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

Open reduction and tension band internal fixation is the standard treatment for patellar fractures. Although this surgery aids early weight-bearing and joint movement, full recovery of knee function - particularly the ability to perform straight leg raising (SLR) - often still requires a longer period, which can affect the patients' daily activities, such as getting out of bed and dressing. To enhance its recovery, we implemented an early high knee walking (HKW) protocol from June 2023. This retrospective analysis was conducted on 48 patients from June 2023 to April 2025, with 42 eligible patients included in the analysis. Among them, 22 patients initiated HKW training (intervention group) on postoperative day 7, while 20 patients received assisted straight leg raise training (assisted straight leg raising; control group). Self-reported measures assessed at postoperative days 7, 14, 28, and 100 included visual analogue scale score, SLR and seated knee extension (SKE) ability, and thigh circumference difference. The results showed no differences between the 2 groups on postoperative day 7. At 14, 28, and 100 days postoperatively, both groups demonstrated significant improvements compared to baseline (day 7) in all indexes (P < .05 or P < .01). Additionally, compared to the control group, the intervention group demonstrated quicker pain relief (Day 14, 28, 100; P < .05) and swelling reduction (Day 14; P < .05), superior SKE (day 28; P < .05) and SLR function (day 100; P < .05), and less muscle atrophy (day 100; P < .01). The results of this study suggest that HKW exercise for the postoperative patients with patellar fractures facilitates pain relief, SLR and SKE recovery, and reduces thigh swelling and muscle atrophy.