A prospective randomised study comparing rotating platform and fixed bearing total knee arthroplasty in a cruciate substituting design — Outcomes at two year follow-up

Ferguson, Kim; Bailey, Orville T.; Anthony, Iain; James, Peter; Stother, I.G.; M.J.G., Blyth

doi:10.1016/j.knee.2013.09.007

Cited by 29 publications

(24 citation statements)

References 32 publications

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“…The KSS-Knee and Oxford Knee scores of both groups across the time were not significantly different from each other. These results reinforce the ones of recently published randomized controlled trials [ 1 , 3 , 5 , 12 , 22 ] and are in accordance with the results of lately published meta-analysis [ 9 , 21 , 33 , 37 , 38 ].…”

Section: Discussionsupporting

confidence: 91%

No differences in clinical outcomes between fixed- and mobile-bearing computer-assisted total knee arthroplasties and no correlations between navigation data and clinical scores

Marques

Daniel

Sufi-Siavach

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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PurposeThe theoretical advantages of mobile-bearing (MB) designs over the conventional fixed bearings (FBs) for total knee arthroplasty (TKA) have not been proved yet through clinical studies. The aim of the study was to test whether the MB design has advantages in terms of better clinical outcomes when compared to FB. Furthermore, the relationships between intra-operative obtained implant positioning data and the clinical scores were analysed.MethodsA total of 99 patients were randomized into the FB or the MB group. All patients received the same posterior cruciate retaining implants and were operated with the use of a computer-assisted navigation system. The clinical outcomes of both groups were compared pre-operatively, at 1 year, and at a mean follow-up time of 4 years after surgery.ResultsThe MB implants showed no advantages over the FB when comparing the Knee Society Scores, the Oxford Score, the range of movement (ROM) and pain intensity of the patients in both groups at 1 and 4 years after surgery. There were no relationships between the computer navigation data and the clinical scores.ConclusionsIn view of the 4-year results, there is no evidence to support the recommendation of one design over the other in terms of better clinical outcome scores, higher ROM or lower pain rates. Long-term follow-up results may be necessary, including survival rates. Further research comparing different TKA designs should also include standardized performance-based tests.Level of evidenceProspective study (Randomized controlled trial with adequate statistical power to detect differences), Level I.

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Section: Discussionsupporting

confidence: 91%

No differences in clinical outcomes between fixed- and mobile-bearing computer-assisted total knee arthroplasties and no correlations between navigation data and clinical scores

Marques

Daniel

Sufi-Siavach

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…Lastly, mobile-bearing PS prosthesis also provided no benefit compared with fixedbearing PS designs. 53,59,67,68 Despite the reports of osteolysis and patellar complications, overall failure rate of the PS implant is equivalent to that of CR implants and the main modes of failure overlap.…”

Section: Posterior Cruciate Substituting Implantsmentioning

confidence: 99%

Modes of Failure of Total Knee Arthroplasty: Registries and Realities

2014

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Revision knee arthroplasty places a major strain on the health care system and is associated with high rates of complications, readmissions, and reoperations. Determining the modes of failure of total knee arthroplasty (TKA) preoperatively is essential for a successful revision procedure. Nationwide arthroplasty registries have served as reliable quality control instruments and as data sources of clinical studies that can potentially help guide the investigation of a failed TKA. Modes of failure vary according to the setting of the procedure (primary vs revision arthroplasty) and the prosthesis level of constraint. This article reviews the most prevalent modes of failure of primary and revision TKA, and further quantifies rates and specific modes of failure of bicruciate retaining, posterior cruciate retaining, posterior stabilizing, varus-valgus constrained, and hinged implants.

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“…In the last 5 years, several studies have compared the efficacy between MB and fixed-bearing (FB) or TKA surgery. Although MB knee prostheses have been regarded as successful with low contact stress, they did not demonstrate better maximum knee flexion, range of motion, posterior condylar translation, tibial axial rotation, knee function score, and durability compared with FB [9], [10], [11], [12]. While some in vivo kinematic studies reported that MB had significant advantages in the axial surface rotation between the tibia and femur over FB [8], [13], [14], other studies did not observe such advantages [15], [16], [17].…”

Section: Introductionmentioning

confidence: 96%

Does mobile-bearing have better flexion and axial rotation than fixed-bearing in total knee arthroplasty? A randomised controlled study based on gait

Zeng

Yan

et al. 2020

Journal of Orthopaedic Translation

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ObjectiveTo analyse the 6 degrees of freedom of the knee and gait data of patients with medial knee osteoarthritis before and after fixed-bearing (FB) and mobile-bearing (MB) total knee arthroplasty (TKA) and examine the influence of TKA on gait characteristics and the difference between FB and MB prosthesis. We also sought to explore the prosthesis options available for TKA in these patients.MethodsThirty patients who underwent TKA at the Department of Orthopedics at our hospital from June to October 2017 were included. All patients had a lower limb mechanical axis (hip-knee-ankle angle) of less than 180° which were regarded as genu varum knees and had medial knee osteoarthritis. Patients were randomised divided into the FB group and the MB group according to the knee prosthesis implanted. An infrared navigation three-dimensional portable knee motion analysis system (Opti-Knee®, Shanghai Innomotion, Inc.) was used to acquire data on the 6 degrees of freedom of both knees when walking on flat ground before and after surgery (angle of tibia relative to femur parameters: flexion-extension, internal rotation–external rotation, abduction–adduction; displacement parameters: anterior–posterior, proximal–distal, medial–lateral). Postoperative follow-up efficacy was assessed using the Oxford Knee Score system.ResultsThere were significant differences in the maximum values of the internal/external rotation and flexion/extension angle between patients post-TKA and the healthy population, p values were 0.007 and <0.001,respectively. The postoperative maximum values of genu varum and internal rotation in both FB [(−9.49 ± 5.99°), (−5.77 ± 3.42°), respectively] and MB [(−9.64 ± 4.83°), (−7.54 ± 4.51°), respectively] groups were lower than the preoperative ones [FB (−15.13 ± 6.78°), (−8.28 ± 4.83°); MB (−13.28 ± 3.98°), (−9.46 ± 4.99°), respectively] (p ≤ 0.001), while the postoperative maximum values of flexion angle and anterior displacement in both FB [(46.11 ± 4.14°), (0.71 ± 0.35 cm), respectively] and MB [(49.33 ± 3.98°), (0.75 ± 0.89 cm), respectively] groups were larger than the preoperative ones [FB (43.15 ± 3.77°), (0.26 ± 0.74 cm); MB (44.62 ± 5.92°), (0.33 ± 0.79°), respectively] (p ≤ 0.001). The postoperative range of flexion/extension angle in both FB (40.13 ± 4.14°) and MB (45.82 ± 3.76°) groups was significantly larger than the preoperative one [FB (36.17 ± 6.07°), MB (37.09 ± 3.93°), respectively] (p ≤ 0.001). There were also significant increases in range of anterior–posterior displacement in the FB group (0.85 ± 0.32 cm) postoperatively compared with the preoperative one (0.71 ± 0.92 cm) (p = 0.016) and significant increases in range of medial-lateral displacement (0.64 ± 0.73 cm) in the MB group postoperatively compared with the preoperative one (0.52 ± 0.91 cm) (p = 0.025). The mean flexion/extension angle of the MB group was significantly greater than the FB group after surgery in both the stance phase and the swing phase (p < 0.001). Th...

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A prospective randomised study comparing rotating platform and fixed bearing total knee arthroplasty in a cruciate substituting design — Outcomes at two year follow-up

Cited by 29 publications

References 32 publications

No differences in clinical outcomes between fixed- and mobile-bearing computer-assisted total knee arthroplasties and no correlations between navigation data and clinical scores

No differences in clinical outcomes between fixed- and mobile-bearing computer-assisted total knee arthroplasties and no correlations between navigation data and clinical scores

Modes of Failure of Total Knee Arthroplasty: Registries and Realities

Does mobile-bearing have better flexion and axial rotation than fixed-bearing in total knee arthroplasty? A randomised controlled study based on gait

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