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Knee Surg Sports Traumatol Arthrosc. 2017 Jun;25(6):1757-1777. doi: 10.1007/s00167-016-4195-x. Epub 2016 Jun 20.

No differences between fixed- and mobile-bearing total knee arthroplasty.

Author information

1
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedics, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands. b.l.fransen@mca.nl.
2
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedics, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
3
MOVE Research Institute Amsterdam, VU University Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.

Abstract

PURPOSE:

For years, numerous studies have been performed to determine whether mobile-bearing total knee arthroplasty (MB-TKA) or fixed-bearing total knee arthroplasty (FB-TKA) is the preferential design in total knee arthroplasty. Reviews and meta-analyses on this subject have focused on a relatively small number of randomised controlled trials, possibly missing important results of smaller studies. The goal of this review was to provide a comprehensive overview of all literature comparing MB-TKA and FB-TKA in the treatment of osteoarthritis of the knee.

METHODS:

An extensive literature search was performed in the PubMed database. All studies that compared MB-TKA with FB-TKA and looked at one of four theorised advantages (insert wear, signs of loosening, survival rate of the prosthesis and clinical outcome) were included.

RESULTS:

The initial search yielded 258 articles, of which 127 were included after the first screening. The included studies consisted of 9 meta-analyses, 3 systematic reviews, 48 RCT's, 44 comparative studies, 10 reviews and 13 studies that examined patients who received bilateral TKA (one MB-TKA and one FB-TKA). Combining the results of all studies showed that almost all studies found no difference between MB-TKA and FB-TKA.

CONCLUSIONS:

Even when examining all different types of studies on MB-TKA and FB-TKA, the results of this review showed no difference in insert wear, risk of loosening, survivorship or clinical outcome. In daily practice, the choice between MB-TKA and FB-TKA should be based on the experience and judgment of the surgeon, since no clear differences are observed in the scientific literature.

LEVEL OF EVIDENCE:

III.

KEYWORDS:

Fixed bearing; Mobile bearing; Review; Total knee arthroplasty

PMID:
27324479
DOI:
10.1007/s00167-016-4195-x
[Indexed for MEDLINE]

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