In two recent randomized, controlled investigations, the effects of immediate weight bearing as tolerated during ambulation and other functional activities after cementless or hybrid arthroplasty were compared with the effects of restricted weight bearing. No short-term or long-term adverse effects of immediate weight bearing were identified in either study. It is important to note that patients in both studies were relatively young compared with most patients undergoing hip arthroplasty, and their bone quality was described as excellent. In addition, all patients in both studies participated in a comprehensive, supervised postoperative rehabilitation program.
In one study, patients assigned to the immediate weight-bearing group were placed on no weight-bearing restrictions. These patients were also encouraged to discontinue use of ambulation aids as soon as possible. In contrast, those in the restricted weight-bearing group were required to ambulate with two crutches and were limited to toe-touch weight bearing for 6 weeks. After 6 weeks these patients were permitted to bear weight as tolerated.
In the other study, patients in the immediate weight-bearing group initially used one crutch but were encouraged to place as much weight as tolerated on the operated lower extremity. Patients in the delayed weight-bearing group ambulated with two crutches and were allowed to place only 10% of body weight on the operated leg for 3 months.
There were no significant differences found between the two groups in either study on several follow-up evaluations. Authors of both studies suggested that early weight bearing as tolerated after cementless or hybrid primary THA can be safe in a young patient population ( 60 to 65 years of age) with excellent bone quality. However, in the clinical setting, the responsibility of determining the need for protected weight bearing during the early phase of postoperative rehabilitation after THA remains with the surgeon.

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