Mobile-Bearing Total Knee Arthroplasty

Post, Zachary D.; Matar, Wadih Y.; Leur, Tim van de; Grossman, Eric L; Austin, Matthew S.

doi:10.1016/j.arth.2009.07.014

Cited by 47 publications

(29 citation statements)

References 31 publications

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“…Some studies have compared all mobile-bearing subtypes as a single cohort with fixed-bearing designs [4,5,33]; some meta-analyses performed the same comparison as a result of the availability of data [17,24,28,37,38,41,42]. Six of the meta-analyses comparing mobile-bearing and fixedbearing prostheses that we reviewed in preparation for our meta-analysis found no significant differences in The Knee Society scores, Hospital for Special Surgery scores, ROM, radiolucent lines, prosthesis-related complications, or patient preference [24,27,28,37,38,42].…”

Section: Discussionmentioning

confidence: 99%

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

Moskal

Capps²

2014

Clinical Orthopaedics &Amp; Related Research

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Background Mobile bearings have been compared with fixed bearings used in TKA. However, rotating platforms, a specific type of mobile bearing, have not been compared with fixed-bearings using meta-analysis. Questions/purposes We asked whether the performance of a rotating-platform bearing is superior to, comparable to, or worse than a fixed bearing. Four areas were investigated: clinical performance, component alignment, adverse event rates, and revision rates. Methods Searches of Medline, EMBASE, Google Scholar, and the Cochrane databases, combined with reference lists from published meta-analyses and systematic reviews of mobile-bearing versus fixed-bearing prostheses used in TKAs, provided 17 nonlanguage-restricted studies consisting of 1910 TKAs (966 rotating platform versus 944 fixed bearing). Random-effect modeling was used for all meta-analyses, thereby mitigating possible effects of heterogeneity among studies. All meta-analyses were examined for publication bias using funnel plots; publication bias was not detected for any meta-analysis. Results There were no statistically or clinically significant differences in clinical performance (clinical scores, ROM, and radiographic evaluation), component alignment, revision rates, or adverse event rates except for tibial component alignment in the AP plane, which favored TKA with fixed-bearings (p = 0.020; standardized mean difference, 0.229; 95% CI, 0.035-0.422), but the effect size was small enough that it was not considered clinically important. Conclusions Based on our findings, which agree substantially with those of prior systematic reviews of TKAs with mobile-bearing versus fixed-bearing prostheses, there is no compelling case for either rotating-platform or fixedbearing implant design in terms of clinical performance, component alignment, adverse event frequencies, or survivorship. This dataset, which was limited to a maximum 6 years followup, is insufficient to address questions related to wear or late revisions. We therefore suggest that implant choice should be made on the basis of other factors, perhaps including cost or surgeon experience.

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Section: Discussionmentioning

confidence: 99%

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

Moskal

Capps²

2014

Clinical Orthopaedics &Amp; Related Research

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“…Most of these studies compared the results of these two implants either in different patient groups or in same patient who received both the implants, the design was different for the two variants [9,[17][18][19][20][21][22][23][24][25][26][27]. However, comparisons are more meaningful if confounding is minimal.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous comparative studies have been published in the literature analyzing the results of mobile bearing TKA with fixed bearing [9,[17][18][19][20][21][22][23][24][25][26][27]. Most of these studies compared the results of these two implants either in different patient groups or in same patient who received both the implants, the design was different for the two variants [9,[17][18][19][20][21][22][23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis between fixed bearing total knee arthroplasty (PFC Sigma) and rotating platform total knee arthroplasty (PFC-RP) with minimum 3-year follow-up

Jawed

Kumar

Malhotra

et al. 2012

Arch Orthop Trauma Surg

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“…Many theoretical benefits of the MB design, including the improvement in kinematics [5], have yet to be substantiated, with numerous authors documenting no improvements in outcomes when compared to fixed bearing (FB) designs [6], [7], [8], [9] and [10]. The majority of studies comparing FB and MB prostheses have used questionnaire based outcome measures that have been shown to be less sensitive than gait analyses when detecting changes in gait [11].…”

Section: Introductionmentioning

confidence: 99%

Gait analysis of fixed bearing and mobile bearing total knee prostheses during walking: Do mobile bearings offer functional advantages?

et al. 2014

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Mobile-Bearing Total Knee Arthroplasty

Cited by 47 publications

References 31 publications

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

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

A comparative analysis between fixed bearing total knee arthroplasty (PFC Sigma) and rotating platform total knee arthroplasty (PFC-RP) with minimum 3-year follow-up

Gait analysis of fixed bearing and mobile bearing total knee prostheses during walking: Do mobile bearings offer functional advantages?

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