No adverse effects of early weight bearing after uncemented total hip arthroplastyA randomized study of 20 patients Unrestricted Weight Bearing and Intensive Physiotherapy after Uncemented Total Hip Arthroplasty Immediate weight bearing after uncemented total hip arthroplasty with an anteverted stem: A prospective randomized comparison using radiostereometry Treadmill training with partial body-weight support after total hip arthroplasty: a randomized controlled trial. Task-oriented exercises and early full weight-bearing contribute to improving disability after total hip replacement: a randomized controlled trial A prospective randomized assessment of earlier functional recovery in THA patients treated by minimally invasive direct anterior approach: a gait analysis study. The effect of early weight bearing on migration pattern of the uncemented CLS stem in total hip arthroplasty. Rapid Rehabilitation and Recovery with Minimally Invasive Total Hip Arthroplasty Can the Length of Hospital Stay After Total Hip Arthroplasty be Predicted by Preoperative Physical Function Characteristics? [Measurement of ground reaction forces after total hip arthroplasty using different surgical approaches]. Surgical access and damage extent after total hip arthroplasty influence early gait pattern and guide rehabilitation treatment. Hip replacement and hip hemiarthroplasty surgery: potential opportunities to shorten lengths of hospital stay. Minimally invasive compared with traditional transgluteal approach for total hip arthroplasty: a comparative gait analysis. Comparison of gait in patients following a computer-navigated minimally invasive anterior approach and a conventional posterolateral approach for total hip arthroplasty: a randomized controlled trial. A randomized pilot study of a comprehensive postoperative exercise program compared with usual care following primary total hip arthroplasty in subjects less than 65 years of age: feasibility, selection of outcome measures and timing of assessment Reduced patient restrictions following total hip arthroplasty: study protocol for a randomized controlled trial Motor Imagery during Action Observation of Locomotor Tasks Improves Rehabilitation Outcome in Older Adults after Total Hip Arthroplasty
BACKGROUND Few guidelines are available whether early weight-bearing after an  uncemented total hip arthroplasty ( THA ) can be recommended or not . Stability and ingrowth may be jeopardized by immediate loading of the implant while functional recovery may be promoted and periprosthetic demineralization reduced . PATIENTS AND METHODS We did a prospect i ve study of 20 patients who were operated on with a hydroxyapatite-coated ( HA ) , uncemented total hip arthroplasty with a tapered stem because of unilateral arthrosis , and r and omized the patients to the immediate ( I ) or late ( L ) weight-bearing ( after 3 months ) group . The shoe on the operated side was equipped with an auditory device signaling when the patient placed a load on the extremity . The clinical assessment was done with the Harris hip score at the time of the operation and after 12 and 24 months . Radiographs and dual-energy x-ray absorptiometry ( DEXA ) were evaluated for migration , femoral remodeling and bone mineral density ( BMD ) after 3 , 6 , 12 and 24 months .  Tc-scintigraphy  was done after 6 , 12 and 24 months . RESULTS Postoperatively , the Harris hip score showed no group difference . After 3 months , we noted a large reduction in BMD around the stem prosthesis . This was most marked in the proximal regions and the bone loss was significantly larger in zone 1 , 4 and 5 in the L group . Distally , the BMD normalized with time , but the loss of bone persisted in the proximal zones after 24 months . An initial increase in the scintigraphic uptake ratio in all zones in both groups declined with time , but it was still increased on the operated side after 24 months . Several radiographic signs of bone remodeling were seen , but the patterns were similar in both groups . INTERPRETATION We found no adverse effect of immediate weight bearing with this prosthesis Background and Aims : The effectiveness of partial weightbearing after hip surgery has been question ed as well as the need of intensive physiotherapy . Material and Methods : 36 patients ( average age 54.4 , 19 women ) operated with uncemented hip arthroplasty were r and omized either to unrestricted weightbearing ( UWB ) combined with intensive physiotherapy or to partial weightbearing ( PWB ) for 3 months combined with a short self-training program . The load during walking and the muscle strength ( MS ) in abduction was measured preoperative and subsequent up to 12 months . Results : The average peak load on the operated leg at one week was 39.0 kg for the UWB and 25.8 for the PWB group ( P = 0.009 ) while at three months 70.0 and 31.7 ( P = 0.001 ) respectively . At 6 and 12 months there were no differences between the groups . The muscle strength increased in both groups up to six months but there were no differences between the groups . Conclusions : Even though patients applied more load than the recommended 15 kg most patients were able to comply with partial weightbearing fairly well . The effect of intensive physiotherapy on the muscle strength after hip arthroplasty is question able Background In uncemented total hip arthroplasty with hydroxyapatite coating , early weight bearing is frequently practice d but there is still not much evidence to support this recommendation . Method In a prospect i ve r and omized study we evaluated the effect of partial and full weight bearing after  cementless total hip arthroplasty ( ABG ; Stryker-Howmedica ) using radiostereometric analysis ( RSA ) . Between February 1996 and February 2000 , 43 consecutive patients ( mean age 53 ( 41–63 ) years , 23 women ) with hip osteoarthrosis received an uncemented and hydroxyapatite-coated prosthesis with an anteverted stem . All patients were operated in a st and ardized way by three experienced surgeons and they were r and omized to partial ( P ) or full ( F ) weight bearing during the first 6 weeks after surgery . The patients in the partial weight bearing group were equipped with a pressuresensitive insole signaling when their load exceeded the prescribed weight limit . Results At 3-month follow-up , the mean proximal (+)/ distal ( - ) migration of the stem was -0.14 mm ( -1.93– 0.11 ) in group P and -0.31 mm ( -4.30–0.16 ) in group F ( p = 0.6 ) . At 1-year follow-up , the mean migration was –0.17 mm ( -2.18–0.21 ) and -0.28 mm ( -4.31–0.11 ) , respectively ( p = 0.9 ) . There was no significant difference in stem rotations either ( p < 0.2 ) . The cup translations , rotations , and femoral head penetration were similar in the two groups ( p < 0.1 ) . There were no re-operations during the first year . Interpretation We did not find any adverse effect of full weight bearing immediately after operation , which justifies use of this regimen after uncemented total hip arthroplasty of the ABG type OBJECTIVE To compare treadmill training with partial body-weight support ( TT-BWS ) and conventional physical therapy ( PT ) in ambulatory patients with hip arthroplasty . DESIGN R and omized controlled trial . SETTING Rehabilitation center . PARTICIPANTS Eighty patients with a fully loadable implant who could walk independently with crutches after unilateral total hip arthroplasty were r and omized to receive either TT-BWS ( treatment group ) or conventional PT ( controls ) , for 10 working days . INTERVENTIONS Each patient received 45 minutes of individualized PT , either treadmill training plus PT in the experimental or PT alone in the control group . MAIN OUTCOME MEASURES The Harris score , recorded by blind assessors , served as the primary outcome measure . Secondary outcome measures were the hip extension deficit , gait velocity , gait symmetry , affected hip abductor power ; hip abductor amplitude of electromyographic activation ; and the interval from surgery to ab and oning crutches . RESULTS At the end of training , the treatment group 's Harris score was 13.6 points higher ( P<.0001 ) than the control group 's score . Further , hip extension deficit was 6.8 degrees less ( P<.0001 ) , gait symmetry was 10 % greater ( P=.001 ) , affected hip abductor was stronger ( Medical Research Council grade s 4.24 vs 3.73 ; P<.0001 ) , and the amplitude of gluteus medius activity was 41.5 % greater ( P=.001 ) than those measures for controls . Gait velocity did not differ in the 2 groups . These significant differences in favor of the treatment group persisted at 3 and 12 months . The treatment group ab and oned crutches sooner than the control group ( 3 vs 8wk ) . In the treatment group , 39 patients finished treatment , 35 appeared at 3 , and 26 at 12 months for follow-up . In the control group , the corresponding numbers were 40 , 35 , and 24 patients , respectively . CONCLUSION TT-BWS is more effective than conventional PT at restoring symmetrical independent walking after hip replacement Objective : To evaluate the efficacy of an in-hospital programme based on task-oriented exercises associated with early full weight-bearing in patients with multiple comorbidities undergoing total hip replacement . Design : R and omized controlled trial . Setting : Specialised rehabilitation centre . Subjects : A total of 100 patients ( mean age of 69 ( 8) years ; 40 males , 60 females ) . Interventions : The experimental group underwent task-oriented exercises and was encouraged to ab and on any walking aids by the end of their in-hospital stay . The control group underwent open chain kinetic exercises , and was recommended to use partial weight-bearing and walking aids until three months after surgery . Both groups individually followed programmes of 90-minute sessions five times a week for three weeks . Outcome measures : Western Ontario and McMaster Universities Osteoarthritis Index , Pain Numerical Rating Scale , Functional Independence Measure , and Short-Form Health Survey . The participants were evaluated before , after training , and after a further 12 months . Results : There were no significant between-group differences at baseline . After training , a between-group difference of 12 points was found for the Western Ontario and McMaster Universities Osteoarthritis Index – functional subscale , indicating a clinical ly tangible treatment effect on disability . The Functional Independence Measure increased by 31 and 15 points in the experimental and control group , respectively . A linear mixed model revealed significant effects of time , group , and time by group interaction on disability , pain , activities of daily living , and most of the physical quality of life domains . Conclusion : Task-oriented exercises associated with early full weight-bearing improve disability , pain , activities of daily living , and quality of life after total hip replacement BACKGROUND  Total hip replacement  using a minimally invasive surgical approach is cl aim ed to enable recovering of motor function more quickly . The purpose of this prospect i ve As per the stylesheet , kindly provide section headings for abstract . and r and omized study was to test this cl aim by evaluating early patient functional outcomes by gait analysis . METHODS Seventeen patients were operated on using a traditional anterolateral approach ( AL ) , 16 using a minimally invasive direct anterior approach ( DA ) .  Gait analysis was performed the day before surgery , and at 6 and 12 weeks after surgery . Time-distance and kinematics analyses were performed by a recently proposed anatomically-based gait analysis protocol . A static double-leg stance and five walking trials at self-selected speeds were recorded on a 9-m walkway . FINDINGS At 6 weeks follow-up , but in the DA group only , a statistically significant improvement with respect to preoperative status was observed for the percentage of single support and for the stride time . Between 6- and 12-week follow-up , the DA group showed a significant improvement in cadence , stride time and length , walking speed , hip flexion at foot contact , maximum hip flexion in swing , and hip total range of motion in the sagittal and the coronal planes . Between 6 and 12 weeks , the AL group showed significant improvements in opposite foot contact and step time , and in flexion at foot contact , maximum flexion in swing , and range of flexion at the hip joint . INTERPRETATION Minimally invasive DA patients improved in a larger number of gait parameters than patients receiving the traditional AL approach . The majority of improvements occurred between the 6- and 12-week follow-ups Forty-two patients ( younger than 65 years ) with osteoarthritis were operated on with an uncemented CLS stem and r and omized to early unrestricted weight bearing combined with intensive physiotherapy or to partial weight bearing combined with self-training . Radiostereometric analysis showed 1.2 ( + 0.11 to -6.76 ) mm subsidence of the stem at 24 months in both groups . There was no significant difference in the migration pattern between the unrestricted and partial weight bearing groups . Actual loading on the operated leg , measured with the F-scan system , did not influence the migration of the stem . There was a strong correlation between the average subsidence at 3 and 24 months ( r = 0.96 ) . Early full weight bearing and active rehabilitation can be used for the uncemented CLS stem without increased risk of early loosening To assess the potential recovery rate of a  minimally invasive total hip replacement technique  with minimal soft tissue disruption , an accelerated rehabilitation protocol was implemented with weightbearing as tolerated on the day of surgery . One hundred consecutive patients were enrolled in this prospect i ve study . Ninety-seven patients ( 97 % ) met all the inpatient physical therapy goals required for discharge to home on the day of surgery ; 100 % of patients achieved these goals within 23 hours of surgery .  Outpatient therapy  was initiated in 9 % of patients immediately , 62 % of patients by 1 week , and all patients by 2 weeks . The mean time to discontinued use of crutches , discontinued use of narcotic pain medications , and resumed driving was 6 days postoperatively . The mean time to return to work was 8 days , discontinued use of any assistive device was 9 days , and resumption of all activities of daily living was 10 days . The mean time to walk ½ mile was 16 days . Furthermore , there were no readmissions , no dislocations , and no reoperations . Therefore , a rapid rehabilitation protocol is safe and fulfills the potential benefits of a rapid recovery with minimally invasive total hip arthroplasty Objective The aim of the present study was to identify independent preoperative hip function characteristics sensitive for preoperative intervention that are predictive of an extended length of hospital stay ( LOS ) after primary total hip arthroplasty ( THA ) .  Design This is a longitudinal cohort study . A retrospective chart analysis was conducted on prospect ively collected data of patients ( 158 ) who underwent unilateral primary elective cemented THA in a 4-yr period . The main outcome measure was LOS after primary THA . Results The median LOS was 6.0 days . The authors found an 18.5 % increased chance of requiring an LOS of more than 6 days ( odds ratio , 2.15 ; 95 % confidence interval , 1.03–4.50 ) for the patients who needed to use a walking aid preoperatively and a 23.6 % increased chance ( odds ratio , 2.74 ; 95 % confidence interval , 1.31–5.74 ) for the patients who had difficulties managing stairs . Sex , age , body mass index , comorbidity , and preoperative pain did not reach the level of significance in the multivariate analysis . Conclusions Patients who are at risk for a longer stay in the hospital after THA can be identified preoperatively on simple physical function characteristics . These findings enable the identification of appropriate patients for preoperative training to improve functional recovery and decrease the LOS after primary THA AIM Benefits of less damage of soft tissues and muscles in minimally invasive hip replacement lead to expectations of better results in gait rehabilitation . The aim of the study is to evaluate post-operative walking ability in terms of different surgical approaches . METHOD 16 patients underwent a minimally invasive total hip replacement ( MIS group ) and 16 other patients got a THA using a transgluteal approach ( st and ard group ) . Differences in functional indices of ground reaction forces and symmetry indices were measured one day pre-operatively as well as 8 , 14 and 28 weeks post-operatively . The results were compared between the surgical approaches and to an age-matched healthy control group . RESULTS There are significantly reduced pain symptoms and a higher functional ability in both surgical groups 8 weeks post-operatively . There are no differences in gait parameters between the surgical groups after 28 weeks . Trends in gait velocity , temporal parameters and in functional indices of ground reaction forces show advantages for the minimally invasive group 8 and 14 weeks post-operatively . Patients do not reach the age-matched control group . CONCLUSION Obviously the immediate post-operative advantages of minimally invasive hip replacement provide better chances for gait rehabilitation compared to the transgluteal approach . Due to the complexity of the problem clinical and gait analysis studies should be linked more closely AIM Different surgical approaches are used in total hip arthroplasty . The present study confronted two surgical techniques , analysing functional recovery in terms of activities of daily living , and ambulation using gait analysis , after a st and ardized rehabilitation protocol . Our hypothesis was that the increased surgical damage could modify the gait pattern and functional recovery . METHODS Thirty patients were r and omly assigned to two homogeneous groups : Group A was treated with intermuscular minimally invasive surgery ( MIS ) ; Group B was treated with st and ard lateral transmuscular approach . Follow up was planned at 30 and 90 days . Instrumental evaluation using gait analysis and functional evaluation using vali date d scales were performed at follow up . RESULTS No differences could be found as for functional scales . At the first follow up , the MIS approach proved to be the most favourable : data showed a longer duration of the swing phase , an improved range of motion of the non-treated hip , a reduced adduction ( all P<0.005 ) and a correct timing of activation of the gluteus medium muscle on the treated side . At the second evaluation , gait analysis demonstrated some benefits of the intermuscular approach ( a better flexion of both hips , and a minor obliquity of the pelvis during the terminal stance ) , but also advantages in the transmuscular group ( better hip extension ) . CONCLUSION Gait pattern after THA seems to be strictly dependent on surgical access and on the extent and location of surgical damage . It appears important to consider these elements in order to correctly manage the rehabilitation treatment after surgery The potential safety and effectiveness of a practice guideline recommending a 5-day postoperative stay in the acute care hospital for hip surgery patients without clinical findings predictive of a complicated hospital course was studied retrospectively in 230 patients hospitalized for total hip replacement , total hip replacement with osteotomy , or hip hemiarthroplasty .  Seventy percent of total hip replacement and hip hemiarthroplasty patients were classified as being at " low risk " for complications by the guideline ( 161 patients , or 73 % of patients who remained hospitalized ) . Use of the guideline could have reduced the hospital length of stay from 8.4 days ( st and ard deviation 3.3 ) to 5.9 days for these selected low-risk patients . Moreover , physicians ' implicit review determined that 0 % of patients ( 95 % confidence interval , 0 % to 2.3 % ) had a complication that would have benefited from continued stay in an acute care hospital after the fifth postoperative day . Our practice guideline may have the potential to safely reduce acute care hospital length of stay for patients recovering after total hip replacement and hip hemiarthroplasty . The guideline will require further study in a prospect i ve clinical trial before it can be recommended for widespread use BACKGROUND Minimally invasive total hip arthroplasty is purported to allow an improved and faster rehabilitation in the immediate postoperative period because of reduced soft-tissue damage compared with total hip arthroplasty performed with use of a st and ard approach . In the present study , a minimally invasive approach was compared with a traditional st and ard approach in terms of the effect on gait kinematics as demonstrated with gait analysis and electromyography . METHODS Twenty r and omized patients who underwent a primary total hip replacement with use of a minimally invasive modified Watson-Jones approach ( minimally invasive group ) were compared with a group of twenty patients who underwent a total hip arthroplasty with use of a st and ard transgluteal Hardinge approach ( st and ard group ) . All patients received the same cementless implant , inserted with use of st and ard instruments , and all operations were performed by a single , experienced surgeon . The patients were evaluated with use of three-dimensional gait analysis and dynamic electromyograms at three time points : preoperatively , ten days postoperatively , and twelve weeks postoperatively . Temporospatial and joint-kinematic parameters were evaluated . RESULTS There were no significant differences between the two groups with regard to the temporospatial variables of velocity , cadence , step length , and stride length at any tested time point . With regard to the range of motion of the operatively treated hip , the minimally invasive group had a smaller decrease at the ten-day time point in comparison with the st and ard group . However , this finding was not significant . The reduction in the range of motion was mainly caused by reduced hip extension . A compensatory increase in the pelvic tilt was observed in both groups . One patient in the st and ard group showed a positive Trendelenburg gait ten days postoperatively ; it had disappeared completely at the twelve-week time point . CONCLUSIONS With regard to gait kinematics in the early postoperative period ( three months ) , the present study showed no significant benefit for patients who underwent a total hip arthroplasty through a minimally invasive Watson-Jones approach in comparison with those who were managed with a st and ard transgluteal approach Minimally invasive total hip arthroplasty ( MIS THA ) aims at minimizing damage to muscles and tendons to accelerate postoperative recovery . Computer navigation allows a precise prosthesis alignment without complete visualization of the bony l and marks during MIS THA . A r and omized controlled trial ( RCT ) was conducted to determine the effectiveness of a computer-navigated MIS anterior approach for THA compared to a conventional posterolateral THA technique on the restoration of physical functioning during recovery following surgery . Thirty-five patients underwent computer-navigated MIS THA via the anterior approach , and 40 patients underwent conventional THA using the conventional posterolateral approach .  Gait analysis was performed preoperatively , 6 weeks , and 3 and 6 months postoperatively using a body-fixed-sensor based gait analysis system . Walking speed , step length , cadence , and frontal plane angular movements of the pelvis and thorax were assessed . The same data were obtained from 30 healthy subjects . No differences were found in the recovery of spatiotemporal parameters or in angular movements of the pelvis and thorax following the computer-navigated MIS anterior approach or the conventional posterolateral approach . Although gait improved after surgery , small differences in several spatiotemporal parameters and angular movements of the trunk remained at 6 months postoperatively between both patient groups and healthy subjects Background Total Hip Arthroplasty ( THA ) is being used more commonly in younger higher dem and patients . The purpose of this r and omized pilot study was to explore a ) feasibility of comprehensive postoperative rehabilitation compared to usual care  following primary THA in subjects < 65 years , b ) appropriate outcome measures including performance-based measures and c ) timing of assessment s. Methods 21 subjects who underwent primary THA were r and omized to receive a three-month out-patient rehabilitation program ( Intervention ) or usual postoperative care ( Control ) . Subjects were assessed preoperatively , six-weeks postoperatively ( Pre-intervention ) and four and 12 months postoperatively ( Post-intervention ) . Self-report measures were the Western Ontario McMaster Osteoarthritis Index ( WOMAC ) and R and 36-Item Health Survey ( R AND -36 ) . Performance-based measures included lower extremity strength , walking speed and endurance , and gait laboratory assessment . Results Ten Control and 11 Intervention subjects with an average age of 53.4 ( SD9.3 ) years were r and omized . All Intervention subjects completed the program without adverse effects . Although no statistically significantly results were reported , four months postoperatively , Intervention subjects had clinical ly important differences ( CID ) in strength compared with Control subjects . Walking endurance , WOMAC and R AND scores improved significantly with no CID noted between groups . Ten ( 48 % ) subjects reported a ceiling effect on the WOMAC ( 9 ( 43 % ) subjects on Pain ; 1 ( 5 % ) subject on Function ) . No group CID were noted in gait measures . Conclusions Our recommendations would be that performance-based strength measures should be considered for the primary outcome in this younger cohort . Because of the ceiling effects with WOMAC Pain , a different pain measure is indicated . Other more challenging functional performance-based tests should be considered such as a more prolonged endurance test . There is merit in one-year follow-up as strength improved after four months in both groups Background Total hip arthroplasty ( THA ) is a very common procedure in orthopedic surgery . In the Netherl and s , 25,642 primary THAs were performed in 2013 . Postoperative hip dislocation is one of the major complications and has been reported in 0.5 to 10.6 % of patients after primary THA.Several reports regarding the use of an anterolateral surgical approach have shown that a non-restriction or reduced restriction protocol does not increase the dislocation rate . For the posterolateral surgical approach it has been suggested that patient restrictions might be unnecessary but the amount of available literature is scarce . As such , r and omized controlled trials aim ed at investigating restrictions following THA using a posterior approach are strongly recommended . The aim of this prospect i ve r and omized controlled trial is to investigate the non-inferiority hypothesis concerning the early dislocation rate after THA in patients with and without the use of a reduced restriction protocol . Methods / Design After providing informed consent a group of 456 patients with symptomatic coxarthrosis will be r and omized to receive a THA either with care as usual , i.e. receiving postoperative restrictions including the advice to sleep in a supine position for the first 8 weeks postoperatively , or reduced restrictions with no recommendations regarding the position during sleeping . Primary outcome measure will be the percentage of early dislocations within the first 8 weeks after THA . Secondary outcome measures will be patient satisfaction , time to functional recovery , quality of sleep and patient ’s self-reported compliance with postoperative instructions . Discussion To our knowledge this will be the first r and omized controlled trial that compares a reduced restriction protocol with a restricted protocol following THA using a posterolateral surgical approach . Our hypothesis is that a reduced restriction protocol following THA with use of a posterolateral surgical approach has no influence on the early dislocation rate compared to a restricted protocol . Instead , embracing a reduced restriction protocol might even contribute to a higher quality of sleep , thereby facilitating a faster uptake and return to daily functions in patients after THA.Trial registration Clinical Trials.gov NCT02107248 , registration date 3 April 2014 This study aim ed at determining whether the combination of action observation and motor imagery ( AO + MI ) of locomotor tasks could positively affect rehabilitation outcome  after hip replacement surgery . Of initially 405 screened participants , 21 were r and omly split into  intervention group ( N = 10 ; mean age = 64 y ; AO + MI of locomotor tasks : 30 min/day in the hospital , then 3 × /week in their homes for two months ) and  control group ( N = 11 , mean age = 63 y , active controls ) . The functional outcomes ( Timed Up and Go , TUG ; Four Step Square Test , FSST ; and single- and dual-task gait and postural control ) were measured before ( PRE ) and 2 months after surgery ( POST ) . Significant interactions indicated better rehabilitation outcome for the intervention group as compared to the control group : at POST , the intervention group revealed faster TUG ( p = 0.042 ) , FSST ( p = 0.004 ) , and dual-task fast-paced gait speed ( p = 0.022 ) , reduced swing-time variability ( p = 0.005 ) , and enhanced cognitive performance during dual tasks while walking or balancing ( p < 0.05 ) . In contrast , no changes were observed for body sway parameters ( p ≥ 0.229 ) . These results demonstrate that AO + MI is efficient to improve motor-cognitive performance after hip surgery . Moreover , only parameters associated with locomotor activities improved whereas balance skills that were not part of the AO + MI intervention were not affected , demonstrating the specificity of training intervention . Overall , utilizing AO + MI during rehabilitation is advised , especially when physical practice is limited
We found moderate to strong evidence that no adverse effects on subsidence and osseous integration of the femoral stem after uncemented THA occur after immediate UWB .
The aim of this systematic review was to find evidence -based support in the literature to allow immediate unrestricted weight bearing after  primary uncemented total hip arthroplasty ( THA ) .
Accelerated rehabilitation programs for THA are becoming increasingly popular to shorten hospital stay and to facilitate rapid restoration of function .
The goals of these rehabilitation programs could be more easily achieved if immediate unrestricted weight bearing ( UWB ) could be allowed after a THA .
So far , however , immediate weight bearing is frequently contraindicated in widely accepted protocol s for uncemented THA due to fear for subsidence and absence of osseous integration of the femoral stem .
Thus , frequently protected weight bearing and restricted activities are still advocated for at least 6 weeks after surgery .
In addition , we analyzed the literature to come to a recommendation on gait pattern and walking aid .