AccScience Publishing / OTE / Online First / DOI: 10.36922/OTE025350014
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ORIGINAL RESEARCH ARTICLE

Impact of weight-bearing timing on recovery after tissue-engineering-based hip-preserving surgery for femoral head necrosis: A retrospective analysis

Junming Zhang1,2 ,  Yanbin Wu2 ,  Yazhou Li2 ,  Tingjie Zhao2 ,  Zexian Liu2 ,  Lijun Sun2 ,  Sice Wang2 ,  Biao Ma2 ,  Jiazhou Wu2 ,  Rile Wu3 ,  Dawei Zhang4* ,  Jiang Peng2*
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1 Department of Third Clinical Hospital, Postgraduate Training Base of Jinzhou Medical University, The 960th Hospital of the Joint Logistic Support Force, Jinzhou, Liaoning, China
2 Department of Orthopedic Research Institute, The Fourth Medical Center of The PLA General Hospital, Beijing, China
3 Department of Office, Inner Mongolia Autonomous Region Rehabilitation Center for Disabled Children, Hohhot, Inner Mongolia Autonomous Region, China
4 Department of Orthopedics, The 960th Hospital of The Joint Logistic Support Force, Jinan, Shandong, China
OTE, 025350014 https://doi.org/10.36922/OTE025350014
Received: 31 August 2025 | Revised: 10 November 2025 | Accepted: 11 November 2025 | Published online: 28 November 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Despite advances in surgical management, the optimal timing and progression of weight bearing (WB) after hip-preserving procedures for osteonecrosis of the femoral head (ONFH) remain uncertain. This study aims to explore the impact of WB timing on rehabilitation outcomes after hip-preserving surgery for ONFH. A retrospective analysis was conducted in 42 patients (76 hips) with ONFH who received hip-preserving surgery at our hospital in 2023. The control group did not bear weight for 8 months postoperatively, while the WB group began partial WB 6 weeks postoperatively and full WB after 3 months. Patients were followed for ≥16 months to compare radiological progression rates and clinical functional outcomes between the two groups. At 8 months postoperatively, the radiological progression rate was lower in the control group than in the WB group (p<0.05), although this difference was not statistically significant at the final follow-up. Hip joint mobility in the control group was better than that in the WB group (p<0.05), whereas at 16 months, the WB group had higher Harris hip scores and higher scores in some 36-Item Short Form Health Survey dimensions (p<0.05). Early WB in patients with Association Research Circulation Osseous Stage IIIA and Japanese Investigation Committee (JIC) C2-type lesions may increase the risk of short-term femoral head collapse, while timely WB in patients with JIC B- or C1-type lesions appears beneficial for functional recovery.

Keywords
Osteonecrosis of the femoral head
Post-operative rehabilitation
Weight training
Tissue engineering
Funding
This work was funded by the National Key Research and Development Program (2024YFA1108600) and Natural Science Foundation of Beijing (ID:L242042).
Conflict of interest
The authors declare that they have no competing interests.
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