The impact of high knee walking on knee pain and straight leg raising function after patellar fracture surgery: A retrospective study.

High knee walking training resulted in quicker pain relief compared to the control group at multiple postoperative time points.

• 22 patients initiated high knee walking (HKW) training on postoperative day 7 (intervention group); 20 patients received assisted straight leg raise training (control group)
• The intervention group demonstrated quicker pain relief as measured by visual analogue scale score at postoperative days 14, 28, and 100 (P < .05 for all three time points)
• No differences between the two groups were observed at postoperative day 7 (baseline)

The high knee walking intervention group showed greater reduction in thigh swelling at postoperative day 14 compared to the control group.

• Swelling was measured using thigh circumference difference between the operated and non-operated limb
• The intervention group demonstrated superior swelling reduction at day 14 (P < .05)
• No statistically significant between-group difference in swelling reduction was reported at later time points (days 28 and 100)

The high knee walking intervention group demonstrated superior seated knee extension function at postoperative day 28.

• Seated knee extension (SKE) ability was assessed as a self-reported measure at days 7, 14, 28, and 100
• The intervention group showed superior SKE compared to the control group at day 28 (P < .05)
• Both groups showed significant improvements compared to baseline (day 7) at days 14, 28, and 100 (P < .05 or P < .01)

The high knee walking intervention group demonstrated superior straight leg raising function at postoperative day 100.

• Straight leg raising (SLR) ability was a primary outcome assessed as a self-reported measure
• The intervention group showed superior SLR function compared to the control group at day 100 (P < .05)
• No between-group differences in SLR were observed at days 14 or 28

The high knee walking intervention group experienced less muscle atrophy compared to the control group at postoperative day 100.

• Muscle atrophy was assessed via thigh circumference difference
• The intervention group demonstrated less muscle atrophy than the control group at day 100 (P < .01)
• This was the strongest between-group statistical finding in the study (P < .01 versus P < .05 for other outcomes)

Both intervention and control groups showed significant improvements from baseline in all measured indexes by postoperative day 14 and beyond.

• Outcomes measured included visual analogue scale score, SLR ability, SKE ability, and thigh circumference difference
• Assessments were conducted at postoperative days 7, 14, 28, and 100
• At days 14, 28, and 100, both groups demonstrated significant improvements compared to baseline (day 7) in all indexes (P < .05 or P < .01)
• The study was retrospective and included 42 eligible patients from an initial pool of 48 patients treated from June 2023 to April 2025