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

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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).

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Musculoskeletal Physiotherapy, MGM Institute of Physiotherapy, Aurangabad, Maharashtra, India

    Anagha Kadam, Surendra Wani, Goutami Katage, Kapil Garg & Sanket Mungikar

  2. Department of Orthopedics, MGM Medical College and Hospital, Aurangabad, Maharashtra, India

    Girish Gadekar

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  1. Anagha Kadam
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Contributions

All authors contributed to the study conception and design. Data collection was done by Anagha Kadam. Material preparation and analysis were performed by Anagha Kadam, Surendra Wani and Sanket Mungikar. The first draft of the manuscript was written by Anagha Kadam, Surendra Wani, Goutami Katage. The first draft was reviewed and edited by Girish Gadekar, Surendra Wani and Kapil Garg, all authors commented on previous versions of the manuscript and was supervised by Surendra Wani. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Surendra Wani.

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Competing Interests

The authors have no competing interests to declare that are relevant to the content of this article.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Patients provided informed consent for publishing their data and photographs.

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study was approved by the Institutional ethics committee, MGM Institute of Physiotherapy (MGM/IOP/IEC/PG/2022/10) and was registered with the ClinicalTrialsRegistry.gov (CTRI/2022/10/046797).

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Kadam, A., Wani, S., Gadekar, G. et al. Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial. Arch Orthop Trauma Surg (2024). https://doi.org/10.1007/s00402-024-05347-w

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