Comparison of High-Flexion Fixed-Bearing and High-Flexion Mobile-Bearing Total Knee Arthroplasties—A Prospective Randomized Study

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

doi:10.1016/j.arth.2017.07.025

Cited by 18 publications

(27 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…46,47 However, while high flexion designs have improved kinematic outcomes in some patients, these results have not been consistently demonstrated indicating that kinematics are likely driven by factors other than articular shape. [48][49][50] The results of this study support the premise that bony knee shape is not the primary factor determining high flexion knee kinematics.…”

Section: Discussionsupporting

confidence: 66%

Shape is only a weak predictor of deep knee flexion kinematics in healthy and osteoarthritic knees

Lynch

Perriman

Scarvell

et al. 2020

Journal Orthopaedic Research

View full text Add to dashboard Cite

Tibiofemoral shape influences knee kinematics but little is known about the effect of shape on deep knee flexion kinematics. The aim of this study was to examine the association between tibiofemoral joint shape and kinematics during deep kneeling in patients with and without osteoarthritis (OA). Sixty‐one healthy participants and 58 patients with end‐stage knee OA received a computed tomography (CT) of their knee. Participants completed full flexion kneeling while being imaged using single‐plane fluoroscopy. Six‐degree‐of‐freedom kinematics were measured by registering a three‐dimensional (3D)‐static CT onto 2D‐dynamic fluoroscopic images. Statistical shape modeling and bivariate functional principal component analysis (bfPCA) were used to describe variability in knee shape and kinematics, respectively. Random‐forest‐regression models were created to test the ability of shape to predict kinematics controlling for body mass index, sex, and group. The first seven modes of the shape model up to three modes of the bfPCAs captured more than 90% of the variation. The ability of the random forest models to predict kinematics from shape was low, with no more than 50% of the variation being explained in any model. Furthermore, prediction errors were high, ranging between 24.2% and 29.4% of the data. Variations in the bony morphology of the tibiofemoral joint were weakly associated with the kinematics of deep knee flexion. The models only explained a small amount of variation in the data with high error rates indicating that additional predictors need to be identified. These results contribute to the clinical understanding of knee kinematics and potentially the expectations placed on high‐flexion total knee replacement design.

show abstract

Section: Discussionsupporting

confidence: 66%

Shape is only a weak predictor of deep knee flexion kinematics in healthy and osteoarthritic knees

Lynch

Perriman

Scarvell

et al. 2020

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…Three component positions were measured in four studies 3,14,15,18 : femoral component position in coronal plane and tibial component positions in the coronal and sagittal planes, with 385 participators in both groups. There was no statistically significant difference between the two groups in femoral and tibial component positions in the coronal plane (p ¼ 0.55, 95% CI: À1.70 to 0.91; p ¼ 0.35, 95% CI: À1.32 to 0.47; ►Fig.…”

Section: Radiographic Outcomesmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

“…À1.55 to 0.59; p ¼ 0.30, 95% CI: À0.93 to 3.03; ►Fig. 4A, B).Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score was evaluated in four studies3,8,14,15 …”

mentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Comprehensive evaluation of risk factors for aseptic loosening in cemented total knee arthroplasty: A systematic review and meta‐analysis

Yao,

Chen

2024

J. exp. orthop.

View full text Add to dashboard Cite

PurposeAseptic loosening is the most common cause for revisions after total knee arthroplasty (TKA). Despite many studies exploring various risk factors associated with aseptic loosening, findings often present inconsistencies. To address this, we conducted a thorough review of the literature to identify and analyse these risk factors in cemented TKA. Additionally, we performed a meta‐analysis to reconcile the divergent conclusions observed across studies.MethodsWe searched PubMed, Web of Science and Embase from 1996 up to 2024 and evaluated the quality of the included literature. Seventy‐four studies were included to assess the association of BMI, diabetes, high physical activity (HPA), osteoporosis, rheumatoid arthritis (RA), cement material and implant design. Twenty‐nine studies were used to calculate relative risk and CIs (using the random effects theory) and study heterogeneity for six different risk factors (BMI, diabetes, HPA level, cement material, polyethylene and implant design).ResultsPatients with diabetes are eight times more likely to experience aseptic loosening compared to those without diabetes (RR = 9.18, 95% CI: 1.80−46.77, p < 0.01). The use of tibial stem extension or highly crosslinked polyethylene can help reduce the incidence of aseptic loosening. However, we did not identify BMI, HPA, osteoporosis, RA, the use of high‐viscosity cement and the utilization of mobile‐bearing designs as risk factors for aseptic loosening post‐cemented TKA.ConclusionsPatients with diabetes undergoing TKA should be counselled regarding their potential increased risk of aseptic loosening. The use of tibial stem extensions and HXLPE can mitigate the incidence of aseptic loosening in cemented TKA. However, given a limited number of studies were included in the meta‐analysis, we believe that higher‐level studies are necessary to clearly identify other risk factors.Level of EvidenceLevel III.

show abstract

Comparison of High-Flexion Fixed-Bearing and High-Flexion Mobile-Bearing Total Knee Arthroplasties—A Prospective Randomized Study

Cited by 18 publications

References 39 publications

Shape is only a weak predictor of deep knee flexion kinematics in healthy and osteoarthritic knees

Shape is only a weak predictor of deep knee flexion kinematics in healthy and osteoarthritic knees

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

Comprehensive evaluation of risk factors for aseptic loosening in cemented total knee arthroplasty: A systematic review and meta‐analysis

Contact Info

Product

Resources

About