Skip to main content
Log in

No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

It is hypothesized that mobile polyethylene bearings in total knee arthroplasty (TKA) may confer benefits with regard to range of motion and have improved clinical outcome scores in comparison with an arthroplasty with a fixed-bearing design. Our study compares clinical outcomes between patients who undergo TKA with either a rotating platform or fixed bearing using a posterior cruciate-retaining design.

Methods

Three hundred and thirty-one patients were randomized to receive either a rotating-platform (161 patients) or a fixed-bearing (170 patients) implant. All patients were assessed pre-operatively and at 1 and 2 years post-operatively using standard tools (range of movement, Oxford Knee Score, American Knee Society Score, SF12 and Patella Score).

Results

There was no difference in pre- to 2-year post-operative outcomes between the groups with regard to improvement in range of motion (10° ± 16 vs. 9° ± 15), improvement in Oxford Knee Score (−17.6 ± 9.9 vs. −19.1 ± 8.4), improvement in American Knee Society Score (49.5 ± 24.7 vs. 50.7 ± 21.0), function (23.6 ± 19.6 vs. 25.0 ± 22.5) and pain (34.9 ± 16.2 vs. 35.8 ± 14.1) subscores, improvement in SF12 Score (10.0 ± 16.3 vs. 12.3 ± 15.8) or improvement in Patella Score (9.7 ± 7.4 vs. 10.6 ± 7.1).

Conclusion

No difference was demonstrated in clinical outcome between patients with a rotating-platform and fixed-bearing posterior cruciate-retaining TKA at 2-year follow-up.

Level of evidence

I.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Aglietti P, Baldini A, Buzzi R, Lup D, Luca L (2005) Comparison of mobile-bearing and fixed-bearing total knee arthroplasty. J Arthroplast 20:145–153

    Article  Google Scholar 

  2. Banks S, Bellemans J, Nozaki H, Whiteside LA, Harman M, Hodge WA (2003) Knee motions during maximum flexion in fixed and mobile-bearing arthroplasties. Clin Orthop Relat Res 410:131–138

    Article  PubMed  Google Scholar 

  3. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D, Stroup DF (1996) Improving the quality of reporting of randomized controlled trials.The CONSORT statement. JAMA 276:637–639

    Article  CAS  PubMed  Google Scholar 

  4. Bhan S, Malhotra R, Kiran E, Shukla S, Bijjawara M (2005) A comparison of fixed-bearing and mobile-bearing total knee arthroplasty at a minimum follow-up of 4.5 years. J Bone Joint Surg Am 87:2290–2296

    Article  CAS  PubMed  Google Scholar 

  5. Bhatt H, Rambani R, White W, Chakrabarty G (2012) Primary total knee arthroplasty using the P.F.C Sigma®-rotating platform cruciate retaining endoprosthesis—a 6 year follow up. Knee 19:856–859

    Article  CAS  PubMed  Google Scholar 

  6. Burton A, Williams S, Brockett CL, Fisher J (2012) In vitro comparison of fixed- and mobile meniscal–bearing unicondylar knee arthroplasties: effect of design, kinematics, and condylar liftoff. J Arthroplast 27:1452–1459

    Article  Google Scholar 

  7. Chouteau J, Lerat JL, Testa R, Moyen B, Fessy MH, Banks SA (2009) Kinematics of a cementless mobile bearing posterior cruciate ligament-retaining total knee arthroplasty. Knee 16:223–227

    Article  CAS  PubMed  Google Scholar 

  8. D’Lima DD, Trice M, Urquhart AG, Colwell CW (2001) Tibiofemoral conformity and kinematics of rotating-bearing knee prostheses. Clin Orthop Relat Res 386:235–242

    Article  PubMed  Google Scholar 

  9. Elwood JJ, Callaghan JJ, Liu SS, Goetz DD (2012) Posterior cruciate-retaining, rotating-platform total knee arthroplasty: minimum 4-year follow-up study. Orthopedics 35:1699–1704

    Article  Google Scholar 

  10. Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  11. Gioe T, Glynn J, Sembrano J, Suthers K, Santos E, Singh J (2009) Mobile and fixed-bearing (all polyethylene tibial component) total knee arthroplasty designs. A prospective randomised trial. J Bone Joint Surg Am 91:2104–2112

    Article  PubMed  Google Scholar 

  12. Haider H, Garvin K (2008) Rotating platform versus fixed-bearing total knees: an in vitro study of wear. Clin Orthop Relat Res 466:2677–2685

    Article  PubMed Central  PubMed  Google Scholar 

  13. Hamai S, Moro-oka TA, Dunbar NJ, Miura H, Iwamoto Y, Banks SA (2013) In vivo healthy knee kinematics during dynamic full flexion. Biomed Res Int. PMID: 23509767

  14. Harrington M, Hopkinson W, Hsu P, Manion L (2009) Fixed-vs mobile- bearing total knee arthroplasty. Does it make a difference?—A prospective randomised study. J Arthroplast 24:24–27

    Article  Google Scholar 

  15. Huang CH, Ma HM, Liau JJ, Ho FY, Cheng CK (2002) Osteolysis in failed total knee arthroplasty: a comparison of mobile-bearing and fixed-bearing knees. J Bone Joint Surg Am 84:2224–2229

    PubMed  Google Scholar 

  16. Jacobs W, Christen B, Wymenga A, Schuster A, Schaaf D, Ham A, Wehrli U (2012) Functional performance of mobile versus fixed bearing total knee prosthesis: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 20:1450–1455

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Jolles BM, Grzesiak A, Eudier A, Dejnabadi H, Voracek C, Pichonnaz C, Aminian K, Martin E (2012) 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

    Article  CAS  PubMed  Google Scholar 

  18. Kalisvaart M, Pagnano M, Trousdale R, Stuart M, Hanssen A (2012) 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

    Article  PubMed  Google Scholar 

  19. Kim D, Seong SC, Lee MC, Lee S (2012) Comparison of the tibiofemoral rotational alignment after mobile and fixed bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20:337–345

    Article  PubMed  Google Scholar 

  20. Kim Y-H, Kim J-S, Choe J-W, Kim H-J (2012) Long-term comparison of fixed-bearing and mobile-bearing total knee replacements in patients younger than fifty-one years of age with osteoarthritis. J Bone Joint Surg Am 94:866–873

    PubMed  Google Scholar 

  21. Ladermann A, Lubbeke A, Stern R, Riand N, Fritschy D (2008) Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomised, clinical and radiological study with med-term results at 7 years. Knee 15:206–210

    Article  CAS  PubMed  Google Scholar 

  22. McEwan HM, Barnett PI, Bell CJ, Auger DD, Stone MH, Fisher J (2005) The influence of design, materials and kinematics on the in vitro wear of total knee replacements. J Biomech 38:357–365

    Article  Google Scholar 

  23. Namba RS, Inacio MCS, Paxton EW, Ake CF, Wang C, Gross TP, Marina-Dabic D, Sedrakyan A (2012) Risk of revision for fixed versus mobile-bearing primary total knee replacements. J Bone Joint Surg Am 94:1929–1935

    Article  PubMed  Google Scholar 

  24. Nutton RW, Wade FA, Coutts FJ, van der Linden ML (2012) Does a mobile- bearing, high-flexion design increase knee flexion after total knee replacement? J Bone Joint Surg Br 94:1051–1057

    Article  CAS  PubMed  Google Scholar 

  25. O’Rourke MR, Callaghan JJ, Goetz DD, Sullivan PM, Johnson RC (2002) Osteolysis associated with a cemented modular posterior-cruciate-substituting total knee design: five to eight-year follow-up. J Bone Joint Surg Am 84:1362–1371

    PubMed  Google Scholar 

  26. Pijls B, Valstar E, Kaptein B, Nelissen R (2012) Differences in long-term fixation between mobile-bearing and fixed-bearing knee prosthesis at ten to 12 years’ follow-up. J Bone Joint Surg Br 94:1366–1371

    Article  CAS  PubMed  Google Scholar 

  27. Price AJ, Rees JL, Beard D, Juszczak E, Carter S, White S, Steiger R, Dodd CAF, Gibbons M, McLardy-Smith P, Goodfellow JW, Murray DW (2003) A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. J Bone Joint Surg Br 85:62–67

    Article  CAS  PubMed  Google Scholar 

  28. Rees JL, Beard DJ, Price AJ, Gill HS, McLardy-Smith P, Dodd CA, Murray DW (2005) Real in vivo kinematic differences between mobile-bearing and fixed-bearing total knee arthroplasties. Clin Orthop Relat Res 432:204–209

    Article  PubMed  Google Scholar 

  29. Rossi R, Bruzzone M, Bonasia DE, Ferro A, Castoldi F (2010) No early tibial tray loosening after surface cementing technique in mobile-bearing TKA. Knee Surg Sports Traumatol Arthrosc 18:1360–1365

    Article  PubMed  Google Scholar 

  30. Sawaquchi N, Majima T, Ishiqaki T, Mori N, Terashima T, Minami A (2012) Mobile-bearing total knee arthroplasty improves patellar tracking and patellofemoral contact stress: in vivo measurements in the same patients. J Arthroplasty 25:920–925

    Article  Google Scholar 

  31. Smith H, Jan M, Mahomed N, Davey JR, Gandhi R (2011) Meta-analysis and systematic review of clinical outcomes comparing mobile bearing and fixed bearing total knee arthroplasty. J Arthroplast 26:1205–1213

    Article  Google Scholar 

  32. Stoner K, Jerabek SA, Tow S, Wright TM, Padgett DE (2013) Rotating-platform has no surface damage advantage over fixed-bearing TKA. Clin Orthop Relat Res 471:76–85

    Article  PubMed Central  PubMed  Google Scholar 

  33. van Stralen RA, Anderson PG, Wymenga AB (2013) The self-aligning knee prosthesis: clinical and radiological outcome and survival analysis of a cruciate retaining meniscal bearing knee at 10-year follow-up. Knee Surg Sports Traumatol Arthrosc PMID: 23839209

  34. Tibesku CO, Daniilidis K, Skwara A, Dierkes T, Rosenbaum D, Fuchs-Winkelmann S (2011) Gait analysis and electromyography in fixed-and mobile-bearing total knee replacement: a prospective, comparative study. Knee Surg Sports Traumatol Arthrosc 19:2052–2059

    Article  PubMed  Google Scholar 

  35. Tibesku CO, Daniilidis K, Vieth V, Skwara A, Heindel W, Fuchs- Winkelmann S (2011) Sagittal plane kinematics of fixed-and mobile-bearing total knee replacements. Knee Surg Sports Traumatol Arthrosc 19:1488–1495

    Article  PubMed  Google Scholar 

  36. Watanabe T, Ishizuki M, Muneta T, Banks SA (2012) Matched comparison of kinematics in knees with mild and severe varus deformity using fixed-and mobile-bearing total knee arthroplasty. Clin Biomech 27:924–928

    Article  Google Scholar 

  37. Wolterbeek N, Nelissen RG, Valstar ER (2012) No differences in in vivo kinematics between six different types of knee prostheses. Knee Surg Sports Traumatol Arthrosc 20:559–564

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to O. Bailey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bailey, O., Ferguson, K., Crawfurd, E. et al. No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 23, 1653–1659 (2015). https://doi.org/10.1007/s00167-014-2877-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-014-2877-9

Keywords

Navigation