Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Jun;144(6):2481-2489.
doi: 10.1007/s00402-024-05347-w. Epub 2024 May 2.

Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial

Anagha Kadam  1 , Surendra Wani  2 , Girish Gadekar  3 , Goutami Katage  1 , Kapil Garg  1 , Sanket Mungikar  1
Affiliations
Randomized Controlled Trial

Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial

Anagha Kadam et al. Arch Orthop Trauma Surg. 2024 Jun.

Abstract

Introduction: Patients are often instructed to avoid weight bearing on the proximal tibia for 6 - 12 weeks post-surgery to avoid fracture fixation failure. However, delayed weight bearing leads to delayed mobility, causing difficulties in daily activities; problems such as pain, limited knee ROM, reduced quadriceps muscle strength, and impaired functional outcomes are reported in long-term follow-up. This study primarily aimed to evaluate the feasibility and explore the effect size. The secondary aim was to determine the effectiveness of early weight bearing along with conventional physiotherapy on functional outcomes.

Materials and methods: A single-blinded pilot randomized controlled trial with 30 participants with proximal tibia type I, II, and III fractures were included; they were randomized using computer-based software. Seven patients were lost to follow-up. Group I received early weight bearing along with conventional physiotherapy whereas Group II received restricted weight bearing along with conventional physiotherapy. Assessments were made on post-operative day 3 (POD-03), at discharge, at 6 weeks, and at 12 weeks. Radiographs were recorded immediately after the operation, at discharge, and at 12 weeks.

Results: A full-scale RCT is feasible with an effect size between 0.3 - 0.7. A statistically significant difference (p < 0.05) was found within both groups 12 weeks post-surgery in all outcome measures; the difference was more prominent in the intervention group. A statistically significant difference (p < 0.05) was found between both the groups post-12 weeks in all outcome measures except quadriceps isometric muscle strength.

Conclusion: A full-scale RCT for early weight bearing along with conventional physiotherapy for patients operated for Type I, II, and III proximal tibia fracture is feasible. Early weight bearing along with conventional physiotherapy could have a positive effect on reducing patient's pain perception and increasing knee joint mobility, quadriceps isometric muscle strength, knee function, and quality of life without any adverse effects.

Trial registration: ClinicalTrialsRegistry.gov (CTRI/2022/10/046797).

Keywords: Early weight bearing; Physiotherapy; Proximal tibia; Rehabilitation; Tibial plateau.

PubMed Disclaimer

References

    1. Rabari YB, Somanni AM, Prasad DV, Thadeshwar KH Various modalities of treatment of proximal tibial fractures: a prospective longitudinal study (2017). Int J Res Orthop 3(2):25c9. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20170784
    1. Reátiga Aguilar J, Rios X, González Edery E, De La Rosa A, Arzuza Ortega L (2022) Epidemiological characterization of tibial plateau fractures. J Orthop Surg Res 17(1):106. https://doi.org/10.1186/s13018-022-02988-8 - DOI - PubMed - PMC
    1. Yao X, Zhou K, Lv B, Wang L, Xie J, Fu X et al (2020) July) 3D mapping and classification of tibial plateau fractures. Bone Joint Res 9(6):258–267. https://doi.org/10.1302/2046-3758.96.bjr-2019-0382.r2 - DOI - PubMed - PMC
    1. Luo CF, Sun H, Zhang B, Zeng BF (2010) Three- column fixation for complex tibial plateau fractures. J Orthop Trauma 24(11):683–692. https://doi.org/10.1097/bot.0b013e3181d436f3 - DOI - PubMed
    1. Gausewitz S, Hohl M (1986) Jan) The significance of early motion in the treatment of tibial plateau fractures. Clin Orthop Relat Res (202):135–138

Publication types

LinkOut - more resources