Abstract:

BACKGROUND: The question regarding whether mobile bearing prostheses has superiority over fixed-bearing prostheses remains controversial. Although some scholars believed that mobile bearing prostheses is better than fixed-bearing prostheses, other researchers argue no differences between both implant types.
OBJECTIVE: To compare the clinical results of mobile bearing with fixed-bearing in total knee arthroplasty (TKA) and to assess the differences between two groups.
METHODS: We conducted computer-aided searches of Medline (January 1966 to November 2009), Embase (January 1980 to November 2009), Cochrane library (November 2009), Chinese Biomedical Databases (CBM, January 1990 to November 2009) with references to mobile bearing versus fixed-bearing in TKA. Randomized controlled studies on TKA between mobile bearing and fixed-bearing prostheses were collected. The methodological quality of included studies was assessed by using of assessments of risk of bias in Cochrane handbook 5.0.1. RevMan 5.0.18 software was used for Meta-analysis.
RESULTS AND CONCLUSION: A total of 11 randomized controlled trials were included with a total of 1 427 knees, 694 knees in mobile bearing and 723 knees in fixed-bearing. The bias in the studies was low. Postoperative outcomes were significantly elevated compared with preoperative outcomes. The outcomes of Meta-analysis showed that no statistical significance differences on Knee score range of motion (ROM), bearing dislocation, need for repeated surgery. But, 4 dislocation knees all occurred in four studies of mobile bearing TKA, the rate of dislocation was 1.8% (4/217). The results showed that no significant differences on clinical results and complications compared mobile bearing prosthesis with fixed-bearing prosthesis in TKA, we advise that more evidences should be needed for supporting the outcomes, and both types of prosthesis can get well results in clinical trial.