Two-year follow-up on joint stability and muscular function comparing rotating versus fixed bearing TKR

Abstract

Mobile and fixed bearing in total knee replacement are still discussed controversially. In a retrospective, matched-pair study, we investigated 40 patients with computer-assisted (BrainLAB) primary total knee replacement (PFC Sigma, DePuy) performed two years before. Twenty patients each received a mobile bearing and a fixed bearing. We compared Womac Score, Knee Society Score, postoperative ROM, fluoroscopic measurement of knee stability in flexion and extension and isokinetic muscle strength using a Biodex-3 dynamometer. Both groups showed similar results concerning WOMAC Score (total rotating bearing: 23.05; fixed bearing: 22.57), KSS (rotating bearing: 174.89; fixed bearing: 176.1). Isokinetic muscle force demonstrated statistically significant superior results for knee flexion in the rotating bearing group. Medio-lateral stability revealed statistically significant superior results for the rotating bearing compared to fixed bearing in extension (P>0.05). In flexion only lateral stability was superior (P>0.05). Two-year clinical follow-up after computer-assisted total knee replacement resulted in good clinical outcome with high patient satisfaction. Statistically significant better values for the rotating platform group were found for the medio-lateral stability in extension and the peak flexion torque.

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

“…comparative studies) [9,26] with a total of 253 TKAs (133 in the rotating-platform group and 120 in the fixed-bearing group) ( Table 1). Included studies were evaluated using the modified Jadad score [29], the average score for quality was 5.9 of 8 possible points (Table 2).…”

Functional outcome of PFC Sigma fixed and rotating-platform total knee arthroplasty. A prospective randomised controlled trial

“…These include randomised controlled trials [6-8, 15-17, 23], prospective case series [9,10] and retrospective reviews [12][13][14]24]. In these studies a variety of knee replacements have been used, but often prostheses of different design and different manufacturers were compared with each other [6][7][8][9][10].…”

“…the PFC Sigma total knee replacement system [12][13][14][15][16][17]. All of these studies, however, differ with regards to PCL status, implantation techniques (cemented or hybrid) and resurfacing of the patella (Table 3).…”

“…Luring et al [14] investigated joint stability and muscular function in a retrospective matched-pair analysis of 40 patients with osteoarthritis. All patients received a PCL retaining prosthesis which was implanted using a computer-assisted technique.…”

“…In recent years a number of studies have investigated the functional outcome of the PFC Sigma fixed-bearing and PFC Sigma rotating-platform total knee replacement systems [12][13][14][15][16][17]. Only three of these are randomised controlled trials [15][16][17].…”