A Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Arthroplasty at a Minimum Follow-Up of 4.5 Years

Bhan, Surya; Malhotra, Rajesh; Kiran, E. Krishna; Shukla, Sagrika; Mahesh, Bijjawara

doi:10.2106/00004623-200510000-00020

Cited by 38 publications

(49 citation statements)

References 20 publications

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“…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]. None of these studies showed a statistically significant difference between the mobile and fixed bearing, but the use of different types and designs of implants may have affected the clinical outcome as has previously been acknowledged by Biau et al [24] and Kim et al [15].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Hanusch

Lou

Warriner³

et al. 2009

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

“…Various studies have been published comparing mobile-and fixed-bearing knee replacements [4][5][6][7][8][9][10], but often different types and designs of prostheses were compared. The studies also differ in methodology, patient selection, operative technique and outcome measures.…”

Section: Introductionmentioning

confidence: 99%

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

Hanusch

Lou

Warriner³

et al. 2009

International Orthopaedics (SICOT)

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“…Protezler arasındaki diğer bir yapısal fark polietilen insertin mobil (öne-arkaya veya rotasyonel) ya da sabit olmasıdır. İlk üre-tilen protez yapıları sabit insertli olsada mobil insertlerin hem femoral roll back mekanizmasına yardımcı olarak, hemde fleksiyon esnasında tibial platonun iç rotasyonuna izin vererek diz hareketlerini kolaylaştıracığı ve fleksiyonu arttıracağı düşüncesiyle protez piyasasına girmiştir [18][19]. Price ve arkadaşlarının [20] çalışmasında mobil bağ koruyan ve sabit insertli bağ koruyan protezlerin hareket açıklığı yönünden ameliyat sonrası sonuçlarında fark olmadığı gözlenmiştir.…”

Section: İstatistiksel Analizunclassified

Comparison of Range of Motion After Total Knee Prosthesis According to Different Type of Prosthesis

2016

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada farklı markalarda total diz protezi uygulanmış hastaların ameliyat sonrası hareket açıklığının değerlendirilmesi ve çeşitlilik gösteren protez tiplerinden hangisi ya da hangilerinin en iyi sonucu verdiğinin tespit edilmesi amaçlandı. Gereç ve Yöntem: Nisan 2005 ile eylül 2007 yılları arasında gonartroz tanısı primer total diz artroplastisi uygulanan 225 hastadan takibi yapılan 180 tanesi (139 kadın, 41erkek. Ort. Yaş: 65 dağılım 51-82) ça-lışmaya alındı. Bütün hastalarda gonartroz nedeni primer osteoartrit idi. Sekonder osteoartriti olan hastalar çalışmaya alınmadı. Bütün hastalar aynı cerrahi teknik ile ameliyat edildi ve aynı rehabilitasyon protokolü uygulandı. Patella hiçbir hastada değiştirilmedi. Arka çapraz bağ olguların bir kısmın-da korundu bir kısmında kesildi. Hastalarda toplam 7 farklı protez 16 alt grup kullanıldı. Bütün ölçümler aynı cerrah tarafından yapıldı. Ortalama takip süre-si 31 ay (24-49ay) idi. Bulgular: Hastalar ameliyat öncesi ve sonrası hareket açıklıkları alt gruplara ayrılmadan ana ticari markalara göre değerlendirildi-ğinde, rotaglide® ve LCS® diz protezlerinde ameliyat sonrası hareket açıklı-ğında azalma gözlenirken, maxim ve kinemax protezlerde hareket açıklığı değişmemiş olup diğer incelenen markalarda hareket açıklığı artmıştır.İstatis-tiksel olarak nexgen ve scorpio protezlerde ameliyat sonrası fleksiyon derecesinde artış anlamlı olarak değerlendirilmiştir (p<0.001). Hastalar; protezin mekanik özelliklerine göre sınıflandırıldığında ise bağkesen protezler ve mobil protezlerde ameliyat sonrası hareket açıklığında anlamlı artış bulunmuş-tur (p<0.001).Hiperflex, fix ve bağ koruyan protezlerde ise hareket açıklığında anlamlı artış saptanmamıştır ( p>0.001). Tartışma: Sonuç olarak farklı protez tipleri arasında fleksiyon dereceleri farklı çıksada en yüksek değerlere sahip olan son üç protez ile en düşük değerlere sahip protezler arasında 10 o fark olduğu saptandı. Hareket açıklığındaki değişiklikler istatiksel olarak fark yaratsada alınan sonuçlar klinik olarak anlamsız görünmektedir. All patients underwent to primary total knee arthroplasty. Primary osteoartrhritis is the reason of gonarthrosis. The patients with secondary osteoartrhritis were excluded from the study. All the patients were operated by the same surgical team and rehabilitated after surgery. Patella didnt change any patient. PCL was protected in some of the patients and cut some of patients. Totally seven type prosthesis in 16 subgroup were applied to the patients. All measurement were done by the same surgeon. Average follow up period was 31 months (24-49 months). Results: Patients without subgrouping were tested according to the range of motion before and after surgery to the type of the prosthesis trademark. Range of motion was decreased with the usage of Rotaglide and LCS® type of prosthesis. Range of motion didnt change with the usage of Maxim and Kinemax type. The range of motion increased in the other trademark of prosthesis. Flexion angle was increased statistically significant with nexge...

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“…Although favorable longterm outcomes have been reported [3][4][5], it has been suggested that clinical symptoms (range of motion and pain relief) and long-term outcomes do not differ when compared with the conventional fixed-type TKA [6][7][8][9]. In addition, the mobile bearing TKA did not display more favorable outcomes in regards to dislocation of the mobile insert, which is a complication specific to the mobile-bearing TKA [10,11]. Abrasion of the undersurface of the insert has also been reported to occur with the mobile bearing TKA [12].…”

Section: Introductionmentioning

confidence: 96%

In vivo kinematics of high-flex mobile-bearing total knee arthroplasty, with a new post-cam design, in deep knee bending motion

Kurita

Tomita

Yamazaki

et al. 2012

International Orthopaedics (SICOT)

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Purpose The objective of this study was to evaluate the in vivo knee kinematics to assess the available functional motion of the characteristic mobile-bearing prosthesis design and to examine whether the artificial joint would work in vivo according to its design concept. Methods We studied 14 knees (11 patients) implanted with the Vanguard RP Hi-Flex prosthesis. This prosthesis has a highly original form of post-cam called a PS saddle design with high compatibility, and with a rotating plate mobilebearing mechanism. The cylinder-type post-cam is designed to enable contact in early flexion ranges, and to prevent paradoxical anterior femoral component movement. Each patient performed weight-bearing deep knee bending under fluoroscopic surveillance. Motion between each component including the polyethylene insert was analyzed using the 2D/3D registration technique.Results The mean range of motion was 122.0°. The mean femoral component rotation for the tibial tray was 5.0°. No paradoxical anterior movement of the nearest point was confirmed between the femoral component and the tibial tray in the early flexion ranges. Initial contact of the postcam was confirmed at a knee flexion angle of 33.8°. Subsequently, the wide contact of the post-cam was maintained until flexion reached 120°in all knees, but disengagement of the post-cam was observed in two knees when flexion was ≥130°. ConclusionsThe results of this study demonstrated that the prosthesis design generally works in vivo as intended by its design concept. The present kinematic data may provide useful information for improvement of high-flex type prostheses.

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A Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Arthroplasty at a Minimum Follow-Up of 4.5 Years

Cited by 38 publications

References 20 publications

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

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

Comparison of Range of Motion After Total Knee Prosthesis According to Different Type of Prosthesis

In vivo kinematics of high-flex mobile-bearing total knee arthroplasty, with a new post-cam design, in deep knee bending motion

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