Twenty-Year Evaluation of Meniscal Bearing and Rotating Platform Knee Replacements

Análise fluoroscópica da movimentação in vivo do insert na ATJ de plataforma rotatória

“…1 However, despite its proven efficacy, it still presents problems in its long-term follow-up, with issues such as aseptic loosening, wear and tear of the polyethylene and osteolysis. [1][2][3] Several studies of implants with the rotating tibial platform arose in the evolution of TKA. 3 The biomechanical justification for the use of implants with rotating platform is based on the theory that this movement reduces the wear and tear of polyethylene 1,2 and allows greater mobility for the knee.…”

“…3 Some studies demonstrated a reduction of the wear and tear of polyethylene with the use of this kind of implant in relation to fixed platform implants, 1,2 while there are various studies in literature demonstrating no difference in the wear and tear of polyethylene. 1,2 The maintenance of the rotation property of polyethylene on the tibia over the years is relevant for the maintenance of the mechanical properties, and a necessary premise when discussing the functioning of mobile platform TKA. 1,2 Accordingly, it is discussed whether the movement between the polyethylene and the tibial base continues or disappears over the years.…”

“…1,2 Accordingly, it is discussed whether the movement between the polyethylene and the tibial base continues or disappears over the years. [1][2][3] Loss of mobility among components is a possible occurrence with mobile TKA, 2,3 , which might present loss of the biomechanical advantages of this platform and even impairment of the mobile platform in relation to the fixed platform as a consequence. [1][2][3] In this regard, as moving platform prostheses are developed and designed observing the principle of rotation between the polyethylene and the tibial base.…”

“…[1][2][3] Loss of mobility among components is a possible occurrence with mobile TKA, 2,3 , which might present loss of the biomechanical advantages of this platform and even impairment of the mobile platform in relation to the fixed platform as a consequence. [1][2][3] In this regard, as moving platform prostheses are developed and designed observing the principle of rotation between the polyethylene and the tibial base. [1][2][3] In vivo studies analyzing preservation of this property are extremely pertinent.…”

CORR Insights®: Rotating-platform TKA No Different from Fixed-bearing TKA Regarding Survivorship or Performance: A Meta-analysis

“…While there is an abundance of clinical series reporting excellent results in terms of pain, function, or durability (many of which were reported by prosthesis designers or high-volume surgeons) [4,5], there are many randomized controlled trials [1,3,10,13] and others presenting joint registry data [11] that have failed to prove the superiority of mobile bearings compared to fixed bearings. This unproven nature of the superiority of mobile bearings has been echoed by multiple meta-analyses [2,7,12,[14][15][16][17].…”