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Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact

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

Abstract

Purpose

In anteroposterior (AP)-gliding mobile-bearing total knee arthroplasty (TKA), the femoral component can theoretically slide forward resulting in a more anterior contact point, causing pain due to impingement. A lower lever arm of the extensor apparatus can also attribute to higher patella pressures and pain. The goal of this study was to determine the contact point in a cohort of mobile- and fixed-bearing TKAs, to determine whether the contact point lies more anteriorly in mobile-bearing TKA and to confirm whether this results in anterior knee pain.

Methods

We used 38 fixed-bearing TKA and 40 mobile-bearing TKA from a randomized trial with straight lateral knee X-rays and measured the contact point. The functional outcome was measured by Knee Society Score at 12 months postoperatively. Pain scores were analysed using a VAS score (0–100 mm) in all patients at rest and when moving. Difficulty at rising up out of a chair was also assessed using a VAS score.

Results

The contact point in mobile-bearing TKA was situated at 59.5 % of the AP distance of the tibia and in the fixed-bearing TKA group at 66.1 % (P< 0.05). Patients with mobile- and fixed-bearing TKAs had similar knee scores, pain scores and difficulty in chair rise. No significant correlation was found between contact point and knee pain.

Conclusion

The hypothesis of a more anterior contact point in the mobile-bearing cohort was confirmed but no correlation with functional and pain scores in this cohort could be found. The tibiofemoral contact point could not be correlated with a different clinical outcome and higher incidence of anterior knee pain. This study further adds to the knowledge on possible differences between mobile- and fixed-bearing prostheses. Next to that, bad outcomes could not be explained by CP.

Level of evidence

Case series, Level IV.

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Authors and Affiliations

  1. Sint Maartenskliniek, Hengstdal 3, Postbus 9011, 6500 GM, Nijmegen, The Netherlands

    R. A. van Stralen, P. J. C. Heesterbeek & A. B. Wymenga

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  1. R. A. van Stralen
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  2. P. J. C. Heesterbeek
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  3. A. B. Wymenga
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Correspondence to R. A. van Stralen.

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van Stralen, R.A., Heesterbeek, P.J.C. & Wymenga, A.B. Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact. Knee Surg Sports Traumatol Arthrosc 23, 3368–3374 (2015). https://doi.org/10.1007/s00167-014-3178-z

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  • DOI: https://doi.org/10.1007/s00167-014-3178-z

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