Effect of Timing of Weight-Bearing Training on Postoperative Recovery After Hip-Preserving Surgery for Femoral Head Necrosis: A Retrospective Analysis

Effect of Timing of Weight-Bearing Training on Postoperative Recovery After Hip-Preserving Surgery for Femoral Head Necrosis: A Retrospective Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of Timing of Weight-Bearing Training on Postoperative Recovery After Hip-Preserving Surgery for Femoral Head Necrosis: A Retrospective Analysis Junming Zhang, Yanbin Wu, Yazhou Li, Tingjie Zhao, Zexian Liu, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6899359/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: There is currently no clear consensus regarding whether and when weight-bearing should be initiated following hip-preserving surgery for osteonecrosis of the femoral head (ONFH). This study aimed to investigate the impact of the timing of weight-bearing training on postoperative recovery outcomes in patients undergoing hip-preserving procedures for ONFH. Methods: A retrospective analysis was conducted on 42 ONFH patients (78 hips) who underwent hip-preserving treatment at the Fourth Medical Center of PLA General Hospital in 2023. Twenty patients (38 hips) were assigned to the control group (no weight-bearing for 8 months postoperatively, followed by partial weight-bearing), and 22 patients (38 hips) were assigned to the weight-bearing (WB) group (non-weight-bearing for 6 weeks postoperatively, then partial weight-bearing, progressing to full weight-bearing at 3 months). Radiographic progression and clinical outcomes were assessed over a minimum follow-up period of 16 months using the Association Research Circulation Osseous (ARCO) classification system. Results: At 8 months postoperatively, the control group had a significantly lower radiographic progression rate compared to the WB group ( P 0.05). All progressed hips were classified as Japan Investigation Committee (JIC) type C2. Kaplan–Meier survival analysis showed superior hip survival in the control group at 8 months ( P 0.05). Functional assessment revealed better hip range of motion in the control group at 8 and 16 months postoperatively ( P < 0.05), while the WB group demonstrated superior Harris Hip Score (HHS), general health, social function, and health change scores at 16 months ( P < 0.05). Conclusion: For patients with ARCO stage IIIA and JIC type C2 ONFH, postoperative weight-bearing should be avoided. In contrast, for patients with JIC types B and C1, appropriately timed weight-bearing training may enhance functional recovery. Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Osteonecrosis of the femoral head (ONFH) is a common clinical condition characterized by localized abnormalities in bone metabolism and severely compromises patients' quality of life 1 – 4 .In China, the annual incidence is estimated at 75,000 to 150,000 new cases, with approximately 8.12 million individuals affected by non-traumatic osteonecrosis 5 .ONFH has a high disability rate and, if not treated in a timely manner, can rapidly progress to femoral head collapse 6 .In recent years, core decompression combined with stem cells or growth factors has become a mainstream treatment for ONFH, achieving favorable outcomes 7 – 10 .However, while most studies have focused on surgical techniques, there remains no clear consensus regarding the optimal timing of postoperative weight-bearing rehabilitation. Previous studies have suggested 11 – 16 that early weight-bearing may enhance bone mineral density and promote osteogenesis. Conversely, other research has indicated 17 that the biomechanical properties of the necrotic area are compromised, and sustained stress on the femoral head may accelerate collapse. From the perspectives of skeletal mechanobiology and Wolff’s law, reducing mechanical loading might increase bone resorption, potentially accelerating the development of the crescent sign and the risk of femoral head collapse. On the other hand, from a biomechanical standpoint, weight-bearing restriction reduces mechanical forces on the femoral head and may help prevent structural failure 18 .Thus, whether postoperative weight-bearing is advisable after hip-preserving surgery for ONFH remains a controversial issue requiring further investigation. In this study, we designed a protocol based on the most frequently adopted timeline in the literature 19 – 21 ,defining a 6-week non-weight-bearing phase, followed by partial weight-bearing, and transitioning to full weight-bearing at 3 months postoperatively in the weight-bearing (WB) group. The control group was restricted from weight-bearing for 8 months (primarily bed-based non-weight-bearing training), followed by partial weight-bearing thereafter. This study aimed to investigate the optimal timing and effects of postoperative weight-bearing training following hip-preserving surgery for ONFH, with the goal of improving patient recovery and quality of life. Methods Inclusion and Exclusion Criteria This study was approved by the Medical Ethics Committee of the General Hospital of the People's Liberation Army (Approval No. 2024KY0147-KS001). The trial was conducted in accordance with the principles of the Declaration of Helsinki. All participants were fully informed of the study objectives and procedures and provided written informed consent prior to enrollment.A total of 42 patients (76 hips) with ONFH who underwent hip-preserving treatment at the General Hospital of the PLA in 2023 were included. Among them, 20 patients (38 hips) were assigned to the control group (complete non-weight-bearing for 8 months, primarily bed-based non-weight-bearing training, followed by partial weight-bearing), and 22 patients (38 hips) were assigned to the WB group (non-weight-bearing for 6 weeks postoperatively, followed by partial weight-bearing, and full weight-bearing starting at 3 months postoperatively). Preoperative imaging evaluations included standard anteroposterior and lateral X-rays, bilateral hip CT scans, and MRI examinations. Disease staging was performed using the 2019 revised classification of the Association Research Circulation Osseous (ARCO), and only patients with stage I to IIIA lesions were included. Additionally, lesion types were classified according to the Japanese Investigation Committee (JIC) system 22 .Exclusion criteria were as follows: traumatic ONFH; follow-up duration less than 16 months (excluding patients who received total hip arthroplasty (THA) within 16 months); patients with severe systemic diseases or psychiatric disorders; those deemed ineligible by the attending physicians; previous recipients of hip-preserving surgery; or individuals unable or unwilling to comply with the study protocol. Surgical method Using core decompression combined with bone repair materials and adipose-derived stromal vascular fraction (SVF) for hip preservation treatment. Imaging and Clinical Assessment Hip function recovery was evaluated using anteroposterior and lateral pelvic radiographs, as well as hip CT and MRI imaging. Based on the ARCO staging system, radiographic progression was defined as advancement of the disease stage by at least one grade in a given hip, and the progression rate was subsequently calculated. At 4, 8, and 16 months postoperatively, hip range of motion (ROM) was assessed using a standard universal goniometer 23 ,Hip joint function was evaluated using the Harris Hip Score (HHS), while pain levels were measured using the Visual Analogue Scale (VAS). Health-related quality of life was assessed using the 36-Item Short Form Health Survey (SF-36) 24 . Statistical analysis For normally distributed data, results were presented as mean (standard deviation); for skewed data, medians and inter quartile range (IQR) were reported. Between-group differences in ROM, HHS, VAS, and SF-36 scores were estimated using linear mixed-effects models. Independent sample t -tests and chi-square tests were used to compare group-level differences in continuous and categorical variables, respectively. Kaplan–Meier survival curves were constructed to illustrate the proportion of patients without radiographic progression over time in each treatment group. Differences between groups were assessed using the log-rank test. All effect estimates were reported with 95% confidence interval (CI). All statistical tests were two-sided, and a significance level of α = 0.05 was applied. Statistical analyses were conducted using R version 4.4.2 and SPSS version 25, with independent verification performed by a second investigator. Results Table 1 Baseline demographic characteristics of patients Control group (n = 38) WB group (n = 38) χ2/t value P value Age (years) 37.0(9.3) 38.2(10.2) −0.57 0.574 Male/Female 17/3 20/2 0.46 0497 BMI (kg/m 2 ) 25.0(2.9) 25.7(3.5) −0.91 0.364 Follow-up time (month) 18.7(3.6) 17.6(5.2) 1.21 0.232 Hip involved 2.02 0.156 Unilateral 2(10%) 6(27.3%) Bilateral 18(90%) 16(72.7%) Total number 38 38 Etiology 1.70 0.428 Idiopathic 22(57.8) 19(50.0) Alcohol 8(21.1) 13(34.2) Steroid 8(21.1) 6(15.8) ARCO Stage 1.89 0.388 Stage I 3(7.9) 1(2.6) Stage Ⅱ 14(36.8) 11(30.0) Stage ⅢA 21(55.3) 26(68.4) JIC type 2.82 0.245 B 4(10.5) 1(2.6) C1 11(29.0) 16(42.1) C2 23(60.5) 21(55.3) Baseline characteristics of the population A total of 50 patients were initially recruited for this study. During the follow-up period, 8 patients were excluded due to loss to follow-up. Ultimately, 20 patients (38 hips) were included in the control group, and 22 patients (38 hips) were included in the WB group. The mean follow-up duration was 18 months (range: 13–23 months).There were no statistically significant differences between the two groups in terms of age, sex, BMI, follow-up duration, number of affected sites, etiology, ARCO stage, or JIC type ( P > 0.05) (Table 1 ). Table 2 Comparison of the radiological progression rates between two groups Control WB Hips Number of progress Progress rate(%) Hips Number of progress Progress rate(%) P value 8 month 38 1 2.6% 38 6 21.1% 0.047 Final follow-up 38 7 15.8% 38 4 26.3% 0.589 Table 3 Preoperative ARCO staging and JIC classification of two groups of hip joint progress Control WB Hips ARCO Stage JIC type Hips ARCO Stage JIC type 8 month 1 ⅢA C2 6 ⅢA C2 Final follow-up 7 ⅢA C2 4 3ⅢA、1Ⅱ C2 At 8 months postoperatively, radiographic evaluation showed a progression rate of 2.6% (1/38) in the control group and 15.79% (6/38) in the WB group, with the control group demonstrating significantly better radiographic outcomes ( P < 0.05).At the final follow-up, the progression rates were 21.05% (8/38) in the control group and 26.32% (10/38) in the WB group, with no statistically significant difference between the two groups ( P = 0.589) (Table 2 ).Among the progressed hips, only one was classified as ARCO stage II preoperatively; the remaining cases were all ARCO stage IIIA. All progressed lesions were categorized as JIC type C2 (Table 3 ).(Fig. 1 ) shows the cases in the WB group that did not progress 24 months after surgery, while (Fig. 2 ) shows the cases in the WB group that progressed 8 months after surgery. Kaplan–Meier survival analysis was performed to estimate radiographic survival of the hips at the 8-month follow-up, with radiographic progression as the event of interest. Within the first 8 months, the control group consistently showed a higher radiographic survival rate than the WB group, with a statistically significant difference between the two groups (log-rank test, P = 0.049) (Fig. 3 ).Over time, the radiographic survival rate of the control group gradually approached that of the WB group, and no statistically significant difference was observed between the groups at the final follow-up (log-rank test, P = 0.462) (Fig. 4 ). Function result Table 4 Comparison of hip joint range of motion between two groups of patients. Control WB Treatment effect, mean(95%CI) P value Mean(SD) No. of hips Mean(SD) No. of hips Flexion Baseline 104.32 (10.53 ) 38 101.87 ( 9.46 ) 38 2.45 ( -2.13 ,7.02 ) 0.290 4 mo a 96.37 (14.87 ) 35 90.79 (11.88 ) 36 5.58 (-0.57, 11.73 ) 0.075 8 mo 107.26 (12.69 ) 35 99.68 (11.59 ) 36 7.58 (2.03,13.13 ) 0.008 16 mo 115.08 (11.07 ) 32 104.92 (14.15 ) 34 10.16 (4.35,15.96 ) 0.001 Extension Baseline 18.16 ( 8.97 ) 38 16.03 (12.03 ) 38 2.13 ( -2.72, 6.98 ) 0.384 4 mo 18.82 ( 9.71 ) 35 15.42 ( 8.10 ) 36 3.39 ( -0.69, 7.48 ) 0.102 8 mo 26.42 (10.13 ) 35 21.08 ( 9.67 ) 36 5.34 ( 0.82, 9.87 ) 0.021 16 mo 33.47 (12.32 ) 32 23.29 (12.81 ) 34 10.18 ( 4.44, 15.93 ) 0.001 Adduction Baseline 25.71 (13.65 ) 38 23.24 (13.33 ) 38 2.47 ( -3.69, 8.64 ) 0.427 4 mo 26.13 (10.78 ) 35 16.89 ( 9.80 ) 36 9.24 ( 4.53, 13.94 ) 0.001 8 mo 34.71 (10.53 ) 35 25.53 (11.50 ) 36 9.18 ( 4.14, 14.22 ) 0.001 16 mo 36.92 (11.33 ) 32 28.39 (12.97 ) 34 8.53 ( 2.96, 14.09 ) 0.003 Abduction Baseline 32.18 ( 8.10 ) 38 30.00 (11.19 ) 38 2.18 ( -2.28, 6.65 ) 0.333 4 mo 29.29 (10.69 ) 35 24.61 (11.21 ) 36 4.68 ( -0.32, 9.69 ) 0.066 8 mo 37.50 (14.20 ) 35 30.11 (12.45 ) 36 7.39 ( 1.29, 13.50 ) 0.018 1 mo 42.37 (14.08 ) 32 34.37 (12.67 ) 34 8.00 ( 1.88, 14.12 ) 0.011 a mo refers to month We used a universal goniometer to measure the hip joint mobility of patients before surgery and at 4, 8, and 16 months postoperatively. There was no statistically significant difference between the two groups before surgery ( P > 0.05). At 4 months postoperatively, the adduction mobility of the control group was better than that of the WB group ( P < 0.05). At 8 and 16 months postoperatively, the hip joint mobility of the control group was better than that of the WB group ( P < 0.05) (Table 4 ). We compared the VAS scores and HHS scores of two groups of patients. The results showed that there was no statistically significant difference in VAS scores between the two groups ( P > 0.05). At the 16-month follow-up, the HHS score of the WB group was better than that of the Control group, with a statistically significant difference ( P < 0.05). The hips with radiological progression did not undergo THA at the final follow-up, as postoperative pain symptoms were alleviated, thereby delaying the need for THA (Table 5 ). Table 5 Comparison of VAS and HHS scores between two groups of patients. Control WB Treatment effect, mean(95%CI) P value Mean(SD) No. of hips Mean(SD) No. of hips VAS b Baseline 4.32 ( 1.74 ) 38 4.03 ( 1.85 ) 38 0.29 ( -0.53, 1.11 ) 0.485 4 mo 3.68 ( 1.53 ) 36 3.79 ( 1.45 ) 35 -0.11 ( -0.79, 0.58 ) 0.759 8 mo 2.37 ( 1.55 ) 36 2.00 ( 1.27 ) 35 0.37 ( -0.28, 1.02 ) 0.261 16 mo 1.24 ( 1.32 ) 34 1.24 ( 1.50 ) 34 0.00 ( -0.65, 0.65 ) 1.000 HHS c Baseline 69.63 (16.51 ) 38 71.21 (12.23 ) 38 1.58 ( -5.06, 8.22 ) 0.637 4 mo 56.11 (14.42 ) 36 60.66 (12.01 ) 35 4.55 ( -1.51, 10.62 ) 0.139 8 mo 66.63 (14.00 ) 36 71.71 (10.30 ) 35 5.08 ( -0.54, 10.70 ) 0.076 16 mo 74.84 (15.26 ) 34 81.79 (11.71 ) 35 6.95 ( 0.73, 13.16 ) 0.029 b Based on an 11-point numerical pain scale (range, 0–10; higher scores indicate more severe pain). c Based on the Harris hip score (scale range, 0-100; higher scores indicate more hip joint function). In terms of quality of life, at 8 months, the WB group showed better General health than the control group, with a statistically significant difference ( P < 0.05). At 16 months, the WB group had better General health, Social function, and Health change than the control group, with a statistically significant difference ( P < 0.05) (Table 6 ). Table 6 Comparison of SF-36 scores between two groups of patients.d Control WB Treatment effect, mean(95%CI) P value Mean(SD) No. of hips Mean(SD) No. of hips Physical function Baseline 58.32 (16.02) 38 60.26 (13.40 ) 38 1.95 ( -4.80, 8.70 ) 0.567 4 mo 31.45 (14.23 ) 36 37.37 (12.18 ) 37 5.92 ( -0.13, 11.98 ) 0.055 8 mo 45.79 (19.50 ) 36 48.58 (16.89 ) 35 2.79 ( -5.55, 11.13 0.507 12 mo 60.55 (17.97 ) 34 62.24 (16.75 ) 32 1.68 ( -6.26, 9.63 ) 0.674 Role- physical Baseline 13.29 (22.70 ) 38 13.16 (20.74 ) 38 -0.13 ( -10.07, 9.81 ) 0.979 4 mo 2.63 ( 9.71 ) 36 3.29 (10.35 ) 37 0.66 ( -3.93, 5.24 ) 0.776 8 mo 11.18 (22.28 ) 36 10.53 (16.06 ) 35 -0.66 ( -9.54, 8.22 ) 0.883 12 mo 30.26 (28.57 ) 34 36.45 (26.12 ) 32 6.18 ( -6.33, 18.70 ) 0.328 Bodily pain Baseline 49.00 (18.46 ) 38 47.29 (14.81 ) 38 -1.71 ( -9.36, 5.94 ) 0.657 4 mo 51.29 (16.45 ) 36 58.50 (17.41 ) 37 7.21 ( -0.53, 14.95 ) 0.068 8 mo 64.74 (18.04 ) 36 69.29 (19.11 ) 35 4.55 ( -3.94, 13.05 ) 0.289 12 mo 80.37 (16.94 ) 34 76.42 (22.54 ) 32 -3.95 ( -13.06, 5.17 ) 0.391 General health Baseline 59.97 (16.80 ) 38 62.21 (13.34 ) 38 2.24 ( -4.70, 9.17 ) 0.522 4 mo 61.37 (15.62 ) 36 69.05 (12.78 ) 37 7.68 ( 1.16, 14.21 ) 0.022 8 mo 66.55 (16.56 ) 36 73.82 (13.67 ) 35 7.26 ( 0.32, 14.20 ) 0.041 12 mo 68.45 (21.89 ) 34 78.18 (13.20 ) 32 9.74 ( 1.47, 18.00 ) 0.022 Vitality Baseline 63.29 (19.53 ) 38 63.03 (15.05 ) 38 -0.26 ( -8.23, 7.71 ) 0.948 4 mo 52.50 (12.72 ) 36 53.32 (12.73 ) 37 0.82 ( -5.00, 6.63 ) 0.781 8 mo 63.29 (12.10 ) 36 65.82 (12.76 ) 35 2.53 ( -3.16, 8.21 ) 0.379 12 mo 76.58 (13.81 ) 34 75.87 (14.74 ) 32 -0.71 ( -7.24, 5.82 ) 0.829 Social function Baseline 65.49 (22.19 ) 38 59.06 (20.03 ) 38 -6.43 ( -16.09, 3.23 ) 0.189 4 mo 48.53 (17.41 ) 36 49.12 (18.92 ) 37 0.58 ( -7.73, 8.89 ) 0.889 8 mo 98.83 (12.52 ) 36 104.18 (17.80 ) 35 5.35 ( -1.69, 12.38 ) 0.134 12 mo 104.07 (15.23 ) 34 115.02 (11.26 ) 32 10.95 ( 4.83, 17.08 ) 0.001 Role- emotion Baseline 41.23 (39.08 ) 38 30.96 (28.10 ) 38 -10.26 ( -25.82, 5.30 ) 0.193 4 mo 12.28 (26.19 ) 36 16.93 (27.56 ) 37 4.65 ( -7.64, 16.94 ) 0.453 8 mo 33.59 (29.76 ) 36 32.80 (28.10 ) 35 -0.79 ( -14.02, 12.44 ) 0.906 12 mo 54.65 (32.86 ) 34 60.79 (32.28 ) 32 6.14 ( -8.75, 21.03 ) 0.414 Mental health Baseline 66.53 (17.58 ) 38 66.37 (15.14 ) 38 -0.16 ( -7.66, 7.34 ) 0.967 4 mo 68.32 (15.20 ) 36 70.05 (14.53 ) 37 1.74 ( -5.06, 8.53 ) 0.612 8 mo 72.21 (15.99 ) 36 73.16 (14.07 ) 35 0.95 ( -5.94, 7.83 ) 0.785 12 mo 76.21 (17.09 ) 34 75.82 (14.50 ) 32 -0.39 ( -7.64, 6.85 ) 0.914 Health change Baseline 9.87 (16.99 ) 38 8.55 (15.68 ) 38 -1.32 ( -8.79, 6.16 ) 0.727 4 mo 59.21 (24.26 ) 36 71.05 (16.97 ) 37 11.84 ( 2.27, 21.41 ) 0.016 8 mo 73.95 (23.86 ) 36 83.55 (19.52 ) 35 9.61 ( -0.36, 19.57 ) 0.059 12 mo 77.63 (24.52) 34 88.16 (17.18 ) 32 10.53 ( 0.85, 20.20 ) 0.033 d Based on the Medical Outcomes Study 36-Item Short-Form Health Survey (scale range, 0-100; higher scores indicate a better health state). Adverse Events No adverse events occurred. Discussion Our research indicates that at 8 months, the control group had only 1 hip joint progression, while the WB group had 6 hip joint progressions ( P < 0.05), and all progressed hip joints were at ARCOⅢA stage, with JIC classification all being type C2. At the final follow-up, there was no statistical difference in progression rates between the two groups ( P > 0.05), and among the progressed hip joints at the final follow-up, only 1 was at ARCOⅡ stage, while the others were all at ⅢA stage, with JIC classification all being type C2. Functional outcomes indicated that at the final follow-up, the WB group performed better than the control group. This suggests that patients at ARCOⅠ and Ⅱ stages are not affected by weight-bearing postoperatively, and patients at ⅢA stage C1 can also bear weight postoperatively. Postoperative weight-bearing can improve clinical functional levels; however, for patients at ARCOⅢA stage C2, postoperative weight-bearing may accelerate femoral head collapse. The cause of femoral head collapse is still unclear. Yang et al. 25 indicated that the collapse of necrotic femoral heads is caused by fatigue fractures, which occur due to continuous stress on the femoral head and the weakening of bone strength in the necrotic area, leading to microfractures in the primary region. The repair process is then activated, but due to ongoing risk factors, there may be an imbalance between repair and microfractures, resulting in collapse. Ma JX et al. 17 suggested that enhancing bone strength may be an effective method for preventing and treating ONFH due to the internal structural and stress imbalances within the femoral head. Chen WH et al. 26 indicated that after stress relief in the femoral head, the revascularization of the femoral head accelerates, and the use of anti-osteoporosis medications can reduce bone resorption and promote bone repair in the femoral head. Therefore, for ARCO stage IIIA type C2 ONFH, it is advisable to avoid weight-bearing postoperatively, and taking medications that enhance bone strength may be a good option, with specific weight-bearing times assessed based on radiological results. Wen PF et al. 27 indicated that the cortical part of the lateral column is the main biomechanical support for the femoral head. Ma XL et al. 17 noted that the biomechanical properties of the necrotic area are weaker, while the sclerotic area becomes stronger. In our study, there was no collapse observed in JIC type B and C1, and at the final follow-up, no collapse was noted, indicating that weight-bearing training can be performed postoperatively for types B and C1. Research shows 28 , 29 that during partial weight bearing after surgery, bilateral axillary crutches can reduce lower limb weight bearing by about 80%, while bilateral elbow crutches can reduce weight bearing on the affected limb by 40%.Therefore, in the first six weeks post-surgery, bilateral axillary crutches can be used, gradually transitioning to bilateral elbow crutches. When using a walker, it is important to avoid prolonged pressure to prevent vascular and nerve damage. Partial weight bearing (PWB) refers to the percentage of body weight supported by the affected lower limb. For example, a gait with 10% PWB means that the affected side bears 10% of the body weight, while the remaining weight is supported by the crutches 30 , For the weight-bearing group, the first six weeks post-surgery should maintain a non-weight bearing status, then gradually increase weight bearing every two weeks, in sequence as 1/3 weight bearing, 1/2 weight bearing, and 2/3 weight bearing, with full weight bearing allowed after 12 weeks of treatment. The choice of gait for ONFH patients after surgery depends on whether the lesion is unilateral or bilateral, as well as the ARCO stage and JIC classification. After hip preservation surgery, using a three-point gait and a two-point gait can effectively achieve PWB. Subsequently, patients can adopt a bilateral crutch weight-bearing swing gait, and finally gradually walk without crutches. The innovation of this study lies in the first systematic exploration of the impact of the timing of weight-bearing training on rehabilitation outcomes in patients with ONFH after hip preservation surgery. Although previous studies have proposed different viewpoints on the timing of weight-bearing training 21 , we confirmed the effects of different weight-bearing strategies on postoperative radiological progression rates and clinical functional outcomes by retrospectively analyzing clinical data from 42 patients. These results provide important references for subsequent research and offer a new perspective for the formulation of clinical treatment plans. The limitations of this study lie in the small sample size and the fact that it was conducted at a single center, which may affect the generalizability of the results. Additionally, the study did not explore biological mechanisms, and the follow-up period was relatively short, which may not fully reflect the long-term effects. Therefore, future research should expand the sample size and consider multi-center data support to enhance the reliability of the results. At the same time, the follow-up period should be extended to assess the effects of weight-bearing training in the long-term rehabilitation process. These improvements will help deepen the understanding of the long-term impact of weight-bearing training on different types of ONFH patients and provide a basis for more comprehensive clinical practice. Conclusion For patients with ARCO IIIA stage JIC type C2, weight-bearing should be avoided postoperatively, while patients of type B and C1 should initiate weight-bearing training appropriately after surgery. Abbreviations ONFH Osteonecrosis of the Femoral Head WB Weight-bearing ARCO Association Research Circulation Osseous JIC Japan Investigation Committee HHS Harris hip score THA Total hip arthroplasty SVF Adipose-derived stromal vascular fraction ROM Range of motion VAS Visual analogue scale SF-36 36-Item Short Form Health Survey IQR Inter quartile range CI Confidence interval PWB Partial weight bearing Declarations Acknowledgements We wish to thank all patients and medical staff for their co-operation. Author contributions Jiang peng designed the study. Tingjie zhao contributed to the data analysis. All authors reviewed the manuscript. Funding This work was funded by the Natural Science Foundation of Beijing (ID:24L20608). National Key Research and Development Program (2024YFA1108600). Data availability The datasets generated and/or analyzed during the current study are not publicly available due to limitations of ethical approval involving the patient data and anonymity but are available from the corresponding author on reasonable request. Ethics approval and consent to participate This study was approved by the Medical Ethics Committee of the General Hospital of the People's Liberation Army of China.e (Approval No: 2024KY098-KS001,approval date: 2 September 2024). The experiment adheres to the principles set forth in the Declaration of Helsinki, and all participants were formally informed of the purpose and content of the research and signed an informed consent form. Clinical trial number: Not applicable Competing interests The authors declare no competing interests. Consent for publication Not applicable References Liu N, Zheng C, Wang Q, Huang Z. Treatment of non-traumatic avascular necrosis of the femoral head (Review). Exp Ther Med. 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Stem Cell Res Ther Oct. 2018;25(1):274. 10.1186/s13287-018-1030-y . Saklecha AV, Wadhokar OC, Patil DS, Naqvi WM. Effect of physiotherapy rehabilitation on stage 4 avascular necrosis of femur following pyogenic arthritis: a case report. Pan Afr Med J. 2022;41:17. 10.11604/pamj.2022.41.17.32883 . Wen MT, Liang XZ, Luo D, et al. The Effect of the Hip Flexion Angle in Osteonecrosis of the Femoral Head Based on China-Japan Friendship Hospital Classification - A Finite Element Study. Orthop Surg Oct. 2023;15(10):2689–700. 10.1111/os.13865 . Chang X, Xu S, Zhang H. Regulation of bone health through physical exercise: Mechanisms and types. Front Endocrinol (Lausanne). 2022;13:1029475. 10.3389/fendo.2022.1029475 . Zhang S, Huang X, Zhao X, et al. Effect of exercise on bone mineral density among patients with osteoporosis and osteopenia: A systematic review and network meta-analysis. J Clin Nurs Aug. 2022;31(15–16):2100–11. 10.1111/jocn.16101 . Kemmler W, Kohl M, Jakob F, Engelke K, von Stengel S. Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study. Nutrients Aug. 2020;5(8). 10.3390/nu12082341 . Wang P, Wang C, Meng H, et al. The Role of Structural Deterioration and Biomechanical Changes of the Necrotic Lesion in Collapse Mechanism of Osteonecrosis of the Femoral Head. Orthop Surg May. 2022;14(5):831–9. 10.1111/os.13277 . Ma JX, He WW, Zhao J, et al. Bone Microarchitecture and Biomechanics of the Necrotic Femoral Head. Sci Rep Oct. 2017;17(1):13345. 10.1038/s41598-017-13643-2 . Qi T, Yan Y, Qi W, Chen W, Yang H. Hip joint-preserving strategies for treating osteonecrosis of the femoral head: From nonoperative to operative procedures. J Orthop Translat Mar. 2025;51:256–77. 10.1016/j.jot.2025.02.001 . Aoyama T, Fujita Y, Madoba K, et al. Rehabilitation program after mesenchymal stromal cell transplantation augmented by vascularized bone grafts for idiopathic osteonecrosis of the femoral head: a preliminary study. Arch Phys Med Rehabil Mar. 2015;96(3):532–9. 10.1016/j.apmr.2014.09.040 . Li Q, Liao W, Fu G, et al. Combining autologous bone marrow buffy coat and angioconductive bioceramic rod grafting with advanced core decompression improves short-term outcomes in early avascular necrosis of the femoral head: a prospective, randomized, comparative study. Stem Cell Res Ther Jun. 2021;19(1):354. 10.1186/s13287-021-02436-0 . Hong Z, Zhang Y, Chen J, Bi Q. Adipose-derived stromal vascular fraction injection following core decompression and biochemistry artificial bone graft implantation in osteonecrosis of the femoral head. Int Orthop Jun. 2023;47(6):1481–6. 10.1007/s00264-023-05792-z . Sugano N, Atsumi T, Ohzono K, Kubo T, Hotokebuchi T, Takaoka K. The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci. 2002;7(5):601–5. 10.1007/s007760200108 . Kouyoumdjian P, Coulomb R, Sanchez T, Asencio G. Clinical evaluation of hip joint rotation range of motion in adults. Orthop Traumatol Surg Res Feb. 2012;98(1):17–23. 10.1016/j.otsr.2011.08.015 . Ware JEJ, Sherbourne CD. The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection. Med Care. 1992;30(6):473–83. Yang JW, Koo KH, Lee MC, et al. Mechanics of femoral head osteonecrosis using three-dimensional finite element method. Arch Orthop Trauma Surg Mar. 2002;122(2):88–92. 10.1007/s004020100324 . Chen WH, Guo WX, Li JX, Wei QS, Li ZQ, He W. Application of protective weight-bearing in osteonecrosis of the femoral head: A systematic review and meta-analysis of randomized controlled trials and observational studies. Front Surg. 2022;9:1000073. 10.3389/fsurg.2022.1000073 . Wen PF, Guo WS, Zhang QD, et al. Significance of Lateral Pillar in Osteonecrosis of Femoral Head: A Finite Element Analysis. Chin Med J (Engl) Nov. 2017;5(21):2569–74. 10.4103/0366-6999.217077 . Potter BE, Wallace WA, Crutches. Bmj . Nov 3 1990;301(6759):1037–1039. 10.1136/bmj.301.6759.1037 Sehgal M, Jacobs J, Biggs WS. Mobility Assistive Device Use in Older Adults. Am Fam Physician Jun. 2021;15(12):737–44. Rasouli F, Reed KB. Walking assistance using crutches: A state of the art review. J Biomech Jan 2. 2020;98:109489. 10.1016/j.jbiomech.2019.109489 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6899359","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":473306487,"identity":"1188ed12-f401-44c9-8a0c-4a1735dc55b5","order_by":0,"name":"Junming Zhang","email":"","orcid":"","institution":"Postgraduate Training Base of Jinzhou Medical University (The 960th Hospital of the Joint Logistic Support Force)","correspondingAuthor":false,"prefix":"","firstName":"Junming","middleName":"","lastName":"Zhang","suffix":""},{"id":473306488,"identity":"58f8d81a-0c5e-4cfa-9660-7eeed3cde081","order_by":1,"name":"Yanbin Wu","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yanbin","middleName":"","lastName":"Wu","suffix":""},{"id":473306489,"identity":"e9c52455-d873-4329-b7b6-f613e94a46fb","order_by":2,"name":"Yazhou Li","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yazhou","middleName":"","lastName":"Li","suffix":""},{"id":473306490,"identity":"27eea12a-656e-49e3-9167-e5689b90aa65","order_by":3,"name":"Tingjie Zhao","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tingjie","middleName":"","lastName":"Zhao","suffix":""},{"id":473306491,"identity":"6837dc0f-b7b3-46a3-be68-fc7e47f12bef","order_by":4,"name":"Zexian Liu","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Zexian","middleName":"","lastName":"Liu","suffix":""},{"id":473306492,"identity":"b0a3d47f-5664-4575-ba48-c378e8851080","order_by":5,"name":"Lijun Sun","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Lijun","middleName":"","lastName":"Sun","suffix":""},{"id":473306493,"identity":"63ea7eca-9b0d-4438-a7e6-579ad3985c75","order_by":6,"name":"Sice Wang","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sice","middleName":"","lastName":"Wang","suffix":""},{"id":473306494,"identity":"e11c783f-8c01-42ef-b7e0-c7f3c025c0f8","order_by":7,"name":"Biao Ma","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Biao","middleName":"","lastName":"Ma","suffix":""},{"id":473306495,"identity":"b545f247-10bf-4414-9bb5-4963dded6568","order_by":8,"name":"Jiazhou Wu","email":"","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jiazhou","middleName":"","lastName":"Wu","suffix":""},{"id":473306496,"identity":"e6ab5170-d6f9-40ec-91f4-51d1d26f928d","order_by":9,"name":"Rile Wu","email":"","orcid":"","institution":"Inner Mongolia Autonomous Region Rehabilitation Service Center for the Disabled","correspondingAuthor":false,"prefix":"","firstName":"Rile","middleName":"","lastName":"Wu","suffix":""},{"id":473306497,"identity":"a5ce5201-3c45-429e-b091-8ac1e09e7adf","order_by":10,"name":"Dawei Zhang","email":"","orcid":"","institution":"The 960th Hospital of the Joint Logistic Support Force","correspondingAuthor":false,"prefix":"","firstName":"Dawei","middleName":"","lastName":"Zhang","suffix":""},{"id":473306498,"identity":"69d2dc8f-5fd3-457a-9a3b-f5c67ef95dd7","order_by":11,"name":"Jiang Peng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYLACCQMgwd/YcOCDgY0cCVokDh88OKMgzZgUu9KSD/N8OJxIUJ05e+/hFxYFdnnyDmcMDtsYMCcwsB8+ugGfFsuec2kWEgbJxYaHewwO5xiw5THwpKXdwKfF4EaOmYGEAXPixoYzIC08xQwSPGb4tdx/A9JSD9SSY3DYwkAisYGglhs8xg8kDA4nzmdISzjMYGBAWItlT44ZMJCPJ26QOHzgYI9BgjEbIb+Ys58x/izxpzpxfn9j84cff/7L8bMfPobfYQwMbNISIMYBqAgbPuVQLcwfPwAZ8g2ElI6CUTAKRsGIBQBcJU9ePzOtEAAAAABJRU5ErkJggg==","orcid":"","institution":"The Fourth Medical Center of the PLA General Hospital","correspondingAuthor":true,"prefix":"","firstName":"Jiang","middleName":"","lastName":"Peng","suffix":""}],"badges":[],"createdAt":"2025-06-15 16:23:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6899359/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6899359/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85180863,"identity":"604a3617-4ad8-4c6c-9f2e-341d71d3d254","added_by":"auto","created_at":"2025-06-23 07:19:45","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":2858643,"visible":true,"origin":"","legend":"\u003cp\u003eA case of a 29-year-old with left femoral head necrosis (ARCO stage IIIA, JIC type B), \u003cstrong\u003eA\u003c/strong\u003e is the preoperative X-ray, \u003cstrong\u003eB\u003c/strong\u003e is 3 days post-surgery, \u003cstrong\u003eC\u003c/strong\u003e is 12 months post-surgery, \u003cstrong\u003eD\u003c/strong\u003e is 24 months post-surgery, and the X-rays show no progression.\u003c/p\u003e","description":"","filename":"Fig.1.png","url":"https://assets-eu.researchsquare.com/files/rs-6899359/v1/2fbd0d8e6259a50c0290bce7.png"},{"id":85180203,"identity":"fa3a32d4-e28b-4bc8-b177-585f63e8eadc","added_by":"auto","created_at":"2025-06-23 07:11:45","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":2377442,"visible":true,"origin":"","legend":"\u003cp\u003eA case of a 24-year-old with bilateral femoral head necrosis (both sides are ARCO stage IIIA, JIC type C2), \u003cstrong\u003eA\u003c/strong\u003eis the preoperative X-ray, \u003cstrong\u003eB\u003c/strong\u003e is 6 days post-operation, \u003cstrong\u003eC\u003c/strong\u003e is 8 months post-operation, \u003cstrong\u003eD\u003c/strong\u003e is 12 months post-operation, the X-ray shows bilateral progression.\u003c/p\u003e","description":"","filename":"Fig.2.png","url":"https://assets-eu.researchsquare.com/files/rs-6899359/v1/800f99cb1303149316f74b4a.png"},{"id":85180202,"identity":"2cef9309-f71d-440c-aea8-7808be56904c","added_by":"auto","created_at":"2025-06-23 07:11:45","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":11723,"visible":true,"origin":"","legend":"\u003cp\u003eThe cumulative proportion of patients with no progression in imaging at eight months\u003c/p\u003e","description":"","filename":"Fig.3.png","url":"https://assets-eu.researchsquare.com/files/rs-6899359/v1/bb2209c17f9a2e4022bb92a4.png"},{"id":85180201,"identity":"94fdbb72-030b-4ddf-b0bc-66b14abfd48c","added_by":"auto","created_at":"2025-06-23 07:11:45","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":11935,"visible":true,"origin":"","legend":"\u003cp\u003eThe cumulative proportion of patients with no progression in imaging at the final follow-up\u003c/p\u003e","description":"","filename":"Fig.4.png","url":"https://assets-eu.researchsquare.com/files/rs-6899359/v1/e22fac0ddbcc6fc1f4737762.png"},{"id":87094563,"identity":"ea2ebf67-69d3-453d-8d94-9116278dedd2","added_by":"auto","created_at":"2025-07-19 10:01:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":7029245,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6899359/v1/3c9e6acb-3633-41ec-a130-05b90a324ee3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of Timing of Weight-Bearing Training on Postoperative Recovery After Hip-Preserving Surgery for Femoral Head Necrosis: A Retrospective Analysis","fulltext":[{"header":"Background","content":"\u003cp\u003eOsteonecrosis of the femoral head (ONFH) is a common clinical condition characterized by localized abnormalities in bone metabolism and severely compromises patients' quality of life\u003csup\u003e\u003cspan additionalcitationids=\"CR2 CR3\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.In China, the annual incidence is estimated at 75,000 to 150,000 new cases, with approximately 8.12\u0026nbsp;million individuals affected by non-traumatic osteonecrosis\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e.ONFH has a high disability rate and, if not treated in a timely manner, can rapidly progress to femoral head collapse\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e.In recent years, core decompression combined with stem cells or growth factors has become a mainstream treatment for ONFH, achieving favorable outcomes\u003csup\u003e\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.However, while most studies have focused on surgical techniques, there remains no clear consensus regarding the optimal timing of postoperative weight-bearing rehabilitation.\u003c/p\u003e \u003cp\u003ePrevious studies have suggested\u003csup\u003e\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e that early weight-bearing may enhance bone mineral density and promote osteogenesis. Conversely, other research has indicated\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e that the biomechanical properties of the necrotic area are compromised, and sustained stress on the femoral head may accelerate collapse. From the perspectives of skeletal mechanobiology and Wolff\u0026rsquo;s law, reducing mechanical loading might increase bone resorption, potentially accelerating the development of the crescent sign and the risk of femoral head collapse. On the other hand, from a biomechanical standpoint, weight-bearing restriction reduces mechanical forces on the femoral head and may help prevent structural failure\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e.Thus, whether postoperative weight-bearing is advisable after hip-preserving surgery for ONFH remains a controversial issue requiring further investigation.\u003c/p\u003e \u003cp\u003eIn this study, we designed a protocol based on the most frequently adopted timeline in the literature\u003csup\u003e\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e,defining a 6-week non-weight-bearing phase, followed by partial weight-bearing, and transitioning to full weight-bearing at 3 months postoperatively in the weight-bearing (WB) group. The control group was restricted from weight-bearing for 8 months (primarily bed-based non-weight-bearing training), followed by partial weight-bearing thereafter. This study aimed to investigate the optimal timing and effects of postoperative weight-bearing training following hip-preserving surgery for ONFH, with the goal of improving patient recovery and quality of life.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and Exclusion Criteria\u003c/h2\u003e \u003cp\u003e This study was approved by the Medical Ethics Committee of the General Hospital of the People's Liberation Army (Approval No. 2024KY0147-KS001). The trial was conducted in accordance with the principles of the Declaration of Helsinki. All participants were fully informed of the study objectives and procedures and provided written informed consent prior to enrollment.A total of 42 patients (76 hips) with ONFH who underwent hip-preserving treatment at the General Hospital of the PLA in 2023 were included. Among them, 20 patients (38 hips) were assigned to the control group (complete non-weight-bearing for 8 months, primarily bed-based non-weight-bearing training, followed by partial weight-bearing), and 22 patients (38 hips) were assigned to the WB group (non-weight-bearing for 6 weeks postoperatively, followed by partial weight-bearing, and full weight-bearing starting at 3 months postoperatively).\u003c/p\u003e \u003cp\u003ePreoperative imaging evaluations included standard anteroposterior and lateral X-rays, bilateral hip CT scans, and MRI examinations. Disease staging was performed using the 2019 revised classification of the Association Research Circulation Osseous (ARCO), and only patients with stage I to IIIA lesions were included. Additionally, lesion types were classified according to the Japanese Investigation Committee (JIC) system\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e.Exclusion criteria were as follows: traumatic ONFH; follow-up duration less than 16 months (excluding patients who received total hip arthroplasty (THA) within 16 months); patients with severe systemic diseases or psychiatric disorders; those deemed ineligible by the attending physicians; previous recipients of hip-preserving surgery; or individuals unable or unwilling to comply with the study protocol.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSurgical method\u003c/h3\u003e\n\u003cp\u003eUsing core decompression combined with bone repair materials and adipose-derived stromal vascular fraction (SVF) for hip preservation treatment.\u003c/p\u003e\n\u003ch3\u003eImaging and Clinical Assessment\u003c/h3\u003e\n\u003cp\u003eHip function recovery was evaluated using anteroposterior and lateral pelvic radiographs, as well as hip CT and MRI imaging. Based on the ARCO staging system, radiographic progression was defined as advancement of the disease stage by at least one grade in a given hip, and the progression rate was subsequently calculated.\u003c/p\u003e \u003cp\u003eAt 4, 8, and 16 months postoperatively, hip range of motion (ROM) was assessed using a standard universal goniometer\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e,Hip joint function was evaluated using the Harris Hip Score (HHS), while pain levels were measured using the Visual Analogue Scale (VAS). Health-related quality of life was assessed using the 36-Item Short Form Health Survey (SF-36)\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eFor normally distributed data, results were presented as mean (standard deviation); for skewed data, medians and inter quartile range (IQR) were reported. Between-group differences in ROM, HHS, VAS, and SF-36 scores were estimated using linear mixed-effects models. Independent sample \u003cem\u003et\u003c/em\u003e-tests and chi-square tests were used to compare group-level differences in continuous and categorical variables, respectively.\u003c/p\u003e \u003cp\u003eKaplan\u0026ndash;Meier survival curves were constructed to illustrate the proportion of patients without radiographic progression over time in each treatment group. Differences between groups were assessed using the log-rank test. All effect estimates were reported with 95% confidence interval (CI). All statistical tests were two-sided, and a significance level of α\u0026thinsp;=\u0026thinsp;0.05 was applied. Statistical analyses were conducted using R version 4.4.2 and SPSS version 25, with independent verification performed by a second investigator.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline demographic characteristics of patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWB group\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ2/t value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.0(9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.2(10.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.574\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale/Female\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17/3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20/2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0497\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.0(2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.7(3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.364\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFollow-up time (month)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.7(3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.6(5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.232\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHip involved\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(27.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18(90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(72.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal number\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEtiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.428\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIdiopathic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22(57.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(34.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSteroid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(15.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eARCO Stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage Ⅱ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14(36.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage ⅢA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(55.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(68.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJIC type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11(29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(42.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23(60.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(55.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBaseline characteristics of the population\u003c/p\u003e \u003cp\u003eA total of 50 patients were initially recruited for this study. During the follow-up period, 8 patients were excluded due to loss to follow-up. Ultimately, 20 patients (38 hips) were included in the control group, and 22 patients (38 hips) were included in the WB group. The mean follow-up duration was 18 months (range: 13\u0026ndash;23 months).There were no statistically significant differences between the two groups in terms of age, sex, BMI, follow-up duration, number of affected sites, etiology, ARCO stage, or JIC type (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of the radiological progression rates between two groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e \u003cp\u003eWB\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber of progress\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProgress rate(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNumber of progress\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eProgress rate(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.6%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e21.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinal follow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.589\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePreoperative ARCO staging and JIC classification of two groups of hip joint progress\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eWB\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eARCO Stage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eJIC type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eARCO Stage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eJIC type\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eⅢA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eC2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eⅢA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eC2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinal follow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eⅢA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eC2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3ⅢA、1Ⅱ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eC2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAt 8 months postoperatively, radiographic evaluation showed a progression rate of 2.6% (1/38) in the control group and 15.79% (6/38) in the WB group, with the control group demonstrating significantly better radiographic outcomes (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).At the final follow-up, the progression rates were 21.05% (8/38) in the control group and 26.32% (10/38) in the WB group, with no statistically significant difference between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.589) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).Among the progressed hips, only one was classified as ARCO stage II preoperatively; the remaining cases were all ARCO stage IIIA. All progressed lesions were categorized as JIC type C2 (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).(Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) shows the cases in the WB group that did not progress 24 months after surgery, while (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) shows the cases in the WB group that progressed 8 months after surgery.\u003c/p\u003e \u003cp\u003eKaplan\u0026ndash;Meier survival analysis was performed to estimate radiographic survival of the hips at the 8-month follow-up, with radiographic progression as the event of interest. Within the first 8 months, the control group consistently showed a higher radiographic survival rate than the WB group, with a statistically significant difference between the two groups (log-rank test, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.049) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).Over time, the radiographic survival rate of the control group gradually approached that of the WB group, and no statistically significant difference was observed between the groups at the final follow-up (log-rank test, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.462) (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eFunction result\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of hip joint range of motion between two groups of patients.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eWB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c7\" namest=\"c6\" rowspan=\"2\"\u003e \u003cp\u003eTreatment effect,\u003c/p\u003e \u003cp\u003emean(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo. of hips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo. of hips\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFlexion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c8\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104.32 (10.53 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e101.87 ( 9.46 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e2.45 ( -2.13 ,7.02 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.290\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96.37 (14.87 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90.79 (11.88 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e5.58 (-0.57, 11.73 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107.26 (12.69 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99.68 (11.59 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e7.58 (2.03,13.13 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115.08 (11.07 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e104.92 (14.15 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e10.16 (4.35,15.96 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExtension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c8\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.16 ( 8.97 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.03 (12.03 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e2.13 ( -2.72, 6.98 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.384\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.82 ( 9.71 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.42 ( 8.10 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e3.39 ( -0.69, 7.48 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.42 (10.13 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.08 ( 9.67 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e5.34 ( 0.82, 9.87 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33.47 (12.32 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.29 (12.81 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e10.18 ( 4.44, 15.93 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdduction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.71 (13.65 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.24 (13.33 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e2.47 ( -3.69, 8.64 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.427\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.13 (10.78 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.89 ( 9.80 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e9.24 ( 4.53, 13.94 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34.71 (10.53 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.53 (11.50 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e9.18 ( 4.14, 14.22 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.92 (11.33 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.39 (12.97 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e8.53 ( 2.96, 14.09 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbduction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.18 ( 8.10 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.00 (11.19 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e2.18 ( -2.28, 6.65 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.29 (10.69 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.61 (11.21 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e4.68 ( -0.32, 9.69 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.50 (14.20 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.11 (12.45 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e7.39 ( 1.29, 13.50 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42.37 (14.08 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.37 (12.67 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e8.00 ( 1.88, 14.12 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003ea\u003c/sup\u003e mo refers to month\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWe used a universal goniometer to measure the hip joint mobility of patients before surgery and at 4, 8, and 16 months postoperatively. There was no statistically significant difference between the two groups before surgery (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). At 4 months postoperatively, the adduction mobility of the control group was better than that of the WB group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At 8 and 16 months postoperatively, the hip joint mobility of the control group was better than that of the WB group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWe compared the VAS scores and HHS scores of two groups of patients. The results showed that there was no statistically significant difference in VAS scores between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). At the 16-month follow-up, the HHS score of the WB group was better than that of the Control group, with a statistically significant difference (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The hips with radiological progression did not undergo THA at the final follow-up, as postoperative pain symptoms were alleviated, thereby delaying the need for THA (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of VAS and HHS scores between two groups of patients.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eWB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatment effect,\u003c/p\u003e \u003cp\u003emean(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo. of hips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo. of hips\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVAS\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.32 ( 1.74 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.03 ( 1.85 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.29 ( -0.53, 1.11 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.68 ( 1.53 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.79 ( 1.45 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.11 ( -0.79, 0.58 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.759\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.37 ( 1.55 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.00 ( 1.27 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.37 ( -0.28, 1.02 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.261\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.24 ( 1.32 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.24 ( 1.50 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.00 ( -0.65, 0.65 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHHS\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.63 (16.51 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.21 (12.23 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.58 ( -5.06, 8.22 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.637\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56.11 (14.42 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.66 (12.01 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.55 ( -1.51, 10.62 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.63 (14.00 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.71 (10.30 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.08 ( -0.54, 10.70 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74.84 (15.26 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81.79 (11.71 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.95 ( 0.73, 13.16 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003eb\u003c/sup\u003e Based on an 11-point numerical pain scale (range, 0\u0026ndash;10; higher scores indicate more severe pain).\u003c/p\u003e \u003cp\u003e\u003csup\u003ec\u003c/sup\u003e Based on the Harris hip score (scale range, 0-100; higher scores indicate more hip joint function).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn terms of quality of life, at 8 months, the WB group showed better General health than the control group, with a statistically significant difference (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). At 16 months, the WB group had better General health, Social function, and Health change than the control group, with a statistically significant difference (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of SF-36 scores between two groups of patients.d\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eWB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatment effect,\u003c/p\u003e \u003cp\u003emean(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo. of hips\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo. of hips\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical function\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58.32 (16.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.26 (13.40 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.95 ( -4.80, 8.70 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.45 (14.23 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.37 (12.18 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.92 ( -0.13, 11.98 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45.79 (19.50 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.58 (16.89 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.79 ( -5.55, 11.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.507\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.55 (17.97 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.24 (16.75 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.68 ( -6.26, 9.63 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRole-\u003c/p\u003e \u003cp\u003ephysical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.29 (22.70 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.16 (20.74 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.13 ( -10.07, 9.81 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.979\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.63 ( 9.71 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.29 (10.35 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.66 ( -3.93, 5.24 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.776\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.18 (22.28 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.53 (16.06 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.66 ( -9.54, 8.22 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.883\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.26 (28.57 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.45 (26.12 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.18 ( -6.33, 18.70 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.328\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBodily pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49.00 (18.46 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.29 (14.81 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.71 ( -9.36, 5.94 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.657\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51.29 (16.45 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.50 (17.41 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.21 ( -0.53, 14.95 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.74 (18.04 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.29 (19.11 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.55 ( -3.94, 13.05 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.289\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80.37 (16.94 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.42 (22.54 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-3.95 ( -13.06, 5.17 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.391\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.97 (16.80 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.21 (13.34 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.24 ( -4.70, 9.17 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.522\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61.37 (15.62 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.05 (12.78 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.68 ( 1.16, 14.21 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.55 (16.56 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.82 (13.67 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.26 ( 0.32, 14.20 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.45 (21.89 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78.18 (13.20 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.74 ( 1.47, 18.00 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVitality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.29 (19.53 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.03 (15.05 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.26 ( -8.23, 7.71 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.948\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.50 (12.72 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.32 (12.73 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.82 ( -5.00, 6.63 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.781\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.29 (12.10 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.82 (12.76 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.53 ( -3.16, 8.21 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.379\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76.58 (13.81 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.87 (14.74 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.71 ( -7.24, 5.82 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.829\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial function\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.49 (22.19 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.06 (20.03 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-6.43 ( -16.09, 3.23 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48.53 (17.41 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.12 (18.92 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.58 ( -7.73, 8.89 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.889\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98.83 (12.52 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e104.18 (17.80 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.35 ( -1.69, 12.38 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.134\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104.07 (15.23 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115.02 (11.26 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.95 ( 4.83, 17.08 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRole-\u003c/p\u003e \u003cp\u003eemotion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41.23 (39.08 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.96 (28.10 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-10.26 ( -25.82, 5.30 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.28 (26.19 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.93 (27.56 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.65 ( -7.64, 16.94 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33.59 (29.76 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.80 (28.10 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.79 ( -14.02, 12.44 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.906\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54.65 (32.86 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.79 (32.28 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.14 ( -8.75, 21.03 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.53 (17.58 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.37 (15.14 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.16 ( -7.66, 7.34 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.32 (15.20 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70.05 (14.53 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.74 ( -5.06, 8.53 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.612\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72.21 (15.99 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.16 (14.07 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95 ( -5.94, 7.83 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.785\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76.21 (17.09 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.82 (14.50 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.39 ( -7.64, 6.85 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.914\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth change\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.87 (16.99 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.55 (15.68 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.32 ( -8.79, 6.16 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.727\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.21 (24.26 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.05 (16.97 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.84 ( 2.27, 21.41 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73.95 (23.86 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83.55 (19.52 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.61 ( -0.36, 19.57 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12 mo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77.63 (24.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.16 (17.18 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.53 ( 0.85, 20.20 )\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003ed\u003c/sup\u003e Based on the Medical Outcomes Study 36-Item Short-Form Health Survey (scale range, 0-100; higher scores indicate a better health state).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAdverse Events\u003c/h3\u003e\n\u003cp\u003eNo adverse events occurred.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur research indicates that at 8 months, the control group had only 1 hip joint progression, while the WB group had 6 hip joint progressions (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and all progressed hip joints were at ARCOⅢA stage, with JIC classification all being type C2. At the final follow-up, there was no statistical difference in progression rates between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), and among the progressed hip joints at the final follow-up, only 1 was at ARCOⅡ stage, while the others were all at ⅢA stage, with JIC classification all being type C2. Functional outcomes indicated that at the final follow-up, the WB group performed better than the control group. This suggests that patients at ARCOⅠ and Ⅱ stages are not affected by weight-bearing postoperatively, and patients at ⅢA stage C1 can also bear weight postoperatively. Postoperative weight-bearing can improve clinical functional levels; however, for patients at ARCOⅢA stage C2, postoperative weight-bearing may accelerate femoral head collapse.\u003c/p\u003e \u003cp\u003eThe cause of femoral head collapse is still unclear. Yang et al. \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003eindicated that the collapse of necrotic femoral heads is caused by fatigue fractures, which occur due to continuous stress on the femoral head and the weakening of bone strength in the necrotic area, leading to microfractures in the primary region. The repair process is then activated, but due to ongoing risk factors, there may be an imbalance between repair and microfractures, resulting in collapse. Ma JX et al.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003esuggested that enhancing bone strength may be an effective method for preventing and treating ONFH due to the internal structural and stress imbalances within the femoral head. Chen WH et al.\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003eindicated that after stress relief in the femoral head, the revascularization of the femoral head accelerates, and the use of anti-osteoporosis medications can reduce bone resorption and promote bone repair in the femoral head. Therefore, for ARCO stage IIIA type C2 ONFH, it is advisable to avoid weight-bearing postoperatively, and taking medications that enhance bone strength may be a good option, with specific weight-bearing times assessed based on radiological results. Wen PF et al.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003eindicated that the cortical part of the lateral column is the main biomechanical support for the femoral head. Ma XL et al.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003enoted that the biomechanical properties of the necrotic area are weaker, while the sclerotic area becomes stronger. In our study, there was no collapse observed in JIC type B and C1, and at the final follow-up, no collapse was noted, indicating that weight-bearing training can be performed postoperatively for types B and C1.\u003c/p\u003e \u003cp\u003eResearch shows\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e that during partial weight bearing after surgery, bilateral axillary crutches can reduce lower limb weight bearing by about 80%, while bilateral elbow crutches can reduce weight bearing on the affected limb by 40%.Therefore, in the first six weeks post-surgery, bilateral axillary crutches can be used, gradually transitioning to bilateral elbow crutches. When using a walker, it is important to avoid prolonged pressure to prevent vascular and nerve damage. Partial weight bearing (PWB) refers to the percentage of body weight supported by the affected lower limb. For example, a gait with 10% PWB means that the affected side bears 10% of the body weight, while the remaining weight is supported by the crutches\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e, For the weight-bearing group, the first six weeks post-surgery should maintain a non-weight bearing status, then gradually increase weight bearing every two weeks, in sequence as 1/3 weight bearing, 1/2 weight bearing, and 2/3 weight bearing, with full weight bearing allowed after 12 weeks of treatment. The choice of gait for ONFH patients after surgery depends on whether the lesion is unilateral or bilateral, as well as the ARCO stage and JIC classification. After hip preservation surgery, using a three-point gait and a two-point gait can effectively achieve PWB. Subsequently, patients can adopt a bilateral crutch weight-bearing swing gait, and finally gradually walk without crutches.\u003c/p\u003e \u003cp\u003eThe innovation of this study lies in the first systematic exploration of the impact of the timing of weight-bearing training on rehabilitation outcomes in patients with ONFH after hip preservation surgery. Although previous studies have proposed different viewpoints on the timing of weight-bearing training\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, we confirmed the effects of different weight-bearing strategies on postoperative radiological progression rates and clinical functional outcomes by retrospectively analyzing clinical data from 42 patients. These results provide important references for subsequent research and offer a new perspective for the formulation of clinical treatment plans.\u003c/p\u003e \u003cp\u003eThe limitations of this study lie in the small sample size and the fact that it was conducted at a single center, which may affect the generalizability of the results. Additionally, the study did not explore biological mechanisms, and the follow-up period was relatively short, which may not fully reflect the long-term effects. Therefore, future research should expand the sample size and consider multi-center data support to enhance the reliability of the results. At the same time, the follow-up period should be extended to assess the effects of weight-bearing training in the long-term rehabilitation process. These improvements will help deepen the understanding of the long-term impact of weight-bearing training on different types of ONFH patients and provide a basis for more comprehensive clinical practice.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eFor patients with ARCO IIIA stage JIC type C2, weight-bearing should be avoided postoperatively, while patients of type B and C1 should initiate weight-bearing training appropriately after surgery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eONFH \u0026nbsp;Osteonecrosis of the Femoral Head\u003c/p\u003e\n\u003cp\u003eWB \u0026nbsp;\u0026nbsp;Weight-bearing\u003c/p\u003e\n\u003cp\u003eARCO \u0026nbsp;Association Research Circulation Osseous\u003c/p\u003e\n\u003cp\u003eJIC \u0026nbsp;Japan Investigation Committee\u003c/p\u003e\n\u003cp\u003eHHS \u0026nbsp;Harris hip score\u003c/p\u003e\n\u003cp\u003eTHA \u0026nbsp;Total hip arthroplasty\u003c/p\u003e\n\u003cp\u003eSVF \u0026nbsp;Adipose-derived stromal vascular fraction\u003c/p\u003e\n\u003cp\u003eROM \u0026nbsp;Range of motion\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eVAS \u0026nbsp;Visual analogue scale\u003c/p\u003e\n\u003cp\u003eSF-36 \u0026nbsp;36-Item Short Form Health Survey\u003c/p\u003e\n\u003cp\u003eIQR \u0026nbsp;Inter quartile range\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCI \u0026nbsp;Confidence interval\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePWB \u0026nbsp; Partial weight bearing\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe wish to thank all patients and medical staff for their co-operation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJiang peng designed the study. Tingjie zhao contributed to the data analysis. All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was funded by\u0026nbsp;the Natural Science Foundation of Beijing (ID:24L20608).\u003c/p\u003e\n\u003cp\u003eNational Key Research and Development Program (2024YFA1108600).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not\u003c/p\u003e\n\u003cp\u003epublicly available due to limitations of ethical approval involving the patient data and anonymity but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Medical Ethics Committee of the General Hospital of the People\u0026apos;s Liberation Army of China.e (Approval No:\u0026nbsp;2024KY098-KS001,approval date: 2 September 2024). The experiment adheres to the principles set forth in the Declaration of Helsinki, and all participants were formally informed of the purpose and content of the research and signed an informed consent form.\u003c/p\u003e\n\u003cp\u003eClinical trial number: Not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLiu N, Zheng C, Wang Q, Huang Z. Treatment of non-traumatic avascular necrosis of the femoral head (Review). Exp Ther Med. 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Am Fam Physician Jun. 2021;15(12):737\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRasouli F, Reed KB. Walking assistance using crutches: A state of the art review. J Biomech Jan 2. 2020;98:109489. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jbiomech.2019.109489\u003c/span\u003e\u003cspan address=\"10.1016/j.jbiomech.2019.109489\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6899359/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6899359/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eThere is currently no clear consensus regarding whether and when weight-bearing should be initiated following hip-preserving surgery for osteonecrosis of the femoral head (ONFH). This study aimed to investigate the impact of the timing of weight-bearing training on postoperative recovery outcomes in patients undergoing hip-preserving procedures for ONFH.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA retrospective analysis was conducted on 42 ONFH patients (78 hips) who underwent hip-preserving treatment at the Fourth Medical Center of PLA General Hospital in 2023. Twenty patients (38 hips) were assigned to the control group (no weight-bearing for 8 months postoperatively, followed by partial weight-bearing), and 22 patients (38 hips) were assigned to the weight-bearing (WB) group (non-weight-bearing for 6 weeks postoperatively, then partial weight-bearing, progressing to full weight-bearing at 3 months). Radiographic progression and clinical outcomes were assessed over a minimum follow-up period of 16 months using the Association Research Circulation Osseous (ARCO) classification system.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e At 8 months postoperatively, the control group had a significantly lower radiographic progression rate compared to the WB group (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05). However, by the final follow-up, no statistically significant difference in progression rate was observed between the two groups (\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05). All progressed hips were classified as Japan Investigation Committee (JIC) type C2. Kaplan–Meier survival analysis showed superior hip survival in the control group at 8 months (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), though the difference became nonsignificant over time (\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05). Functional assessment revealed better hip range of motion in the control group at 8 and 16 months postoperatively (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), while the WB group demonstrated superior Harris Hip Score (HHS), general health, social function, and health change scores at 16 months (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e For patients with ARCO stage IIIA and JIC type C2 ONFH, postoperative weight-bearing should be avoided. In contrast, for patients with JIC types B and C1, appropriately timed weight-bearing training may enhance functional recovery.\u003c/p\u003e","manuscriptTitle":"Effect of Timing of Weight-Bearing Training on Postoperative Recovery After Hip-Preserving Surgery for Femoral Head Necrosis: A Retrospective Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-23 07:11:41","doi":"10.21203/rs.3.rs-6899359/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"20522e95-aab0-4100-8974-d39964ce4657","owner":[],"postedDate":"June 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-19T09:53:43+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-23 07:11:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6899359","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6899359","identity":"rs-6899359","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}