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

Cheng,Mengqi; Chen,Desheng; Guo,Yongyuan; Zhu,Chen; Zhang,Xianlong

doi:10.3892/etm.2013.1122

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

Authors:
- Mengqi Cheng
- Desheng Chen
- Yongyuan Guo
- Chen Zhu
- Xianlong Zhang
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Affiliations: Department of Orthopedics, The Sixth Affiliated People's Hospital, Medical School of Shanghai Jiaotong University, Shanghai 200233, P.R. China, Department of Orthopedics, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China
Published online on: May 17, 2013 https://doi.org/10.3892/etm.2013.1122
Pages: 45-51

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Abstract

Controversy exists regarding the clinical and radiological differences in outcomes between fixed‑bearing (FB) and mobile‑bearing (MB) total knee arthroplasties (TKAs) at the mid‑ or long‑term follow‑up. We therefore conducted a meta‑analysis and systematic review of randomized controlled trials (RCTs) that have evaluated FB and MB TKAs. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline and Embase. The data, including demographic information, methodological quality, duration of follow‑up, clinical and radiographical outcomes, patient preferences and complications, were extracted. The methodological quality of the studies was assessed in accordance with the guidelines presented in the Cochrane Handbook for Systematic Reviews of Interventions. Nine trials, studying 1,821 knees, were eligible for data extraction and meta‑analysis. The Knee Society score and the maximum knee flexion demonstrated no difference between the FB and MB groups (P=0.47 and P=0.72, respectively). Similarly, no difference was revealed between the groups for radiological outcomes or general health results. An increased number of high‑quality RCTs with long‑term follow‑ups are required to validate the results.

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1.	Gandhi R, Dhotar H, Razak F, Tso P, Davey JR and Mahomed NN: Predicting the longer term outcomes of total knee arthroplasty. Knee. 17:15–18. 2010. View Article : Google Scholar : PubMed/NCBI
2.	Gioe TJ, Sinner P, Mehle S, Ma W and Killeen KK: Excellent survival of all-polyethylene tibial components in a community joint registry. Clin Orthop Relat Res. 464:88–92. 2007.PubMed/NCBI
3.	Ritter MA: The Anatomical Graduated Component total knee replacement: a long-term evaluation with 20-year survival analysis. J Bone Joint Surg Br. 91:745–749. 2009.PubMed/NCBI
4.	Robertsson O, Bizjajeva S, Fenstad AM, et al: Knee arthroplasty in Denmark, Norway and Sweden. Acta Orthop. 81:82–89. 2010. View Article : Google Scholar
5.	Spencer SJ, Baird K, Young D and Tait GR: The Rotaglide mobile bearing knee arthroplasty: A 10- to 13-year review from an independent centre. Knee. 19:20–23. 2012.PubMed/NCBI
6.	Bottlang M, Erne OK, Lacatusu E, Sommers MB and Kessler O: A mobile-bearing knee prosthesis can reduce strain at the proximal tibia. Clin Orthop Relat Res. 447:105–111. 2006. View Article : Google Scholar : PubMed/NCBI
7.	Dennis DA and Komistek RD: Kinematics of mobile-bearing total knee arthroplasty. Instr Course Lect. 54:207–220. 2005.PubMed/NCBI
8.	Stukenborg-Colsman C, Ostermeier S, Hurschler C and Wirth CJ: Tibiofemoral contact stress after total knee arthroplasty: comparison of fixed and mobile-bearing inlay designs. Acta Orthop Scand. 73:638–646. 2002. View Article : Google Scholar : PubMed/NCBI
9.	Li ZJ, Zhang K and Kim TK: Mobile- and fixed-bearing total knee arthroplasty for knee osteoarthritis: Comparisons of early clinical outcomes. Journal of Clinical Rehabilitative Tissue Engineering Research. 12:9589–9593. 2008.(In Chinese).
10.	Callaghan JJ, Insall JN, Greenwald AS, et al: Mobile-bearing knee replacement: concepts and results. Instr Course Lect. 50:431–449. 2001.PubMed/NCBI
11.	Jacobs WC, Christen B, Wymenga AB, et al: Functional performance of mobile versus fixed bearing total knee prostheses: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc. 20:1450–1455. 2012. View Article : Google Scholar : PubMed/NCBI
12.	Holinka J, Bahrami N, Lass R, Frantal S, Windhager R and Wanivenhaus HA: No difference in ROM and knee function between mobile and floating platforms in TKA. Knee Surg Sports Traumatol Arthrosc. Jun 29–2012.(Epub ahead of print).
13.	Lampe F, Sufi-Siavach A, Bohlen KE, Hille E and Dries SP: One year after navigated total knee replacement, no clinically relevant difference found between fixed bearing and mobile bearing knee replacement in a double-blind randomized controlled trial. Open Orthop J. 5:201–208. 2011.
14.	Ball ST, Sanchez HB, Mahoney OM and Schmalzried TP: Fixed versus rotating platform total knee arthroplasty: a prospective, randomized, single-blind study. J Arthroplasty. 26:531–536. 2011. View Article : Google Scholar : PubMed/NCBI
15.	Hanusch B, Lou TN, Warriner G, Hui A and Gregg P: Functional outcome of PFC Sigma fixed and rotating-platform total knee arthroplasty. A prospective randomised controlled trial. Int Orthop. 34:349–354. 2010. View Article : Google Scholar : PubMed/NCBI
16.	Harrington MA, Hopkinson WJ, Hsu P and Manion L: Fixed-vs mobile-bearing total knee arthroplasty: does it make a difference? - a prospective randomized study. J Arthroplasty. 24:24–27. 2009. View Article : Google Scholar : PubMed/NCBI
17.	Matsuda S, Mizu-uchi H, Fukagawa S, et al: Mobile-bearing prosthesis did not improve mid-term clinical results of total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 18:1311–1316. 2010. View Article : Google Scholar : PubMed/NCBI
18.	Higuchi H, Hatayama K, Shimizu M, Kobayashi A, Kobayashi T and Takagishi K: Relationship between joint gap difference and range of motion in total knee arthroplasty: a prospective randomised study between different platforms. Int Orthop. 33:997–1000. 2009. View Article : Google Scholar : PubMed/NCBI
19.	Wen Y, Liu D, Huang Y and Li B: A meta-analysis of the fixed-bearing and mobile-bearing prostheses in total knee arthroplasty. Arch Orthop Trauma Surg. 131:1341–1350. 2011. View Article : Google Scholar : PubMed/NCBI
20.	Carothers JT, Kim RH, Dennis DA and Southworth C: Mobile-bearing total knee arthroplasty: a meta-analysis. J Arthroplasty. 26:537–542. 2011. View Article : Google Scholar : PubMed/NCBI
21.	Smith TO, Ejtehadi F, Nichols R, Davies L, Donell ST and Hing CB: Clinical and radiological outcomes of fixed- versus mobile-bearing total knee replacement: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 18:325–340. 2010. View Article : Google Scholar : PubMed/NCBI
22.	Oh KJ, Pandher DS, Lee SH, Sung Joon SD Jr and Lee ST: Meta-analysis comparing outcomes of fixed-bearing and mobile-bearing prostheses in total knee arthroplasty. J Arthroplasty. 24:873–884. 2009. View Article : Google Scholar : PubMed/NCBI
23.	Higgins JPT and Green S: Cochrane Handbook for Systematic Reviews of Interventions Version 510 [updated March 2011]. The Cochrane Collaboration. 2011.Available from https://www.cochrane-handbook.org.
24.	Mahoney OM, Kinsey TL, D’Errico TJ and Shen J: The John Insall Award: no functional advantage of a mobile bearing posterior stabilized TKA. Clin Orthop Relat Res. 470:33–44. 2012. View Article : Google Scholar : PubMed/NCBI
25.	Lädermann A, Lübbeke A, Stern R, Riand N and Fritschy D: Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomised, clinical and radiological study with mid-term results at 7 years. Knee. 15:206–210. 2008.PubMed/NCBI
26.	Jolles BM, Grzesiak A, Eudier A, et al: A randomised controlled clinical trial and gait analysis of fixed- and mobile-bearing total knee replacements with a five-year follow-up. J Bone Joint Surg Br. 94:648–655. 2012.PubMed/NCBI
27.	Kalisvaart MM, Pagnano MW, Trousdale RT, Stuart MJ and Hanssen AD: Randomized clinical trial of rotating-platform and fixed-bearing total knee arthroplasty: no clinically detectable differences at five years. J Bone Joint Surg Am. 94:481–489. 2012.PubMed/NCBI
28.	Kim YH, Kim DY and Kim JS: Simultaneous mobile- and fixed-bearing total knee replacement in the same patients. A prospective comparison of mid-term outcomes using a similar design of prosthesis. J Bone Joint Surg Br. 89:904–910. 2007. View Article : Google Scholar : PubMed/NCBI
29.	Shemshaki H, Dehghani M, Eshaghi MA and Esfahani MF: Fixed versus mobile weight-bearing prosthesis in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 20:2519–2527. 2012. View Article : Google Scholar : PubMed/NCBI
30.	Wohlrab D, Hube R, Zeh A and Hein W: Clinical and radiological results of high flex total knee arthroplasty: a 5 year follow-up. Arch Orthop Trauma Surg. 129:21–24. 2009.PubMed/NCBI
31.	Kim YH, Kook HK and Kim JS: Comparison of fixed-bearing and mobile-bearing total knee arthroplasties. Clin Orthop Relat Res. 392:101–115. 2001. View Article : Google Scholar : PubMed/NCBI
32.	Buechel FF Sr: Long-term followup after mobile-bearing total knee replacement. Clin Orthop Relat Res. 404:40–50. 2002. View Article : Google Scholar : PubMed/NCBI
33.	Sorrells RB, Stiehl JB and Voorhorst PE: Midterm results of mobile-bearing total knee arthroplasty in patients younger than 65 years. Clin Orthop Relat Res. 390:182–189. 2001.PubMed/NCBI
34.	Buechel FF: Mobile-bearing knee arthroplasty: rotation is our salvation! J Arthroplasty. 19(Suppl 1): 27–30. 2004.PubMed/NCBI
35.	Jacobs WC, Clement DJ and Wymenga AB: Retention versus sacrifice of the posterior cruciate ligament in total knee replacement for treatment of osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev. CD0048032005.
36.	Parks NL, Engh GA, Topoleski LD and Emperado J: The Coventry Award. Modular tibial insert micromotion A concern with contemporary knee implants. Clin Orthop Relat Res. 356:10–15. 1998.PubMed/NCBI
37.	Berry DJ, Currier JH, Mayor MB and Collier JP: Knee wear measured in retrievals: a polished tray reduces insert wear. Clin Orthop Relat Res. 470:1860–1868. 2012. View Article : Google Scholar : PubMed/NCBI
38.	Kelly NH, Fu RH, Wright TM and Padgett DE: Wear damage in mobile-bearing TKA is as severe as that in fixed-bearing TKA. Clin Orthop Relat Res. 469:123–130. 2011. View Article : Google Scholar : PubMed/NCBI
39.	Schunck J and Jerosch J: Knee arthroplasty. Mobile- and fixed-bearing design. Orthopade. 32:477–483. 2003.(In German).
40.	Chouteau J, Lerat JL, Testa R, Moyen B, Fessy MH and Banks SA: Mobile-bearing insert translational and rotational kinematics in a PCL-retaining total knee arthroplasty. Orthop Traumatol Surg Res. 95:254–259. 2009. View Article : Google Scholar : PubMed/NCBI
41.	Vogt JC and Saarbach C: LCS mobile-bearing total knee replacement. A 10-year’s follow-up study. Orthop Traumatol Surg Res. 95:177–182. 2009.
42.	Parsch D, Krüger M, Moser MT and Geiger F: Follow-up of 11-16 years after modular fixed-bearing TKA. Int Orthop. 33:431–435. 2009.PubMed/NCBI
43.	Roberts VI, Esler CN and Harper WM: A 15-year follow-up study of 4606 primary total knee replacements. J Bone Joint Surg Br. 89:1452–1456. 2007.PubMed/NCBI