The Effect of Early Weight Bearing and Delayed Weight Bearing on Functional Recovery in Post Total Knee Replacement
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Abstract
Background: Early mobilization is a central component of rehabilitation after total knee replacement (TKR), yet the timing of loading through the operated limb varies across clinical settings. This study compared early weight bearing with delayed weight bearing for functional recovery after primary unilateral TKR. Methods: Thirty patients aged 50-75 years were included in a prospective comparative interventional study and allocated to an Early Weight Bearing (EWB) group (n=15) or Delayed Weight Bearing (DWB) group (n=15). EWB participants began supported standing and walking within 24-48 hours when medically stable; DWB participants followed protected/minimal loading for the first 14 days before progressive advancement. Outcomes included Knee Society Score (KSS), WOMAC physical function, Visual Analog Scale (VAS), active knee flexion range of motion (ROM), and Timed Up and Go (TUG). Non-parametric between- and within-group tests were used with p<0.05 as the significance level. Results: Baseline characteristics and clinical measures were comparable. At 6 weeks, EWB showed higher KSS (77.15±3.49 vs 69.02±7.16; p=0.002), lower WOMAC disability (29.61±3.29 vs 35.71±4.63; p<0.001), greater knee flexion ROM (106.38±5.22° vs 98.06±4.38°; p<0.001), and faster TUG (9.31±0.79 vs 11.49±1.35 s; p<0.001). VAS was also lower (2.24±0.64 vs 2.69±0.56), although the 6-week difference was not statistically significant (p=0.074). Early advantages were evident at 2 weeks and remained significant for all five outcomes at 3 months. No fall, confirmed deep vein thrombosis, or major implant-related complication occurred. Conclusion: Early, protected and supervised weight bearing was associated with faster early functional recovery after TKR without an observed increase in major short-term complications. Delayed loading may be better reserved for patient- or surgeon-specific restrictions.
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