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

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.

scholarly journals Fixed-bearing vs mobile-bearing prostheses for total knee arthroplasty after approximately 10 years of follow-up: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Dongsheng Hao ◽  
Junjie Wang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Mobile Bearing ◽  
Complication Rates ◽  
Fixed Bearing ◽  
Significant Difference ◽  
Total Knee ◽  
Bearing Design

Abstract Background The benefits and risks of fixed-bearing and mobile-bearing designs for total knee arthroplasty (TKA) were compared, and long-term functional, clinical and radiological outcomes were analysed. Methods A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane Central databases was conducted to identify randomized controlled trials (RCTs) comparing fixed-bearing and mobile-bearing designs with no less than 9 years of follow-up. Primary outcome measures were Knee Society Scores (KSSs), range of motion (ROM) in knee joint values, complication rates and revision rates. The final search was performed on 23 April 2021. Results Six RCTs were included. A total of 451 patients with 612 knees met the inclusion criteria. The mobile-bearing design, in contrast to the fixed-bearing design, can clearly increase the KSFSs, especially with posterior cruciate retention. There was no significant difference in the KSKSs, ROM values, revision rates or complication rates between the two bearing design groups. Conclusion After approximately 10 years of follow-up, the mobile-bearing design has advantages in KSFSs over the fixed-bearing design. The mobile-bearing design may also have advantages in the revision rates over the fixed-bearing design when the posterior cruciate ligament is substituted. There may be no clear difference in KSKSs, ROM values or complication rates between these two designs.

Superior Mid- to Long-Term Clinical Outcomes of Mobile-Bearing Total Knee Arthroplasty Compared to Fixed-Bearing: A Meta-analysis Based on a Minimum of 5 Years of Study

2020 ◽  
Author(s):  
Kaiyang Wang ◽  
Fang Fang Zhang ◽  
Xu Yan ◽  
Yifan Shen ◽  
Weijie Cai ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Meta Analysis ◽  
Mobile Bearing ◽  
Fixed Bearing ◽  
Total Knee ◽  
Standardized Mean Difference

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.

A randomized controlled trial of fixed- versus mobile-bearing total knee arthroplasty

2018 ◽  
Vol 100-B (7) ◽  
pp. 925-929 ◽  
Author(s):  
M. P. Abdel ◽  
M. E. Tibbo ◽  
M. J. Stuart ◽  
R. T. Trousdale ◽  
A. D. Hanssen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Mobile Bearing ◽  
Fixed Bearing ◽  
Randomized Controlled ◽  
Total Knee ◽  
Bearing Design ◽  
Ks Function

Aims It has been suggested that mobile-bearing total knee arthroplasty (TKA) might lead to better outcomes by accommodating some femorotibial rotational mismatch, thereby reducing contact stresses and polyethylene wear. The aim of this study was to determine whether there is a difference between fixed- and mobile-bearing versions of a contemporary TKA with respect to durability, range of movement (ROM) and function, ten years postoperatively. Patients and Methods A total of 240 patients who were enrolled in this randomized controlled trial (RCT) underwent a primary cemented TKA with one of three tibial components (all-polyethylene fixed-bearing, modular metal-backed fixed-bearing and mobile-bearing). Patients were reviewed at a median follow-up of ten years (IQR 9.2 to 10.4). Results There was no difference in durability, as measured by survivorship free of revision for any reason, nor in mean maximal ROM at ten years (p = 0.8). There was also no difference in function, as measured by Knee Society (KS) function scores (p = 0.63) or the prevalence of patellar tilt (p = 0.12). Conclusion In this clinical RCT, the mobile-bearing design of TKA was found to be reliable and durable, but did not provide better maximum knee flexion, function or durability ten years postoperatively compared with a posterior-stabilized, fixed-bearing design incorporating either an all-polyethylene or a modular-metal-backed tibial component. Cite this article: Bone Joint J 2018;100-B:925–9.

A COMPARISON OF FIXED-BEARING AND MOBILE-BEARING TOTAL KNEE ARTHROPLASTY AT A MINIMUM FOLLOW-UP OF 4.5 YEARS

2005 ◽  
Vol 87 (10) ◽  
pp. 2290-2296 ◽  
Author(s):  
S. BHAN ◽  
R. MALHOTRA ◽  
E. KRISHNA KIRAN ◽  
SOURAV SHUKLA ◽  
MAHESH BIJJAWARA
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mobile Bearing ◽  
Fixed Bearing ◽  
Total Knee

scholarly journals Comparison of fixed- and mobile-bearing total knee arthroplasty with a mean five-year follow-up: A meta-analysis

2013 ◽  
Vol 6 (1) ◽  
pp. 45-51 ◽  
Author(s):  
MENGQI CHENG ◽  
DESHENG CHEN ◽  
YONGYUAN GUO ◽  
CHEN ZHU ◽  
XIANLONG ZHANG
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Mobile Bearing ◽  
Total Knee
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