Feedback and Analysis System to Improve Partial Weight Bearing and Bone Healing Following Fractures and Osteotomies of the Lower Limb: Technical Note

Stoller, Ina S.; Babanin, A; Baumgartner, H.; Schröter, Steffen; Ihle, Christoph; Döbele, Stefan

doi:10.55095/achot2021/034

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Partial weight-bearing has always been a major point of discussion after surgery of the lower extremity by orthopedic trauma surgeons. Since new devices are available for the measurement of loading and the possibility of even giving biofeedback, monitoring of mobilization after trauma is much easier [8]. This study demonstrates that many patients experience difficulty with postoperative weight-bearing instructions.…”

Section: Discussionmentioning

confidence: 77%

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Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity

et al. 2022

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Purpose In order to prevent implant failure and secondary fracture dislocation, it is often recommended that patients perform partial weight-bearing after surgery of the lower extremity. Previous examinations showed that patients are often not able to follow these instructions. In this study, patients who had undergone surgery of the lower extremity were studied in order to analyze whether incorrect loading influenced the number and severity of complications. Methods Fifty-one patients were equipped with electronic shoe insoles, which measure loading and other parameters. The measurement period was 24 to 102 hours. Median duration of follow-up was 490 days. The primary outcome parameter was postoperative complications leading to revision surgery. Statistical analysis was performed using the chi-square and Fisher exact tests with significance set at a p < 0.05. Results Seven out of fifty-one patients had postoperative complications. Four wound complications, one implant failure, chronic instability after fracture of the tibia, and one implant loosening of a hip prosthesis were recorded. In total, 26 of 39 patients were not able to follow the postoperative instructions. Five of the twenty-six patients with difficulties in partial weight-bearing suffered a postoperative complication. In comparison, only 2 of the other 25 patients were affected. There was no statistically significant correlation between high weight-bearing and occurrence of complications (p = 0.29). Conclusion Most of the patients were unable to follow the surgeon’s instructions for partial weight-bearing. Excessive loading did not seem to influence the number and severity of postoperative complications, especially regarding implant failure. Therefore, we should continue with measurements and reevaluate the “partial weight-bearing doctrine”.

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Section: Discussionmentioning

confidence: 77%

“…Different training methods are known to improve compliance. Bathroom scales are often used by physiotherapists to visualize loading, but recent investigations confirmed that biofeedback methods, e.g., real-time haptic (vibratory) biofeedback, are more successful [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity

et al. 2022

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Partial weight-bearing following ankle fracture: what’s the actual load in early recovery?

Merkle,

Hofmann,

Knop

et al. 2024

Arch Orthop Trauma Surg

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Digital monitoring of weight-bearing improves success rates and reduces complications in lower extremity surgeries

Otoukesh,

Moshiri,

Jahangiri

et al. 2023

Eur J Transl Myol

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The aim of this study is to develop a digital monitoring system to track weight and evaluate its impact on postoperative outcomes after lower extremity surgeries (LES). This parallel randomized controlled trial enrolled 266 patients who underwent LES (fracture or joint replacement) at our medical center between March 11, 2022, and January 10, 2023. Patients were randomly assigned to the intervention and control groups in a 1:1 ratio. The intervention group (n=116) used a cane and shoes equipped with a weight-bearing system after lower limb surgery, while the control group (n=116) used a simple cane and shoes without a weight-bearing system. The primary outcomes included callus formation, duration of union, and success rate of union in the two groups. The intervention group had a significantly higher rate of complete surgical success than the control group (93.9% vs. 79.3%, p=0.001). The intervention group also had a significantly lower risk of non-union than the control group (OR: 2.33, 95% CI: 1.14, 3.48, p=0.001). The mean duration of surgery until the time of union and the meantime of callus formation was significantly lower in the intervention group (p=0.01). The use of a digital monitoring system for weighing in LES significantly increased the success rate and reduced post-operative complications. Therefore, incorporating this system can enhance the rehabilitation process and prevent revision surgeries in patients with LES.

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Feedback and Analysis System to Improve Partial Weight Bearing and Bone Healing Following Fractures and Osteotomies of the Lower Limb: Technical Note

Cited by 3 publications

References 10 publications

Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity

Influence of Weight Bearing on Postoperative Complications after Surgical Treatment of the Lower Extremity

Partial weight-bearing following ankle fracture: what’s the actual load in early recovery?

Digital monitoring of weight-bearing improves success rates and reduces complications in lower extremity surgeries

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