Rehabilitation overview
MACI rehabilitation — a general overview
Recovery after MACI is prolonged and staged because the repair tissue matures gradually. How it progresses depends on where the defect is — a lesion behind the kneecap (patellofemoral) is protected differently from one on the weight-bearing surfaces where the thigh bone and shin bone meet (tibiofemoral) — and on any other procedures done at the same time. This overview describes the general shape only and does not promise a return to sport or a return to normal cartilage.
Who this protocol is for
A general, plain-language overview of how rehabilitation after MACI is usually approached. It is not a step-by-step protocol and not a downloadable document — always follow the individualized plan your surgical team gives you.
If other procedures were performed at the same time
When another procedure — such as a realignment osteotomy, a ligament or meniscus procedure, or work on patellar tracking — is performed at the same time, rehabilitation is adjusted and the more protective plan generally governs. Your operative note and the plan your surgeon selects take precedence over any general overview.
How rehabilitation is generally structured
Rehabilitation after this procedure is usually organized into progressive phases. The phases below describe the general shape only — specific exercises, precautions, and timelines are individual and are set by your surgeon and physical therapist.
Protection and early motion
Early on, the repair is protected while gentle, controlled motion begins. Weight-bearing and motion are limited and are set by your surgical team; the limits differ for patellofemoral and tibiofemoral lesions.
Progressive loading
As healing allows, weight-bearing and range of motion are gradually increased under the direction of your surgeon and physical therapist.
Strengthening and control
Strength, balance, and control of the knee are rebuilt in stages, guided by how the knee is progressing rather than by fixed dates.
Graded return to activity
Return toward higher-impact activity is gradual and criteria-based, and can extend well beyond the earlier phases as the repair tissue matures. It is not guaranteed and is decided with your surgeon.
This is a general overview, not a prescription. Specific exercises, precautions, weight-bearing limits, and timelines are individual and are set by your surgeon and physical therapist — always follow the plan they give you.
Further reading