I know that I can expect a long road to recovery, but I figure that if Rocky can overcome his obstacles and defeat his opponents, I got this. Eye of the tiger, baby.
The recovery of the patellar cartilage transplant and tibial tubercle transfer (TTT) is extensive and defined by phases. A number of the rehabilitation protocols are slightly modified protocols for ACI (autologous cartilage implantation), and none of them are exactly the same. It makes for some confusion. Especially since I don’t yet have my marching order from my OS. The general phases and goals are described below.
The first phase of recovery is the Proliferation Phase, and it lasts roughly from 0-6 weeks postop. During this stage, the cells are rapidly multiplying and filling the defect. If you could look at the transplant, it would look like a thick, white gel. During this time, the patient is likely restricted to toe touch weight-bearing and is in a brace that’s locked in extension. We’ll see what this stage brings for me. I suspect that I’m pretty much Superman when it comes to growing new cartilage cells, so this phase should only last about a week.
The second phase is the Transitional Phase, and it lasts roughly from 7-12 weeks postop. During this phase, the cells are busy creating the matrix. Sounds cooler than it is. The graft is not yet well integrated into the surrounding cartilage or bone, and the graft is still not firm. I suspect this stage is marked by repetition and boredom because the goal of therapy is to bring back mobility and full range of motion (ROM).
The third phase is the remodeling phase, and it lasts roughly from 12-26 weeks postop. During this phase, the cells are busy reorganizing themselves and integrating into the surrounding bone and cartilage. The transplant is firming up a bit and is more like Silly Putty than gel. This is the point at which I should be able to move about like a human again, free from assistive devices (that means no more crutches!).
The fourth phase is the maturation phase, and it lasts from 6-24 months (that’s up to 2 years, people!) postop. During this phase, the transplant completes maturation somewhere between 9 and 12 months postop. The new cartilage resembles the surrounding tissue when it’s fully integrated. It’s at this point that I’m going to find the longest stack of stairs that I can find and race triumphantly to the top. And then dance around with my arms flailing wildly in the air to celebrate my triumph.