gms | German Medical Science

Although Knee Arthroplasty is one of the most common major surgical procedures, an optimal postoperative treatment regimen is still unknown. In particular, current recommendation regarding weight-bearing after primary unilateral knee replacement vary considerably. The aim of this study was to examine the differences between a recommended full weight-bearing or partial weight-bearing regimen after knee replacement on disability, joint stiffness, pain, quality of life, and patient satisfaction.

Multicenter randomized controlled trial. One group was recommended a full weight-bearing, the other a partial weight-bearing regimen after primary unilateral knee replacement. At baseline, three, six and twelve postoperative months the following outcomes were taken: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-36 (SF-36), Lequesne Knee Score, and a patient satisfaction score based on a consensus paper of the AAOS, SICOT, and the Hip Society.

The primary outcome was assessed in 143 of 150 patients, resulting in a follow-up rate of 95.3 percent. Differences between study groups favoring recommended partial weight-bearing were observed for all measured outcomes. These differences were statistically significant for the Lequesne Knee and the patient satisfaction score at both the three- and six-month follow-up and for WOMAC-function, WOMAC-pain, SF-36 Physical Component Summary at the six-month follow-up. The partial weight-bearing group achieved similar results at the three- and six-month follow-up when compared to the full weight-bearing group at six- and twelve month follow-up, respectively.

After knee arthroplasty, the recommendation of partial weight-bearing regimen leads to superior outcome in health-related quality of life than recommended full weight-bearing.