Rotating-platform Has No Surface Damage Advantage Over Fixed-bearing TKA

Stoner, Kirsten E.; Jerabek, Seth A.; Tow, Stephanie; Wright, Timothy M.; Padgett, Douglas E.

doi:10.1007/s11999-012-2530-1

Cited by 23 publications

(4 citation statements)

References 3 publications

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“…Analysis of a cohort of rotating-platform PFC knees reported a similar average damage score for burnishing, pitting, and scratching at 2 (0.3–3.8) years’ follow-up (Stoner et al. 2013 ). The absence of abnormally high PE wear in our cohort supports the general theory that PE wear in total joint replacement and subsequent osteolysis is not a main cause of early implant loosening but rather affects the long-term survivorship (Gallo et al.…”

Section: Discussionmentioning

confidence: 93%

Early aseptic loosening of a mobile-bearing total knee replacement

et al. 2017

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Background and purposeRegistry-based studies have reported an increased risk of aseptic tibial loosening for the cemented Low Contact Stress (LCS) total knee replacement compared with other cemented designs; however, the reasons for this have not been established. We made a retrieval analysis with the aim of identifying the failure mechanism.Patients and methodsWe collected implants, cement, tissue, blood, and radiographs from 32 failed LCS Complete cases. Damage to the tibial baseplate and insert was assessed. Exposure to wear products was quantified in 11 cases through analysis of periprosthetic tissue and blood. Implant alignment and bone cement thickness was compared with a control group of 43 non-revised cases.ResultsLoosening of the tibial baseplate was the reason for revision in 25 retrievals, occurring at the implant–cement interface in 16 cases. Polishing was observed on the lower surface of the baseplate and correlated to the level of cobalt, chromium, and zirconium in the blood. No evidence of abnormally high polyethylene wear was present. For each 1 mm increase in cement thickness the odds of failure due to aseptic loosening decreased by 61%. Greater varus alignment was associated with a shorter time to failure. The roughness, Ra, of a new LCS baseplate’s lower surface was 3.7 (SD 0.7) µm.InterpretationDebonding of the tibial component at the implant–cement interface was the predominant cause of tibial aseptic loosening. A thin cement layer may partly explain the poor performance. Furthermore, the comparatively low tibial surface roughness and the lack of a keeled stem may have played a role in the failures observed.

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Section: Discussionmentioning

confidence: 93%

Early aseptic loosening of a mobile-bearing total knee replacement

et al. 2017

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“…One possible explanation proposed by Burton et al [6], who analysed wear rates between fixed‐ and a mobile‐bearing unicondylar knees, was that mobile bearings displayed higher wear rates when compared to fixed bearings leading them to speculate to a longer osteolysis‐free post‐operative period with fixed‐bearing knees. This is further considered by Huang et al [15] who report increased tibial wear at revision and by Stoner et al [32] who after laser‐mapping tibial polyethylene inserts report an increased total damage score with the rotating‐platform polyethylene, thereby increasing potential third‐body debris within these knees.…”

Section: Discussionmentioning

confidence: 96%

No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study

Bailey

Ferguson

Crawfurd

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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“…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 ].…”

Section: Introductionmentioning

confidence: 99%

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

Marques

Daniel

Sufi-Siavach

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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PurposeThe theoretical advantages of mobile-bearing (MB) designs over the conventional fixed bearings (FBs) for total knee arthroplasty (TKA) have not been proved yet through clinical studies. The aim of the study was to test whether the MB design has advantages in terms of better clinical outcomes when compared to FB. Furthermore, the relationships between intra-operative obtained implant positioning data and the clinical scores were analysed.MethodsA total of 99 patients were randomized into the FB or the MB group. All patients received the same posterior cruciate retaining implants and were operated with the use of a computer-assisted navigation system. The clinical outcomes of both groups were compared pre-operatively, at 1 year, and at a mean follow-up time of 4 years after surgery.ResultsThe MB implants showed no advantages over the FB when comparing the Knee Society Scores, the Oxford Score, the range of movement (ROM) and pain intensity of the patients in both groups at 1 and 4 years after surgery. There were no relationships between the computer navigation data and the clinical scores.ConclusionsIn view of the 4-year results, there is no evidence to support the recommendation of one design over the other in terms of better clinical outcome scores, higher ROM or lower pain rates. Long-term follow-up results may be necessary, including survival rates. Further research comparing different TKA designs should also include standardized performance-based tests.Level of evidenceProspective study (Randomized controlled trial with adequate statistical power to detect differences), Level I.

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Rotating-platform Has No Surface Damage Advantage Over Fixed-bearing TKA

Abstract: The increased total damage score on the rotating platform, coupled with increased surface area damaged and the propensity for third-body debris, indicates no damage advantage to this mobile-bearing design.

Cited by 23 publications

References 3 publications

Early aseptic loosening of a mobile-bearing total knee replacement

Early aseptic loosening of a mobile-bearing total knee replacement

No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study

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

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