Mobile versus fixed-bearing total knee arthroplasty: mid-term comparative clinical results of 216 prostheses

Abstract

Since the late 1970s, mobile-bearing total knee designs have been advocated as having theoretical advantages over fixed-bearing total knee replacements. At present there is no consensus as to whether there are any differences in clinical results between the two designs. We present the results of two consecutive cohorts each of over 100 prosthesis. The first cohort underwent a fixed-bearing prosthesis, whilst the second cohort received the mobile bearing variant of the same prosthesis. Both groups were assessed pre- and post-operatively using the American Knee Society knee and function scores as well as range of movement and the presence or absence of anterior knee pain. No difference was found statistically significant between the groups, either for the knee score (P=0.068), the function score (P=0.26), the range of movement (P=0.11) or the proportions of anterior knee pain (P=0.06). It is our opinion that mobile bearing knee prosthesis have still to prove their theoretical advantages in clinical practice.

Staged bilateral mobile-bearing and fixed-bearing total knee arthroplasty in the same patients: a prospective comparison of a posterior-stabilized prosthesis

“…In one knee with a mobile-bearing prosthesis, the preoperative femorotibial alignment was 11°o f valgus. The preoperative femorotibial alignment averaged 8.9°of varus (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) in all knees with a fixed-bearing prosthesis. The postoperative femorotibial alignment Fig.…”

“…The postoperative femorotibial alignment Fig. 1 Photographs of the mobile-bearing prosthesis in the right and fixed-bearing prosthesis in the left averaged 5.3°of valgus (1)(2)(3)(4)(5)(6)(7)(8) in the mobile-bearing knees and 5.4°of valgus (2)(3)(4)(5)(6)(7)(8) in the fixed-bearing knees. In both groups, there were no significant differences in the position of the femoral and tibial components in the coronal and sagittal planes ( Fig.…”

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

“…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].…”

“…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].…”

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

“…Of these, we included 34 clinical trials with 4754 patients (6861 TKRs) in the meta-analysis. [4][5][6][7][11][12][13][14][15][16][17][18][19] There were 32 RCTs, two were CCTs, 6,29 and two were from the same trial. 23,41 The characteristics of the studies that were included are shown in Tables I and II.…”