EARLY REHABILITATION AND VERTICALIZATION AFTER ARTHROPLASTY FOR FEMORAL NECK PSEUDARTHROSIS: TIMING, PROTOCOL DIFFERENTIATION, AND 18-MONTH OUTCOMES

Background: Rehabilitation after arthroplasty for femoral neck pseudarthrosis differs fundamentally from post-fracture protocols due to pre-existing soft-tissue contractures, muscle atrophy, and systemic osteoporosis.

Objective: To compare verticalization timelines, functional recovery trajectories, and 18-month outcomes between a capsule-preserving bipolar arthroplasty protocol (study group) and standard arthroplasty (control group).

Methods: 150 patients (n=70 study, n=80 control), 2019–2025. VAS, HHS, SF-36, ROM assessed at baseline, 1 day, 1, 6, 12, 18 months. Standardized physiotherapy with group-specific modification.

Results: Time to full weight-bearing: 1.8±0.6 vs 2.5±0.8 days (p<0.05). HHS at 18 months: 87.4±4.6 vs 76.3±6.2 (p<0.05). ROM flexion: 102.4±8.6° vs 91.2±9.4° (p<0.05). Rehab duration: 24.6±3.8 vs 31.4±4.5 days (p<0.05).

Conclusions: Capsule-preserving bipolar arthroplasty with structured early rehabilitation enables significantly faster verticalization, superior functional recovery, and shorter hospital stay.