Evaluation of the efficacy of physiotherapy and rehabilitation program following osteochondral allograft transplantation surgery

The objective of this study was to evaluate the clinical and functional outcomes of osteochondral allograft (OCA) transplantation supported by a structured postoperative physiotherapy program in patients with knee cartilage lesions. While OCA transplantation is a promising approach for cartilage repair, a standardized rehabilitation protocol remains lacking. Between January 2023 and June 2025, 12 patients (mean age: 31.25 ± 8.09 years; 8 males, 4 females) underwent fresh OCA transplantation and participated in a comprehensive physiotherapy program including cryotherapy (Game Ready), electrotherapy, therapeutic exercise, and taping. All grafts were harvested from donors aged 18–35 years with healthy cartilage, within 24 hours postmortem. Patients received an intensive in-hospital physiotherapy program for the first two months postoperatively, followed by remote monitoring for up to one year through monthly evaluations and personalized home exercise prescriptions.Clinical assessments were conducted at baseline and at multiple postoperative time points: VAS, ROM, and MMT were evaluated at baseline and 2 months; VAS, OKS, IKDC, and KOOS were assessed at baseline, 6 months, and 1 year. Significant improvements were observed across all clinical outcome measures. Pain levels (VAS) decreased significantly from 6.33 ± 1.15 at baseline to 0.08 ± 0.28 at 1 year (p < 0.001), and functional scores improved markedly (IKDC: +43.90 ± 12.02, KOOS: +40.58 ± 12.54, OKS: +11.08 ± 4.18; all p < 0.001). ROM showed a significant increase at 2 months (p = 0.013), while improvements in MMT did not reach statistical significance (p = 0.083). MRI scans at ≥12 months revealed no graft failures. OCA transplantation combined with a phased rehabilitation program demonstrated significant improvements in pain, function, and muscle strength, particularly within the first six months. Full ROM and muscle strength were achieved by the second postoperative month. Keywords: Osteochondral allograft transplantation, cartilage injury, rehabilitation, physiotherapy, knee joint