Medium-term follow-up after mobile-bearing total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2014.26.001

Abstract

Abstract:

BACKGROUND: Mobile-bearing prosthesis has advantages in theoretic design, in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes are better than fixed-bearing prosthesis at present.
OBJECTIVE: To evaluate the medium-term results of total knee arthroplasty using mobile-bearing prosthesis to provide clinical evidence for the choice of prosthesis.
METHODS: The patients who suffered from osteoarthritis or rheumatoid arthritis and underwent total knee arthroplasty with PFC Sigma RP in Beijing Tongren Hospital from December 2006 to June 2009 were included in this study. The postoperative Knee Society Score, Knee Society Score Function Score, Patellar Score and the Pain Score, range of motion, maximun flexion and extension angle were collected and compared with pre-operation. The complications, such as infection, patella clicking, polyethylene insert dislocation, and deep vein thrombosis were recorded after replacement. The anterior-posterior, lateral and Merchant position X-ray images were taken to evaluate the tibiofemoral alignment, radiolucent lines, and patellar dislocation. Then, the results of other medium-term follow-up researches were compared with fixed-bearing arthroplasty.
RESULTS AND CONCLUSION: Finally, 31 patients (45 knees) were followed up. The average age was 64.56±10.33 years, and follow-up period was 3.9-7.6 years. The postoperative scores, range of motion, maximun flexion and extension angle were improved obviously, but there were no differences with other medium-term follow-up researches. No radiolucent lines, prosthetic loosening or polyethylene insert dislocation was found. Lateral patellar release was done, but no patellar dislocation or subluxation appeared in all patients. Two patients (2 knees) accompanied patella clicking. Results indicated that the medium-term clinical result was satisfactory. No patellar dislocation or subluxation was found, although only lateral patellar release was done. This may be the superiority of mobile-bearing arthroplasty.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: arthroplasty, replacement, knee, osteoarthritis, prosthesis implantation, follow-up studies

CLC Number:

R318

Wang Guo-dong, Guo Ai, Qiang Hua, Zhao Er-hong. Medium-term follow-up after mobile-bearing total knee arthroplasty [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(26): 4101-4107.

Figures/Tables 3

References

[1]Carothers JT, Kim RH, Dennis DA, et al. Mobile-bearing total knee arthroplasty: a meta-analysis. J Arthroplasty. 2011;(4): 537-542.
[2]James C, Kevin T. Comparisons between mobile-bearing and fixed-bearing total knee replacement. Curr Orthop Prac.2009; 20(1):35-39.
[3]Sehat K, Devane P, Horne G. Fixed-bearing or mobile-bearing total knee arthroplasty? A review of the recent literature.Curr Opin Orthop. 2007;18:66-70.
[4]Skwara A, Tibesku CO, Ostermeier S, et al. Differences in patellofemoral contact stresses between mobile-bearing and fFixed-bearing total knee arthroplasties: a dynamic in vitro measurement. Arch Orthop Trauma Surg. 2009;129(7): 901-907.
[5]Callaghan JJ, Insall JN, Greenwald AS, et al. Mobile-bearing knee replacement: concepts and results. Instr Course Lect. 2001;50:431-449.
[6]O'Connor JJ, Goodfellow JW. Theory and practice of meniscal kneereplacement: designing against wear. Proc Inst Mech Eng H. 1996;210(3): 217-222.
[7]Woolson ST, Epstein NJ, Huddleston JI. Long-term comparison of mobile-bearing vs fixed-bearing total knee arthroplasty. J Arthroplasty. 2011;26(8):1219-1223.
[8]Raviraj A, Prabhu A, Pai S, et al. Fixed vs. Mobile-bearing total knee arthroplasty: does it make a difference?-a prospective randomized study. J Arthroplasty. 2010;25(5): 835.
[9]Oh KJ, Pandher DS, Lee SH, et al. Meta-analysis comparing outcomes of Fixed-bearing and Mobile-bearing prostheses in total knee arthro-plasty. J Arthroplasty. 2009;24(6):873-884.
[10]张博,潘江,林源,等. 国人膝关节参数对假体设计的意义[J].中国组织工程研究与临床康复, 2010,14(48)：8941-8944.
[11]Feller JA, Bartlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br. 1996; 78(2):226-228.
[12]Price AJ, Rees JL, Beard D, et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial.J Bone Joint Surg Br. 2003;85(1):62-67.
[13]Geiger F, Mau H, Krüger M, et al. Comparison of a new mobile-bearing total knee prosthesis with a fixed-bearing prosthesis: a matched pair analysis. Arch Orthop Trauma Surg. 2008;128(3):285-291.
[14]Harrington MA, Hopkinson WJ, Hsu P, et al. Fixed- vs mobile-bearing total knee arthroplasty: does it make a difference?--a prospective randomized study. J Arthroplasty. 2009;24(6 Suppl):24-27.
[15]Ball ST, Sanchez HB,Mahoney OM, et al. Fixed Versus Rotating Platform Total Knee Arthroplasty: A Prospective, Randomized,Single-Blind Study. J Arthroplasty. 2011;26(4): 531-536.
[16]Lizaur-Utrilla A, Sanz-Reig J, Trigueros-Rentero MA.Greater satisfaction in older patients with a mobile-bearing compared with fixed-bearing total knee arthroplasty. J Arthroplasty.2012; 27(2):207-212.
[17]Smith H, Jan M, Mahomed NN, et al. Meta-analysis and systematic review of clinical outcomes comparing mobile bearing and fixed bearing total knee arthroplasty.J Arthroplasty. 2011;26(8):1205-1213.
[18]Rahman WA, Garbuz DS, Masri BA. Randomized Controlled Trial of Radiographic and Patient-Assessed Outcomes Following Fixed Versus Rotating Platform Total Knee Arthroplasty. J Arthroplasty. 2010;25(8):1201-1208.
[19]Kim YH, Kim DY, Kim JS. Simultaneous mobile- and fixed-bearing total knee replacements in the same patients: a prospective comparison of mid-term outcomes using a similar design of prosthesis. J Bone Joint Surg[Br]. 2007;89-B:904.
[20]Aggarwal AK, Agrawal A. Mobile vs fixed-bearing total knee arthroplasty performed by a single surgeon: a 4- to 6.5-year randomized, prospective, controlled, double-blinded study.J Arthroplasty. 2013;28(10):1712-1716.
[21]Lädermann A, Lübbeke A, Stern R, et al. Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomised, clinical and radiological study with mid-term results at 7 years. Knee. 2008;15(3):206-210.
[22]Laskin RS. Lateral release rates after total knee arthroplasty. Clin Orthop Relat Res. 2001;(392):88-93.
[23]Berger RA, Rubash HE, Seel MJ, et al. Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop Relat Res. 1993;(286):40-47.
[24]陶坤,蔡明,张立国,等.旋转平台全膝关节置换术中胫骨假体的旋转安放及相关研究[J].中国骨与关节外科,2009 ,2(4) :264-268.
[25]Rees JL, Beard DJ, Price AJ, et al. Real in vivo kinematic differences between mobile-bearing and fixed-bearing total kneearthroplasties. Clin Orthop Relat Res. 2005;(432): 204-209.
[26]Callaghan JJ, Squire MW, Goetz DD, et al. Cemented rotating-platform total knee replacement. A nine to twelve-year follow-up study. J Bone Joint Surg Am. 2000; 82(5):705-711.
[27]Sawaguchi N, Majima T, Ishigaki T, et al. Mobile-bearing total knee arthroplasty improves patellar tracking and patellofemoral contact stress: in vivo measurements in the same patients.J Arthroplasty. 2010;25(6):920-925.
[28]Ranawat ASRR, Loreti I. Patellofemoral tracking in posterior stabilized mobile bearing total arthroplasty. East Orthop Assoc Poster. 2004.
[29]Bert JM. Dislocation/subluxation of meniscal bearing elements after New Jersey low-contact stresstotal knee arthroplasty.Clin Orthop Relat Res. 1990;(254):211-215.
[30]Kim YH, Kook HK, Kim JS. Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Arthroplasties. Clin Orthop Relat Res. 2001;392:101-115.
[31]Thompson NW, Wilson DS, Cran GW, et al. Dislocation of the rotating platform after low contact stress total knee arthroplasty. Clin Orthop Relat Res. 2004;(425):207-211.
[32]Hasegawa M, Sudo A, Fukuda A, et al. Dislocation of posterior-stabilized mobile-bearing knee prosthesis. Acase report. Knee. 2006;13(6):478-482.
[33]Agarwala SR, Mohrir GS, Patel AG. Patellar clunk syndrome in a current high flexion total knee design.J Arthroplasty. 2013; 28(10):1846-1850.
[34]Fukunaga K, Kobayashi A, Minoda Y, et al. The incidence of the patellar clunk syndrome in a recently designed Mobile-bearing posteriorly stabilised total knee replacement. J Bone Joint Surg Br. 2009;91:463.
[35]Frye BM, Floyd MW, Pham DC, et al. Effect of femoral component design on patellofemoral crepitance and patella clunksyndrome after posterior-stabilized total knee arthroplasty. J Arthroplasty. 2012;27(6):1166-1170.
[36]王晓峰,陈百成,师晨霞,等.固定平台型和移动平台型假体全膝关节置换术后临床效果的分析比较[J]. 中国矫形外科杂志,2007, 15(18):1367-1370.
[37]Gioe TJ, Glynn J, Sembrano J, et al. Mobile and fixed-bearing (all-polyethylene tibial component) total knee arthroplasty designs. A prospective randomized trial. J Bone Joint Surg Am. 2009;91:2104-2112.
[38]Lu YC, Huang CH, Chang TK, et al. Wear-pattern analysis in retrieved tibial inserts of mobile-bearing and fixed-bearing total knee prostheses.J Bone Joint Surg [Br]. 2010; 92-B: 500-507.
[39]Engh GA, Zimmerman RL, Parks NL, et al. Analysis of wear in retrieved mobile and fixed bearing knee inserts. J Arthroplasty. 2009;24(6 Suppl):28-32.
[40]Atwood SA, Currier JH, Mayor MB, et al. Clinical wear measurement on low contact stress rotating platform knee bearings.J Arthroplasty. 2008;23(3):431-440.