Rehabilitation is the post-surgical program of re-establishing joint motion, muscle strength around the joint and finally joint function. It is very important to understand that rehabilitation is a long process. While the surgery is performed within hours, the rehabilitation needs many months, potentially up to a year. The difference between the length of the surgery and the time needed for rehabilitation is huge, and patients should have that clearly in mind.
When the patient undergoes cartilage surgery of the knee, ankle or shoulder, for example, by whatever method, they should be aware that they need a long recovery period.
It is therefore very important that the patient is committed to the whole process. However, it should also be borne in mind the timeframe of one year for recovery is an example of the amount of time required compared to the hours of the surgery. The actual timeframe required depends on a large number of factors.
The second important point is that rehabilitation is a progressive activity. In this context, ‘progression’ means safely increasing workloads and stimuli on the repaired joint during the recovery process.
The third point is that the tissues need to be stimulated, as they cannot recover by themselves.
It is important to properly stimulate the limb and joint after the cartilage surgery. This is, biologically, a very complex process, because we need to let the tissue mature. The process could be likened to baking bread. You have to wait for the dough to prove (rise) before you can put it in the oven. It is the same with the cartilage – you must wait for some time to help the biological process, and that process needs stimulation. The right stimulation is protected range of motion and exercise.
Consequently, the core of rehabilitation is doing the right exercises at the right time, with the right balance between not enough and too much exercise. So, neither complete rest nor sporting activities is advisable in this phase of rehabilitation. Something in the middle is required. That balance changes during the weeks and months after surgery. What this means in practice is that the intensity of the stimulation increases progressively.