Orthopedists too Conservative With Load Bearing? (Orthopedics This Week)
You put a lot of work into that surgery. Why not play it safe and restrict load bearing? Because, says Erik Kubiak, M.D. and collaborators, the patient may likely undergo unnecessary functional decline and prolonged periods of lost productivity…and because medicine should be based on science. Dr. Kubiak, an associate professor at the University of Utah Medical Center, tells OTW, “My colleagues and I have just published a review article in the Journal of the American Academy of Orthopaedic Surgeons indicating that weight-bearing protocols are often applied arbitrarily based on little objective data. Certain studies suggest that patients with normal protective sensation—those who autoregulate—can safely bear weight sooner than most protocols permit. Then there are the randomized, controlled trials of ankle fractures that have shown no difference in outcomes between immediate and delayed (≥6 weeks) weight bearing. Yet patients with periarticular fractures may not fare as well with early weight bearing.”
“My colleagues and I began considering this issue of autoregulation. Pediatric patients do what they want; olde...
