Purpose: To evaluate in subjects with tibial plateau fractures surgical fixation how
patient’s clinical Rasmussen score, pain, knee ROM, radiographic bony alignment, and muscle strength respond to immediate Weight-bearing to tolerance after surgical fixation.
A pre-test, and post-test comparison group design (randomized clinical trial) was used. A systematic consecutive convenience sample of 52 patients completed the study after open or arthroscopic tibial plateau fracture internal fixation was assigned randomly into one of two groups: (1) the traditional rehab protocol group (TG), and (2) the early weight-bearing group (WBG). The TG was evaluated and treated one time in the hospital and was given the non-weight-bearing rehabilitation protocol for 6 weeks. The WBG allowed weight bearing in addition to the exercise program. The dependent variables, including clinical Rasmussen score, numerical pain rating scale (NPRS), knee active range of motion (ROM), radiological measurements (union, deformity, and alignment), and hip muscle strength were collected at 2-day, 2-week, 6-week, 3-month, and 6-month following the surgery.
There were significant between groups differences in favor of the WG at 6-month for the total clinical Rasmussen score (p=.002) as well as for the NPRS (p=.005), and knee ROM (p=.047).Patients in the WG had significantly better hip isometric muscle strength at 3 months following surgery (p.05). We found neither between groups difference in terms of radiological CT- Scan and X-ray measures, nor for Rasmussen radiological scores
Following surgical treatment of tibia plateau fractures, patients who underwent a weight-bearing protocol earlier were able to recover faster with no higher complications compared with patients who started weight-bearing after 6-weeks.
Early WB allows quicker recovery, better muscle strength and less pain with no difference in radiological measures.
knee surgeries
Post-operative rehabilitation
