The Long-Term Results of Simultaneous High-Flexion Mobile-Bearing and Fixed-Bearing Total Knee Arthroplasties Performed in the Same Patients

Kim, Young Hoo; Park, Jang Won; Kim, Jun Shik

doi:10.1016/j.arth.2018.11.007

Cited by 25 publications

(19 citation statements)

References 36 publications

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“…compared the posterior cruciate-substituting high-flexion NexGen LPS-Flex MB and NexGen LPS-Flex FB in the same younger patients by long-term clinical, radiographic, and computed tomography scanning. They found no significant difference between these two groups with regard to functional outcome, knee motion, prevalence of osteolysis, or survivorship at 13 year follow-up [31].In the current study, postoperative follow-up X-rays demonstrated the proximity of the lower limb mechanical axis to the physiological mechanical axis, good prosthesis positioning, as well as absence of polyethylene insert displacement and prosthesis loosening or infection. In addition, there were no significant differences in the postoperative OKS scores between the two patient groups.…”

Section: Discussioncontrasting

confidence: 49%

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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Section: Discussioncontrasting

confidence: 49%

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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“…In this study, only mobile-bearing rotating plates were used. Scientific publications reported no difference in aseptic loosening between mobile and fixed bearing [28]. For some authors, mobile-bearing insert may reduce shear forces at the boneimplant interface, thus reducing micro-movements that are detrimental to the bony ingrowth process of cementless implants.…”

Section: Discussionmentioning

confidence: 99%

Survival rate of cemented versus cementless tibial component in primary total knee arthroplasty over 5 years of follow-up: comparative study of 109 prostheses

Pacoret

Kalk²,

Labattut

et al. 2020

SICOT-J

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Introduction: Knee osteoarthritis is the main indication for primary total knee arthroplasty (TKA). It is now accepted that cementless implantation of the femoral component provides equivalent results to cemented one, however, the optimal fixation method of the tibial component remains controversial. The purpose of this study was to compare the survivorship of cemented versus cementless tibial baseplate in primary total knee arthroplasty. Materials and methods: We carried out a retrospective, monocentric study, including 109 TKA (Zimmer® Natural Knee II ultra-congruent mobile-bearing) implanted between 2004 and 2010 for primary osteoarthritis, comparing 2 groups depending on tibial component fixation method, one cemented (n = 68) and one cementless (n = 41). Clinical (Knee Society Rating System (KSS), Hospital for Special Surgery (HSS) scores, range of motion) and radiodiological outcomes were assessed at last follow-up with a minimal follow-up of 5 years. Results: Mean follow-up were 8.14 [5.31–12.7] and 8.06 [5.22–12.02] years, respectively, in cemented and cementless groups. The tibial component survival rate was 100% [95CI: 91.4–100] in the cementless group and 97.1% [95CI: 89.78–99.42] in the cemented group (2 aseptic loosenings) (p = 0.27). Radiolucent lines were present in 31.7% (n = 13) of the cementless and 44.1% (n = 30) of the cemented baseplates (p = 0.2). The postoperative KSS knee score was higher in the cementless group (99 ± 3 vs. 97 ± 7.5; p = 0.02), but there was no significant difference in KSS function, global KSS and HSS scores. Mean range of flexion was 120 ± 10° in the cementless group and 122.5 ± 15° in the cemented group (p = 0.37). No significant differences were found on the radiographic data or on complications. Conclusion: In this study, the survival rate of the tibial component is not influenced by its fixation method at a mean follow-up of 8 years in osteoarthritis, which confirms the reliability of cementless fixation in primary TKA.

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“…All included studies 3,8,[14][15][16][17][18] reported the number of revisions, with 21 patients (4.43%) in MB-TKA group and 20 Survival analysis was performed in four articles 3,8,14,15 including 403 and 410 patients in MB-TKA and FB-TKA groups, respectively. The endpoint of survival analysis was defined as revision for any reason or aseptic loosening.…”

Section: Revision and Survival Analysismentioning

confidence: 99%

“…In the last 10 years, many research studies 3,8,[14][15][16][17][18][19][20][21][22][23][24][25] have been performed to compare the difference between MB-TKA and FB-TKA in clinical and radiographic outcomes. Some articles 3,[14][15][16]18,23 suggested no significant difference in function scores, revision rate, and radiographic outcomes between the two groups; some articles demonstrated that MB-TKA can provide better function scores but has no difference in revision rate and radiographic outcomes compared with FB-TKA 8,20,24 ; which others showed that MB-TKA has a higher revision rate than FB-TKA. 17,21,22,25 Given the difference in these comparative results, systematic reviews and meta-analyses [26][27][28][29][30][31][32][33] have been performed to compare outcomes between MB-TKA and FB-TKA.…”

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confidence: 99%

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Mobile Bearing versus Fixed Bearing for Total Knee Arthroplasty: Meta-analysis of Randomized Controlled Trials at Minimum 10-Year Follow-up

et al. 2020

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This meta-analysis aimed to compare the clinical and radiographic outcomes between mobile-bearing total knee arthroplasty (MB-TKA) and fixed-bearing total knee arthroplasty (FB-TKA) at a minimum 10-year follow-up. PubMed, EMBASE, and Cochrane databases were searched. All included articles were evaluated by two trained reviewers according to the guidelines of the Cochrane Collaboration Handbook for potential risk, and the Consolidated Standards on Reporting Trials (CONSORT) checklist and scoring system was also used to assess the methodological quality of each study. The extracted data included function scores, range of motion (ROM) of the knee, incidence of adverse events or revision, survivorship analysis, and radiographic outcomes. Seven randomized controlled trials (RCTs) were included in this meta-analysis, and all RCTs had a follow-up period longer than 10 years. This meta-analysis shows no significant difference between the two groups with respect to the Keen Society Score (KSS; p = 0.38), KSS function score (p = 0.30), the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC; p = 0.59), ROM (p = 0.71), radiolucent line (p = 0.45), femoral and tibial component positions in the coronal plane (p = 0.55 and 0.35, respectively), revision incidence (p = 0.77), and survivorship rates (p = 0.39). Meanwhile, it showed a slight difference between the two groups in the tibial component position in the sagittal plane (p = 0.003). According to this meta-analysis, the current best available evidence suggests no significant difference between the MB-TKA and FB-TKA groups with respect to the clinical outcomes, radiographic outcomes, revision, and survivorship at a minimum 10-year follow-up. This is a Level II, meta-analysis study.

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The Long-Term Results of Simultaneous High-Flexion Mobile-Bearing and Fixed-Bearing Total Knee Arthroplasties Performed in the Same Patients

Cited by 25 publications

References 36 publications

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

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

Survival rate of cemented versus cementless tibial component in primary total knee arthroplasty over 5 years of follow-up: comparative study of 109 prostheses

Mobile Bearing versus Fixed Bearing for Total Knee Arthroplasty: Meta-analysis of Randomized Controlled Trials at Minimum 10-Year Follow-up

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