Mobile and Fixed-Bearing (All-Polyethylene Tibial Component) Total Knee Arthroplasty Designs

Gioe, Terence J.; Glynn, Jason; Sembrano, Jonathan N.; Suthers, Kathleen; Santos, Edward Rainier G; Singh, Jasvinder A.

doi:10.2106/jbjs.h.01442

Cited by 96 publications

(71 citation statements)

References 19 publications

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“…Our review showed improvement in mean Knee Society clinical and functional scores that parallel the results reported in studies that have not separated patients on the basis of patient age [1,2,6,8,12,19,27,30]. Although physician-generated scores suggest improvement, reporting biases that appear to overlook negative patient experiences were identified during this review, including minimizing the impact of revision procedures for patellar resurfacing, polyethylene wear, instability, and stiffness (Table 1).…”

Section: Discussionsupporting

confidence: 68%

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Keeney

Eunice

Pashos

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is important to define the best practices to enhance clinical performance and implant longevity. Questions/purposes We systematically reviewed the literature to assess: (1) how TKAs perform in young patients; (2) whether the TKA is a durable procedure for young patients, and (3) what guidance the literature outlines for TKA in young patients. Methods We searched the literature between 1950 and 2009 for all studies reporting on TKAs for patients younger than 55 years that documented clinical and radiographic assessments with a minimum 2-year followup. Thirteen studies, reporting on 908 TKAs performed for 671 patients, met these criteria. Results Mean Knee Society clinical and functional scores increased by 47 and 37 points, respectively. Implant survivorship was reported between 90.6% and 99% during the first decade and between 85% and 96.5% during the second decade of followup. The literature does not direct specific techniques for TKA for young patients.Conclusions TKA provides surgeon-measured clinical and functional improvements with a moderate increase in second-decade implant failures.

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Section: Discussionsupporting

confidence: 68%

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Keeney

Eunice

Pashos

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…In a recent prospective randomized study comparing mobile and fixed TKA designs, Gioe et al [8] demonstrated no differences in the domains of clinical score, pain relief, or ROM. A recent meta-analysis of 33 studies assessing outcomes of 3532 TKAs [16] also suggested no difference in clinical or radiographic measures, such as clinical Knee Society score, clinical or functional American Knee Society score, ROM, activity, satisfaction, preference, radiographic alignment, osteolysis, wear, radiostereometric analysis measures, and complication rates between fixed-and mobile-bearing designs.…”

Section: Introductionmentioning

confidence: 98%

Wear Damage in Mobile-bearing TKA is as Severe as That in Fixed-bearing TKA

Kelly

Wright

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Mobile-bearing TKAs reportedly have no clinical superiority over fixed-bearing TKAs, but a potential benefit is improved polyethylene wear behavior. Questions/purposes We asked whether extent of damage and wear patterns would be less severe on retrieved mobile-bearing TKAs than on fixed-bearing TKAs and if correlations with patient demographics could explain differences in extent or locations of damage. Methods We performed damage grading and mapping of 48 mobile-bearing TKAs retrieved due to osteolysis/loosening, infection, stiffness, instability or malpositioning. Visual grading used stereomicroscopy to identify damage, and a grade was assigned based on extent and severity. Each damage mode was then mapped onto a photograph of the implant surface, and the area affected was calculated. Results Marked wear damage occurred on both surfaces, with burnishing, scratching, and pitting the dominant modes. Damage occurred over a large portion of both surfaces, exceeding the available articular borders in nearly 30% of implants. Wear of mobile-bearing surfaces included marked third-body debris. Damage on tibiofemoral and mobile-bearing surfaces was not correlated with patient BMI or component alignment. Damage on mobilebearing surfaces was positively correlated with length of implantation and was greater in implants removed for osteolysis or instability than in those removed for stiffness or infection. Conclusions Each bearing surface in mobile-bearing implants was damaged to an extent similar to that in fixedbearing implants, making the combined damage score higher than that for fixed-bearing implants. Mobile-bearing TKAs did not improve wear damage, providing another argument against the superiority of these implants over fixed-bearing implants.

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“…Very few studies have specifically compared fixed-bearing posterior-stabilized and mobile-bearing posterior-stabilized total knee prostheses. In a small number of studies, no differences in midterm functional and radiographic outcomes between patients with fixed and those with mobile-bearing posteriorstabilized prostheses were identified 4,11,12 . In one study with limited follow-up, implant survival rates were also reported to be similar 14 .…”

mentioning

confidence: 97%

“…It has also been argued that mobile bearings have the potential to enhance patellar tracking, reduce pain, enhance function, and reduce patellofemoral-related revision 8 . Many studies have compared clinical and radiographic outcomes of mobile and fixed-bearing total knee prostheses 4,5,7,[9][10][11][12] . One meta-analysis demonstrated an early reduction in anterior knee pain for patients with mobile-bearing total knee prostheses 7 .…”

mentioning

confidence: 99%

International Comparative Evaluation of Knee Replacement with Fixed or Mobile-Bearing Posterior-Stabilized Prostheses

Graves

Sedrakyan

Baste

et al. 2014

The Journal of Bone and Joint Surgery

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Mobile and Fixed-Bearing (All-Polyethylene Tibial Component) Total Knee Arthroplasty Designs

Abstract: The two designs functioned equivalently at the time of early follow-up in this low-to-moderate-demand patient group. The rotating-platform design had no significant clinical advantage over the design with the all-polyethylene tibial component.

Cited by 96 publications

References 19 publications

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

What is the Evidence for Total Knee Arthroplasty in Young Patients?: A Systematic Review of the Literature

Wear Damage in Mobile-bearing TKA is as Severe as That in Fixed-bearing TKA

International Comparative Evaluation of Knee Replacement with Fixed or Mobile-Bearing Posterior-Stabilized Prostheses

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