No difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee arthroplasty: a prospective single-center trial

Abstract

Background Despite numerous scientific investigations, the tribological advantages of mobile bearing inserts have not been sustainably confirmed or refuted for modern knee prostheses in clinical studies. The purpose of this study was to compare fixed and mobile bearing inserts in order to draw conclusions regarding clinical benefits. Methods The present prospective single center cohort study of 2 non-randomized stratified groups consisted of 67 patients. All included patients received cemented total knee arthroplasty (Attune®) due to osteoarthritis. 34 patients were treated with a mobile and 33 patients with a fixed insert. The WOMAC score and the Visual Analogue Scale was used for the subjective assessment of success, while the Knee-Society-Score was used considering the Range of Motion for the objective assessment. The subjective and the clinical scores showed improvements for both compared groups postoperatively at 2 years of minimum follow-up. Results The overall postoperative results of the WOMAC score, the Knee-Society-Score and the Visual Analogue Scale presented no statistically difference between the compared groups (p > 0,05). The postoperative ROM showed a superior improvement of 13.2° ± 18.4° in the mobile-bearing group versus 4.9° ± 18.4° (p = 0.017) in the fixed-bearing group. The flexion of the knee joint was 114° ± 10.1° for the mobile-bearings and 109.2° ± 7.2° for fixed bearings (p = 0.012). Conclusion According to the findings, both inserts showed overall promising postoperative results, in terms of objective as well as subjective parameters, without clinically relevant significant differences, except for ROM, which was superior in the mobile bearing group. The present clinical trial has been registered at the ISRCTN registry with the reverence number ISRCTN15117998 on 04/04/2022.

No difference between mobile and fixed bearing in primary total knee arthroplasty: a meta-analysis

“…Previous evidence suggested that MB may promote greater outcomes in functional scores and complications [ 40 , 44 , 45 , 75 , 95 ]. However, the difference was minimal, and whether mobile bearing provide better outcomes remains controversial [ 5 , 16 , 38 , 46 , 63 , 82 , 96 , 100 , 103 , 111 ]. Several randomized clinical trials (RCTs), which have not been yet considered in any previous meta-analyses, have recently been recently published [ 8 , 24 , 28 , 59 , 93 , 105 , 107 , 123 ].…”

Comparison of revision rates and epidemiological data of a single total knee arthroplasty system of different designs (cruciate retaining, posterior stabilized, mobile bearing, and fixed bearing): a meta-analysis and systematic review of clinical trials and national arthroplasty registries

“…Three publications [ 18 – 20 ] published sufficient epidemiological data in the period from 2020 to 2022 included 205 patients who received primary TKA with the Attune TKA. Cochran's trail [ 25 ] included 64 patients who received primary Attune TKA in 2020.…”

“…Pooled data of three clinical studies [ 18 – 20 ], the Cochrane trial [ 25 ] and the two knee registries (EPRD and NJR) showed an average age of 67.8 years (Range 64–70.5y) and a gender distribution of 60% female and 40% male at implantation (range men 22–44.6%; women 52.4–76%). The three clinical studies and the Cochrane trail showed a pooled average BMI of 29.4 kg/m 2 .…”

“…The Cochrane trail: Ashraf et al (n = 42) and 5 Pubmed studies: (1) Kaptein et al [ 18 ] (n = 38), (2) Moorthy et al [ 19 ] (n = 100), (3) Ruckenstuhl et al [ 20 ] (n = 67), (4) Maniar et al [ 22 ] (n = 72), (5) Vanitcharoenkul, Unnanuntana [ 23 ] (n = 54) had no revisions in Attune TKA.…”

Fixed-Bearing Trabecular Metal Total Ankle Arthroplasty Using the Transfibular Approach for End-Stage Ankle Osteoarthritis

“…The follow-up was relatively short and the series was small for determination of the survivorship of this implant. The study also lacked a control group to assess clinical and radiographic differences with other ankle arthroplasties with different bearings and surgical approaches 33 .…”