Early Advanced Weight-Bearing After Periarticular Fractures: A Randomized Trial Comparing Antigravity Treadmill Therapy Versus Standard of Care.

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Journal of Orthopaedic Trauma


Summary: In current clinical practice, weight-bearing is typically restricted for up to 12 weeks after definitive fixation of lower extremity periarticular fractures. However, muscle atrophy resulting from restricting weight-bearing has a deleterious effect on bone healing and overall limb function. Antigravity treadmill therapy may improve recovery by allowing patients to safely load the limb during therapy, thereby reducing the negative consequences of prolonged non-weight-bearing while avoiding complications associated with premature return to full weight-bearing. This article describes a multicenter randomized controlled trial comparing outcomes after a 10-week antigravity treadmill therapy program versus standard of care in adult patients with periarticular fractures of the knee and distal tibia. The primary hypothesis is that, compared with patients receiving standard of care, patients receiving antigravity treadmill therapy will report better function 6 months after definitive treatment.

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METRC Corporate Authors: rooke Army Medical Center: Sarah N. Pierrie, MD, Edita Dragusin, DPT, NCS (no longer affiliated), and Joseph Kimmel, MS; Carolinas Medical Center, Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute: Joseph R. Hsu, MD; Hennepin Healthcare: Emily A. Wagstrom, MD, and Jerald R. Westberg, BA; Inova Fairfax Medical Campus: Greg E. Gaski, MD, James S. Ahn, JD, MS, Michael Holzman, MD, A. Stephen Malekzadeh, MD, Jeff E. Schulman, MD, Carly C. Schwartzbach, MD, Jaslynn A. N. Cuff, MA, and Lolita Ramsey, PhD, RN; McGovern Medical School at The University of Texas Health Science Center at Houston: Stephen J. Warner, MD, PhD, and Sterling J. Boutte, BS; Naval Medical Center Portsmouth: Colin V. Crickard, MD, and Michelle M. Dalton, MPT, ATC; Naval Medical Center San Diego: Benjamin M. Wheatley, MD; University of California, San Francisco: Eleni Berhaneselase, BA; University of Kentucky: Arun Aneja, MD, PhD, and Brian Noehren, PhD, PT; University of Virginia Medical Center: Kevin M. Cross, PhD, PT, and Eric D. McVey, MEd; Walter Reed National Military Medical Center: Benjamin K. Potter, MD; Heather K. Decot, PhD; and METRC Coordinating Center at the Johns Hopkins Bloomberg School of Public Health: Renan C. Castillo, PhD, Lauren E. Allen, DrPH, Anthony R. Carlini, MS, Linda Gai, ScM (now at the Lieber Institute for Brain Development), and Kuladeep Sudini, PhD.