Urgent warning signs — calf pain or swelling, fever, the knee locking — are one tap away, always.Something feel wrong?Red flags →
AFTER MACI
The evidence

How we decide what to publish

Written by a patient with no external clinical review. That is exactly why the machinery is visible: you should be able to audit how anything here got here without taking anyone’s word for it.

The scale, defined once and used everywhere
Evidence strength 5 of 5
strongSeveral randomized trials in this operation, agreeing. Nothing on this site currently qualifies.
Evidence strength 4 of 5
strongOne good randomized trial in this operation with long follow-up, or a systematic review of the trial literature.
Evidence strength 3 of 5
moderateCohort studies, practice guidelines, or several published protocols pointing the same way.
Evidence strength 2 of 5
expert opinion / observationalExpert opinion or consensus, retrospective series, or regulatory labeling. Clinicians agree; nothing compared it to an alternative.
Evidence strength 1 of 5
weakA case report, a narrative review, or animal and laboratory work — a mechanism or an anecdote, not a result.
different surgery — read with careEvidence from a different operation or population. Named at the point of use, never quietly reclassified as general.
Why two claims can share a page and still not look alike
Evidence strength 4 of 5
Randomized

“Progression toward partial then full weight through the studied 6–9 week window without swelling response.”

Systematic review of RCTs · n = 7 pubs / 3 samples / 136 pts · mean 2.5 yr follow-up — E3

Evidence strength 3 of 5
Practice pattern

“Full passive flexion with no swelling response.”

Clinical practice guideline (institutional, patient-facing) — E292

Both are worth publishing. Presenting them at the same confidence would not be a stylistic slip; it would make the second one false. So the strength mark travels with the claim to wherever it is read — the stage page, the program row, the gate, the exercise page — and never lives only in a bibliography.

What gets excluded

Clinic and surgeon handout PDFs — the single largest source of outdated cartilage rehab information in circulation; manufacturer marketing and sponsored content; forum posts, social media, and YouTube; and anything that cannot be resolved to a PMID, DOI, or an official regulatory document. Case reports and expert opinion are admitted, labeled as exactly that, and never made prescriptive. Where an exclusion or an inaccessible source leaves a real gap, it becomes a numbered entry on what we don’t know rather than disappearing.