure.
Partial loading builds over 6 to 8 weeks, set by the defect location and the surgeon.
Continuous passive motion features in every protocol in the first weeks.
Return to high-load or contact sport is a decision for month 6 onwards, or later.^3,2

Manufacturer’s note

The manufacturer states that these recommendations are drawn from several sources, are meant only as information about the required follow-up treatment, and are no substitute for consultation with the attending physician.¹

Early post-operative regimen

Grouped by loading pattern in the technique guide.

The surgical technique guide distinguishes defects in the main load-carrying area, loaded axially, from defects on the patella or trochlea, loaded only in flexion. Its programme follows the recommendations of the German trauma and orthopaedic societies.²

A person walking with two forearm crutches along a bright clinic corridor, wearing a knee orthosis — Partial loading with forearm crutches in the first weeks, illustrative

Main load zone: femoral condyles and talus

Mobilisation from day 2 after surgery
20 kg partial load on the operated limb for 6 weeks
CPM for one hour at least twice a day
From week 7, build load to 30 kg, then over two weeks to full load
Cycling and swimming once full load is reached; careful muscle building through isometric training
Jumping, running and contact sports after one year

Patella and retropatellar surface

Mobilisation from day 2 after surgery
Flexion limited to 0-0-30° by an IROM splint for 3 weeks
20 kg partial load for one week; full load allowed after week 2
From week 3, increase flexion by 30° every two weeks; remove the splint from 90°
Cycling and swimming from 90° flexion; careful muscle building through isometric training
Sports with a high risk of falling after one year

Phased protocols

Load, mobilisation and activity by period.

Transcribed from the manufacturer’s rehabilitation guidance for four defect sites. Orthosis examples named in the guidance are the manufacturer’s, not Actomed’s.

Source for every table below:¹

Femoral condyle defects

Knee, main load zone

Period	Load	Mobilisation	Activity and rehab
Weeks 1 to 6	Partial load of 15 to 20 kg with forearm crutches, increased every two weeks Alternatively a faster build-up: 20% of body weight in weeks 1 to 2, 50% in weeks 3 to 4, full in weeks 5 to 6	CPM with restrictions, 3 to 8 hours a day Movement limited by orthosis: 0/0/60° in weeks 2 to 3, 0/0/90° in weeks 4 to 6	Water gymnastics and swimming Closed-chain physiotherapy (open chain as an alternative), depending on the defect site Leg control and isometric tension exercises
Weeks 6 to 12	Increase towards full body weight at 15 to 20 kg a week	Mobilise slowly at the end of the flexion range Open-chain physiotherapy as an alternative	Bicycle ergometer, swimming, rowing, cycling Coordination exercise and a physiological gait under full load Aqua jogging and physiotherapy in the exercise pool
Months 3 to 6	Full load	Without restriction	Light sports activities
Month 6 onwards	Full load	Without restriction	Sports involving high loads

Patellofemoral defects

Knee, patella and trochlea

Period	Load	Mobilisation	Activity and rehab
Weeks 1 to 8	Partial load of 15 kg with forearm crutches Alternatively full load with movement limited by the orthosis	Orthosis in extension for 48 hours Flexion 0 to 30° in weeks 1 to 3, 0 to 60° in weeks 4 to 6, 0 to 90° in weeks 7 to 8 CPM 3 to 8 hours a day	Water gymnastics and swimming
Weeks 8 to 12	Increase to full load within two weeks	Free mobility, limited only by pain	Intensive muscle and coordination training Cycling, rowing, swimming
Months 3 to 6	Full load	Without restriction	Light contact sports
Month 6 onwards	Full load	Without restriction	Normal contact sports

Talar defects

Ankle

Period	Load	Mobilisation	Activity and rehab
Weeks 1 to 6	Maximum 20 kg Orthosis at 20°	Immobilise, then passive, assisted and active movement	No sport Manual lymph drainage and electrotherapy
Week 6 to month 3	Gradual increase in load to 100%	Without restriction, full range of movement	No sport Physiotherapy
Months 3 to 6	Full load	Without restriction	Light sports such as swimming and cycling
Month 6 onwards	Full load	Without restriction	Full sports activity

Hip defects

Hip

Period	Load	Mobilisation	Activity and rehab
Weeks 1 to 6	Partial load of 30% of body weight, or 15 to 20 kg, with forearm crutches Hip unloader orthosis	Free mobility CPM: 2 to 3 sessions of 10 minutes a day in week 1, 3 of 15 minutes in week 2, 3 of 20 minutes in week 3, 4 of 20 minutes in weeks 4 to 5	Upper-body training, water gymnastics, sensorimotor training Gait therapy, bicycle ergometer, active physiotherapy and stretching
Weeks 6 to 12	Increase by 10 to 20 kg a week to full load by week 12	Passive and active mobilisation, free mobility	Active physiotherapy and stretching Muscle development, coordination, cross-trainer
Weeks 13 to 16	No jogging	Without restriction	Strength endurance and endurance training Sport-specific elements, bicycle ergometer Start of light impact sport
Month 6 onwards	Full load	Without restriction	Intensified coordination, strength and endurance training Preparation for full sports activity

An adult walking in a hydrotherapy pool with the water at chest height — Water gymnastics and swimming appear from the first phase in every knee protocol, illustrative

Return to sport

Six months before high load, a year before impact.

The rehabilitation tables place sports involving high loads or normal contact from month six onwards. The technique guide is more cautious for the main load zone, allowing jumping, running and contact sports after one year.^1,2

The source document

Download the manufacturer’s guidance.

Rehabilitation
Rehabilitation and post treatment
6 pages
Phased load, mobilisation and activity tables for femoral, patellofemoral, talar and hip defects.
Copy hosted by Actomed
Open PDF

References

1.Meidrix Biomedicals GmbH. ChondroFiller rehabilitation guidance. Manufacturer publication, 2022. View source
2.Meidrix Biomedicals GmbH. ChondroFiller® liquid surgical technique. Manufacturer publication, 2022. View source
3.Meidrix Biomedicals GmbH. ChondroFiller® liquid patient education leaflet. Manufacturer publication, 2022. View source

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Surgical technique Evidence