Michael Critelli MS¹, Kenny Thai BS¹, Janae Rasmussen DO^2,, Gabrielle Aluisio MBA³, Samuel Song MS⁴, Matthew Rohl BS⁵

Introduction: Total knee arthroplasty (TKA) is a popular choice of surgery to improve mobility and quality of life in select patients with degenerative joint disease of the knee. Many studies have shown early mobilization after TKA leads to decreased hospital costs and hospital length of stay. With its increasing popularity, it is necessary to determine the effects of early weight bearing (EWB) to ensure the effects are positive in the short-term and long-term following TKA. Methods: Five authors searched the databases PubMed, Google Scholar, and Elsevier for relevant articles while evaluating their impact. Reviewers used Boolean operators and search terms including “early weight bearing (EWB),” “total knee arthroplasty (TKA),” and “weight bearing protocols.” Data from the articles was assessed to determine the short-term and long-term effects of EWB after TKA. Results: Four studies indicated significant differences in promoting early weight bearing (EWB) and strength training after total knee arthroplasty (TKA). These significant differences between EWB and limited or non-weight bearing groups include range of motion (ROM), quadriceps strength, less pain, and higher overall satisfaction. Looking at the long-term effects, one study demonstrated that there was no loosening at the bone-cement interface after 2-5 years. Conclusion: The short-term effects of early weight bearing (EWB) are generally positive. Patients, on average, have higher patient-reported outcomes scores, and greater range of motion (ROM) following EWB after total knee arthroplasty (TKA). However, there are limitations in research about the long-term effects of EWB in TKA. Complications, such as implant loosening or malalignment, can occur with trauma to a joint after arthroplasty, especially in the setting of comorbidities like osteoporosis or diabetic neuropathy. Studies highlight the importance of considering patient risk factors for falls or trauma, such as fragility scores and in low-demand geriatric patients. Risk factors for falls post-TKA, such as advanced age, obesity, or intraoperative continuous femoral nerve block, should be considered when planning rehabilitation for TKA patients. Although the short-term benefits are overall positive, more research is necessary to determine if there are higher rates for revision and complications in the long-term in patients that follow EWB protocols.

orthopedic surgery, early weight bearing, total knee arthroplasty, rehabilitation, arthroplasty