Is there reduced polyethylene wear and longer survival when using a mobile-bearing design in total knee replacement?

Abstract

The purpose of this study was to undertake a meta-analysis to determine whether there is lower polyethylene wear and longer survival when using mobile-bearing implants in total knee replacement when compared with fixed-bearing implants. Of 975 papers identified, 34 trials were eligible for data extraction and meta-analysis comprising 4754 patients (6861 knees). We found no statistically significant differences between the two designs in terms of the incidence of radiolucent lines, osteolysis, aseptic loosening or survival. There is thus currently no evidence to suggest that the use of mobile-bearing designs reduce polyethylene wear and prolong survival after total knee replacement.

No differences in clinical outcomes between fixed- and mobile-bearing computer-assisted total knee arthroplasties and no correlations between navigation data and clinical scores

“…Attempting to solve these problems, the mobile-bearing (MB) designs were introduced. MB TKA designs were claimed to reduce the risk of aseptic loosening by minimizing the stress transmitted to the prothesis–bone interface, to reduce the wear of the PE insert by increasing the implant conformity [ 34 , 41 ], to increase the overall range of motion by allowing the femur to roll back during flexion and to rotate during extension and to reduce the anterior knee pain rates [ 40 ].…”

Enhanced patella tracking in rotating platform total knee replacements, friend or foe? A case of iliotibial band impingement by rotating polyethylene insert

“…[5][6][7][8][9] Stipulated advantages of the mobilebearing system also appear to be conceptual only thus far, with several systematical reviews finding no statistical differences when compared to fixed-bearing systems in terms of clinical performance (clinical scores, range of motion, component alignment) as well as revision rates or adverse events. [10][11][12][13][14][15] Iliotibial band impingement following total knee replacement is not a novel occurrence. However, to the best of our knowledge, our case is the first in the reported literature to occur in the rotating platform total knee replacement.…”

Knee replacement: clinical perspectives

“…The concept of the rotating platform mobile bearing implant is similar enough for the different individual devices that, for the most part, results can be generalized for the class in terms of outcome assessment. To date, most studies have suggested that there is no functional advantage to mobile bearing designs over fixed bearing designs [32][33][34][35][36].…”