Assessing postoperative physiotherapy adherence and functional recovery among tibial plateau fracture patients in Punjab

Abstract

Background: Tibial plateau fractures are complex intra-articular injuries that require surgical stabilisation and structured rehabilitation to restore optimal knee function. Postoperative physiotherapy adherence is a key determinant of functional recovery, yet evidence from South Asian populations remains limited. Objective: To evaluate the relationship between physiotherapy adherence and functional recovery among patients with surgically treated tibial plateau fractures at tertiary care hospitals in Punjab. Methods: A cross-sectional study was conducted over six months among 120 adult patients who underwent open reduction and internal fixation for tibial plateau fractures. Physiotherapy adherence was assessed using a structured adherence checklist, categorising patients as high, moderate, or low adherence. Functional outcomes were measured with the Lysholm Knee Scoring Scale and goniometric knee range of motion (ROM). Data were analysed using one-way ANOVA and Pearson’s correlation to determine associations between adherence and recovery outcomes. Results: The mean age of participants was 40.7 ± 9.3 years, with 51.7% males. High, moderate, and low physiotherapy adherence were recorded in 40.0%, 38.3%, and 21.7% of patients, respectively. The overall mean Lysholm score was 83.6 ± 10.6, and mean knee ROM was 120.1 ± 15.2 degrees. Patients with higher adherence demonstrated slightly greater ROM (p=0.08) and stable Lysholm scores across groups. A modest positive correlation was observed between adherence and ROM (r=0.19, p=0.03). Conclusion: Consistent physiotherapy adherence was associated with improved knee mobility and maintained functional stability following surgical fixation of tibial plateau fractures. Enhancing access to rehabilitation and patient engagement may optimise recovery outcomes in similar healthcare settings.