A meta-analysis of the fixed-bearing and mobile-bearing prostheses in total knee arthroplasty

AbstractAs more patients undergo total knee arthroplasty (TKA) each year, and the average age of patients gets younger, the patients are generally more active requiring a greater physiological demand and increasing range of motion on the prosthesis than the previous patients. However, there is no consensus on the optimal TKA tibial bearing design. We performed this systematic review to compare the clinical differences between mobile and fixed bearing constructs used in contemporary TKA. We searched PubMed, EMBASE, and Cochrane Library databases, identifying 515 total publications, including 17 randomized controlled trials (RCTs). A meta-analysis was performed, while the quality and bias of the evidence were rated according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) guidelines and the Cochrane Database questionnaire. The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Seventeen studies were included, with a total of 1505 knees receiving a mobile bearing TKA and 1550 knees receiving a fixed bearing TKA. The meta-analysis compared clinical outcomes between mobile bearing (MB)-TKA and fixed bearing (FB)-TKA using postoperative Knee Society Score, postoperative ROM, and survivorship and showed that there was a distinct difference in Knee Society Score between the mobile-bearing and fixed-bearing groups (overall standardized mean difference = 1.38; 95% confidence interval (CI): 0.50–2.25; p = 0.002; I2 = 60%). Patients treated with mobile-bearing prostheses were more likely to report good or excellent range of motion results (overall standardized mean difference = 2.06; 95% CI: 0.65–3.47; p = 0.004). No difference in implant survivorship or reoperation rate were identified. The fixed-bearing and mobile-bearing TKA designs are both capable of producing excellent long-term results with excellent clinical outcomes if properly implanted; however, the mobile-bearing TKA have superiority in mid- to long-term clinical results. Trial registration number for PROSPERO was CRD42019126402.

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Meta-Analysis and Systematic Review of Clinical Outcomes Comparing Mobile Bearing and Fixed Bearing Total Knee Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2010.12.017 ◽

2011 ◽

Vol 26 (8) ◽

pp. 1205-1213 ◽

Cited By ~ 68

Author(s):

Holly Smith ◽

Meryam Jan ◽

Nizar N. Mahomed ◽

J. Rod Davey ◽

Rajiv Gandhi

Keyword(s):

Systematic Review ◽

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Meta Analysis ◽

Mobile Bearing ◽

Fixed Bearing ◽

Total Knee

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Mobile Bearing versus Fixed Bearing for Total Knee Arthroplasty: Meta-analysis of Randomized Controlled Trials at Minimum 10-Year Follow-up

The Journal of Knee Surgery ◽

10.1055/s-0040-1713356 ◽

2020 ◽

Author(s):

Pu Chen ◽

Liuwei Huang ◽

Dong Zhang ◽

Xiaozhe Zhang ◽

Yufeng Ma ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Meta Analysis ◽

Mobile Bearing ◽

Fixed Bearing ◽

Randomized Controlled ◽

Radiographic Outcomes ◽

Significant Difference ◽

Total Knee

AbstractThis meta-analysis aimed to compare the clinical and radiographic outcomes between mobile-bearing total knee arthroplasty (MB-TKA) and fixed-bearing total knee arthroplasty (FB-TKA) at a minimum 10-year follow-up. PubMed, EMBASE, and Cochrane databases were searched. All included articles were evaluated by two trained reviewers according to the guidelines of the Cochrane Collaboration Handbook for potential risk, and the Consolidated Standards on Reporting Trials (CONSORT) checklist and scoring system was also used to assess the methodological quality of each study. The extracted data included function scores, range of motion (ROM) of the knee, incidence of adverse events or revision, survivorship analysis, and radiographic outcomes. Seven randomized controlled trials (RCTs) were included in this meta-analysis, and all RCTs had a follow-up period longer than 10 years. This meta-analysis shows no significant difference between the two groups with respect to the Keen Society Score (KSS; p = 0.38), KSS function score (p = 0.30), the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC; p = 0.59), ROM (p = 0.71), radiolucent line (p = 0.45), femoral and tibial component positions in the coronal plane (p = 0.55 and 0.35, respectively), revision incidence (p = 0.77), and survivorship rates (p = 0.39). Meanwhile, it showed a slight difference between the two groups in the tibial component position in the sagittal plane (p = 0.003). According to this meta-analysis, the current best available evidence suggests no significant difference between the MB-TKA and FB-TKA groups with respect to the clinical outcomes, radiographic outcomes, revision, and survivorship at a minimum 10-year follow-up. This is a Level II, meta-analysis study.

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