Reduced patellofemoral and walking pain with mobile-bearing vs. fixed-bearing total knee replacements: a mid-term prospective analytic study

País-Brito, José Luis; Rafols-Urquiza, Belen; Gonzalez-Massieu, Leon; Herrera-Pérez, Mario; Mendoza, Maria Aciego-De; Bergua-Domingo, J. de

doi:10.3944/aott.2015.14.0299

Cited by 5 publications

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“…Little evidence can be found in the literature in terms of the ability to rise from a chair or climb stairs. Pais-Brito [79] found no differences between the MB- and FB-TKA groups in the ability to ascend and descend stairs. Woolson [80] stated that more patients in the MB group required aid to climb stairs compared with patients in the FB group, however this finding was statistically not significant.…”

Section: Discussionmentioning

confidence: 99%

Comparison of fixed and mobile-bearing total knee arthroplasty in terms of patellofemoral pain and function: a prospective, randomised, controlled trial

Feczko

Jutten

Steyn³

et al. 2017

BMC Musculoskelet Disord

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BackgroundDespite growing evidence in the literature, there is still a lack of consensus regarding the use of the mobile-bearing (MB) design total knee arthroplasty (TKA).MethodsIn a prospective, comparative, randomised, single centre trial, 106 patients with end-stage osteoarthritis of the knee were randomised to either an MB or fixed-bearing (FB) group to receive posterior stabilised (PS)-TKA using a standard medial parapatellar approach and patellar resurfacing with follow-up (FU) for 5 years. The primary outcome was anterior knee pain (AKP) during the chair rise test and the stair climb test 5 years after surgery. The secondary outcome was the ability to rise from a chair and to climb stairs, range of motion (ROM), Knee Society Score (KSS), RAND-36 scores and radiological analysis of the patellar tilt.ResultsNo statistically significant difference was found between the two groups at 5 years FU in terms of median AKP during the chair rise test and the stair climb test (p = 0.5 and p = 0.8, respectively). There was no significant difference in any of the other secondary outcome parameters between the groups at 5 years FU.ConclusionA mobile-bearing TKA does not decrease AKP compared to fixed bearings.Trial registration numberClinicalTrials.gov NCT02892838.Level of evidenceII

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Section: Discussionmentioning

confidence: 99%

Comparison of fixed and mobile-bearing total knee arthroplasty in terms of patellofemoral pain and function: a prospective, randomised, controlled trial

Feczko

Jutten

Steyn³

et al. 2017

BMC Musculoskelet Disord

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“…In 2015 Pais-Brito et al (15) evaluated 157 consecutive knees which underwent NexGen (Zimmer Warsaw, IN, USA) TKA implantation with patellar resurfacing (82 FB LPS and 75 MB MBK). They found a statistically significant advantage for the MB group at 5-year follow-up in terms of pain on walking, pain on ascending/descending stairs, patello-femoral pain, patients' ability to walk and to ascend/descend stairs; no difference was detected in patient satisfaction or muscular strength at 5 years.…”

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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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“…With a reported incidence ranging from 4% to 50%, anterior knee pain (AKP) has been cited as one of the most common causes of persistent pain following total knee arthroplasty (TKA), despite advancements in orthopedic implant architecture and the upward trend for minimally invasive surgery 1, 2. Although multifactorial etiology, AKP is considered to stem primarily from the patellofemoral joint 3, 4. Therefore, considerable research attention has been devoted to comparing patellar retention and patellar resurfacing regarding this issue,3, 5, 6 and there continues to be heated debate over whether or not resurfacing the patella has a role in minimizing the frequency of residual patellofemoral pain in the literature 7, 8…”

Section: Introductionmentioning

confidence: 99%

Prevalence of anterior knee pain after patellar retention total knee arthroplasty: Comparison of patients with rheumatoid arthritis versus primary osteoarthritis

Pehlivanoğlu

Balcı

Demіrel

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to investigate whether there is an increased risk of anterior knee pain (AKP) after total knee arthroplasty (TKA) without patellar resurfacing in patients with rheumatoid arthritis (RA) versus primary osteoarthritis (OA).MethodsThis study was a retrospective review of 388 patients (577 knees) who underwent TKA without patellar resurfacing between 2003 and 2011, with a minimum of 5 years of follow-up. Patients were divided into two groups: Group OA (273 knees of 206 patients; 83 males, 123 females; mean age: 64.4 (47–87) years) and Group RA (304 knees of 182 patients; 92 males, 90 females; mean age: 50.7 (21–72) years). In the clinical evaluation, the knee range of motion (ROM) and several outcome measures such as The Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and International Knee Documentation Committee (IKDC) scores were used preoperatively and at the final follow-up visit. The quality of life was measured using Short Form (SF)-36 MCS and PCS scores. The primary outcome was the frequency and severity of patient-reported AKP. The AKP Scale was used to determine the severity of AKP.ResultsThe IKDC raised from 21.62 (range, 13–29.9) preoperatively to 85.1 (range, 80–88) for group OA and from 21.8 (range, 13–29.9) to 85.2 (range, 81–88) for group RA (p < 0.001). The mean KSS improved from 28.35 (range, 22–38) preoperatively to 90.04 (range, 88–95) for group OA and from 21.9 (range, 18–35) preoperatively to 89.7 (range, 86–95) for group RA. The mean WOMAC increased from 20.61 (range, 17.4–24.2) preoperatively to 95.7 (range, 90.9–97.7) for group OA (p < 0.001) and from 20.2 (range, 16.7–24.2) preoperatively to 95.8 (range, 90.9–98.5) for group RA (p < 0.001). The mean ROM improved from 80.14° (range, 55°–130°) preoperatively to 113.17° (range, 95°–140°) in group OA (P = 0.003) and from 73.4° (range, 10°–130°) to 112.8° (range 90°–140°) in group RA (P = 0.003) postoperatively. The frequency of AKP was 8% in Group OA and 7% in Group RA (p = 0.27). For patients with AKP, the mean AKP Scale was 92.74 (range, 84–98) in Group OA and 93.39 (range, 82–98) in Group RA (p = 0.3).ConclusionAfter TKA without resurfacing the patella, patients with RA were determined to have a similar risk for AKP as those with OA.Level of evidenceLevel III, Therapeutic Study.

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Reduced patellofemoral and walking pain with mobile-bearing vs. fixed-bearing total knee replacements: a mid-term prospective analytic study

Abstract: At a mean follow-up of 5 years, significant differences were observed in the MB prosthesis in terms of postoperative pain, ability to ascend/descend stairs, and patellofemoral pain.

Cited by 5 publications

References 0 publications

Comparison of fixed and mobile-bearing total knee arthroplasty in terms of patellofemoral pain and function: a prospective, randomised, controlled trial

Comparison of fixed and mobile-bearing total knee arthroplasty in terms of patellofemoral pain and function: a prospective, randomised, controlled trial

Mobile bearing and fixed bearing total knee arthroplasty

Prevalence of anterior knee pain after patellar retention total knee arthroplasty: Comparison of patients with rheumatoid arthritis versus primary osteoarthritis

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