Mobile-bearing versus fixed-bearing total knee implants. Results of a series of 100 randomised cases after 9years follow-up

Poirier, Nicolas; Gräf, P.; Dubrana, F.

doi:10.1016/j.otsr.2015.03.004

Cited by 29 publications

(26 citation statements)

References 22 publications

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“…The results of a randomized trial comparing FB and MB TKAs in 61 patients at 9-year follow-up was recently published by Poirier et al (14); they implanted the same prosthesis, Natural-Knee II (Zimmer, Warsaw, IN, USA), that was cementless in all but four cases. There was no significant difference between the two bearing types in terms of ROM, being the ROM at final follow-up identical to the preoperative value.…”

Section: Biomechanical and Clinical Reviewmentioning

confidence: 99%

Mobile bearing and fixed bearing total knee arthroplasty

Capella¹,

Dolfin²,

Saccia³

2016

Ann. Transl. Med.

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The mobile bearing (MB) concept in total knee arthroplasty (TKA) was developed as an alternative to fixed bearing (FB) implants in order to reduce wear and improve range of motion (ROM), especially focused on younger patients. Unfortunately, its theoretical advantages are still controversial. In this paper we exhibit a review of the more recent literature available comparing FB and MB designs in biomechanical and clinical aspects, including observational studies, clinical trials, national and international registries analyses, randomized controlled trials, meta-analyses and Cochrane reviews. Except for some minor aspects, none of the studies published so far has reported a significant improvement related to MBs regarding patient satisfaction, clinical, functional and radiological outcome or medium and long-term survivorship. Thus the presumed superiority of MBs over FBs appears largely inconsistent. The routine use of MB is not currently supported by adequate evidences; implant choice should be therefore made on the basis of other factors, including cost and surgeon experience.

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Section: Biomechanical and Clinical Reviewmentioning

confidence: 99%

Mobile bearing and fixed bearing total knee arthroplasty

Capella¹,

Dolfin²,

Saccia³

2016

Ann. Transl. Med.

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“…The morphological features of the Oxford UKA meniscal bearing are fully congruent over a complete range of motion with the round femur and flat tibial component and have a free floating nature that allows gliding on the metal of the tibia throughout the knee's range of motion. 5,19 The bearing is slightly thicker in the anterior part than the posterior part. There is an anterior marker wire on the front of the liner and two posterior ball markers on the back to identify the anterior and posterior positions of the liner on X-ray.…”

Section: Discussionmentioning

confidence: 99%

The 180° spin of meniscal bearing in unicompartmental knee arthroplasty

Lee

Hwang

Nam

et al. 2017

J Orthop Surg (Hong Kong)

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Mobile-bearing Oxford medial unicompartmental knee arthroplasty (UKA) has been widely used and has produced good results in the treatment of medial compartmental osteoarthritis. But it is associated with the potential risk of meniscal bearing dislocation. Symptoms caused by most meniscal bearing dislocations include acute pain, knee swelling, and locking. We report two unusual cases of meniscal bearing spinning of 180° without remarkable symptoms, which would have been easily missed if we had not watched carefully. Therefore, if there is sudden locking, pain, swelling, or a slight locking history, the possibility of meniscal bearing spin out as well as meniscal bearing dislocation should be considered and the direction of meniscal bearing markers should be confirmed, especially on lateral radiographs.

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“…des Abriebs, der Kinematik und der Fehlerverzeihbarkeit. Die Evidenz für den unikondylären und bikondylären Oberflächenersatz zeigt jedoch eindeutig, dass weder für das klinische Out-come noch für das Langzeitüberleben eines der beiden Designs eine klare Überlegenheit nachweisen kann [28][29][30][31][32][33].…”

Section: Einfluss Von Implantatdesign Und Verankerungunclassified

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

2017

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In end-stage medial osteoarthritis, the surgeon can decide whether to use unicompartmental or total knee arthroplasty for operative treatment of the patient. Despite the available literature there is a lack of evidence to suggest if one procedure can be rated as being superior to the other. With increasing demand for knee arthroplasty, treatment with the highest expectation of success will be of particular interest. The purpose of this manuscript was to analyse and compare the available literature on unicompartmental vs. total knee arthroplasty for the treatment of medial osteoarthritis. In this review of literature, the two procedures were compared regarding their clinical outcome, implant survival, and complication rates. Regarding the clinical outcome the unicompartmental knee arthroplasty was shown to be superior over total knee arthroplasty. However, studies were mostly retrospective and groups were also different preoperatively. Patients treated with unicompartmental knee arthroplasty had better preoperative range of motion and function scores. Unicompartmental and total knee arthroplasty showed comparably increased functional scores. Taking the implant survival as parameter, institutional registries, multicenter studies and arthroplasty registries found total knee arthroplasties to have a significantly better long-term survival in comparison to unicompartmental knee arthroplasty. However, data might be biased by the lower threshold to revise unicompartmental knee arthroplasty due to expected simple revision and more subjective indications for revision. Looking at the complication rate, one has to differentiate between general and implant-specific complications. While the unicompartmental knee arthroplasty was shown to be advantageous in terms of general complications and mortality, it was also shown to be inferior in terms of implant-specific complications. The available literature does not show one procedure to be superior to the other. The trend to a better clinical outcome and a lower mortality rate is advantageous for unicompartmental knee arthroplasty, while the better long-term survival and a lower risk of implant-specific complications may make total knee arthroplasty preferable.

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Mobile-bearing versus fixed-bearing total knee implants. Results of a series of 100 randomised cases after 9years follow-up

Abstract: Prospective randomised study.

Cited by 29 publications

References 22 publications

Mobile bearing and fixed bearing total knee arthroplasty

Mobile bearing and fixed bearing total knee arthroplasty

The 180° spin of meniscal bearing in unicompartmental knee arthroplasty

AE-Beitrag: Unikondylärer Ersatz vs. Totalendoprothese bei medialer Gonarthrose

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