Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2017

01-09-2017 | Knee

No difference in terms of radiostereometric analysis between fixed- and mobile-bearing total knee arthroplasty: a randomized, single-blind, controlled trial

Authors: M. G. M. Schotanus, P. Pilot, B. L. Kaptein, W. F. Draijer, P. B. J. Tilman, R. Vos, N. P. Kort

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2017

Login to get access

Abstract

Purpose

A concern that arises with any new prosthesis is whether it will achieve satisfactory long-term implant stability. The gold standard of assessing the quality of fixation in a new or relatively new implant is to undertake a randomized controlled trial using radiostereometric analysis. It was hypothesized that both mobile-bearing total knee arthroplasty and fixed-bearing total knee arthroplasty have comparable migration patterns at 2-year follow-up. This study investigated two types of cemented total knee arthroplasty, the mobile- or fixed-bearing variant from the same family with use of radiostereometric analysis.

Methods

This prospective, patient-blinded, randomized, controlled trial was designed to investigate early migration of the tibia component after two years of follow-up with use of radiostereometric analysis. A total of 50 patients were randomized to receive a mobile- or fixed-bearing TKA from the same family. Patients were evaluated during 2-year follow-up, including radiostereometric analysis, physical and clinical examination and patient reported outcome measures (PROMs).

Results

At two-year follow-up, the mean (±SD) maximum total point motion (MTPM) in the fixed-bearing group was 0.82 (±1.16) versus 0.92 mm (±0.64) in the mobile-bearing group (p = n.s) with the largest migration seen during the first 6 weeks (0.45 ± 0.32 vs. 0.54 ± 0.30). The clinical outcome and PROMs significantly improved within each group, not between both groups.

Conclusions

Measuring early micromotion is useful for predicting clinical loosening that can lead to revision. The results of this study demonstrate that early migration of the mobile-bearing is similar to that of the fixed-bearing component at two years and was mainly seen in the first weeks after implantation.

Level of evidence

Randomized, single-blind, controlled trial, Level I.
Literature
1.
Ball ST, Sanchez HB et al (2011) Fixed versus rotating platform total knee arthroplasty: a prospective, randomized, single-blind study. J Arthroplasty 26(4):531–536CrossRefPubMed
2.
Breeman S, Campbell MK et al (2013) Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement. Bone Joint J 95(4):486–492CrossRefPubMed
3.
Breugem SJ, van Ooij B, Haverkamp D, Sierevelt IN, van Dijk CN (2014) No difference in anterior knee pain between a fixed and a mobile posterior stabilized total knee arthroplasty after 7.9 years. Knee Surg Sports Traumatol Arthrosc 22(3):509–516CrossRefPubMed
4.
Callaghan JJ (2001) Mobile-bearing knee replacement: clinical results: a review of the literature. Clin Orthop Relat Res 392:221–225CrossRef
5.
Callaghan JJ, Wells CW et al (2010) Cemented rotating-platform total knee replacement: a concise follow-up, at a minimum of 20 years, of a previous report. J Bone Joint Surg Am 92(7):1635–1639CrossRefPubMed
6.
Carothers JT, Kim RH et al (2011) Mobile-bearing total knee arthroplasty. A meta-analysis. J Arthroplasty 26(4):537–542CrossRefPubMed
7.
Collier MB, Engh CA et al (2005) Osteolysis after total knee arthroplasty: influence of tibial baseplate surfacefinish and sterilization of polyethylene insert. Findings at 5 to 10 years postoperatively. J Bone Joint Surg Am 87(12):2702–2708PubMed
8.
Delport HP, Banks SA et al (2006) A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br 88(8):1016–1021CrossRefPubMed
9.
Delport HP (2013) The advantage of a total knee arthroplasty with rotating platform is only theoretical: prospective analysis of 1152 arthroplasties. Open Orthop J 7:635–640CrossRefPubMedPubMedCentral
10.
11.
Duffy GP, Murray BE, Trousdale RR (2007) Hybrid total knee arthroplasty. Analysis of component failures at an average of 15 years. J Arthroplasty 22(8):1112–1115CrossRefPubMed
12.
Ewald FC (1989) The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
13.
Faris PM, Ritter MA, Davis KEPH (2015) Ten-year outcome comparison of the anatomical graduated component and vanguard total knee arthroplasty systems. J Arthroplasty 30(10):1733–1735CrossRefPubMed
14.
Furnes O, Espehaug B et al (2002) Early failures among 7174 primary total knee replacements: a follow-up study from the Norwegian Arthroplasty Register 1994–2000. Acta Orthop Scand 73(2):117–129CrossRefPubMed
15.
Garling EH, Valstar ER, Nelissen RGHH (2005) Comparison of micromotion in mobile bearing and posterior stabilized total knee prostheses: a randomized RSA study of 40 knees followed for 2 years. Acta Orthop 76(3):353–361PubMed
16.
Garling EH, van Eck M et al (2005) Increased muscle activity to stabilise mobile bearing knees in patients with rheumatoid arthritis. Knee 12(3):177–182CrossRefPubMed
17.
Gioe TJ, Glynn J et al (2009) Mobile and fixed-bearing (all-polyethylene tibial component) total knee arthroplasty designs. A prospective randomized trial. J Bone Joint Surg Am 91(9):2104–2112CrossRefPubMed
18.
Grewal R, Rimmer MG, Freeman MA (1992) Early migration of prostheses related to long-term survivorship. Comparison of tibial components in knee replacement. J Bone Joint Surg Br 74(2):239–242CrossRefPubMed
19.
Haverkamp D, Breugem SJM et al (2005) Translation and validation of the Dutch version of the Oxford 12-item knee questionnaire for knee arthroplasty. Acta Orthop 76(3):347–352PubMed
20.
Henricson A, Dalén T, Nilsson KG (2006) Mobile bearings do not improve fixation in cemented total knee arthroplasty. Clin Orthop Relat Res 448:114–121CrossRefPubMed
21.
Hofstede SN, Nouta KA et al (2015) Mobile bearing versus fixed bearing prostheses for posterior cruciate retaining total knee arthroplasty for postoperative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev 4(4):CD003130
22.
Hopley CDJ, Crossett LS, Chen AF (2013) Long-term clinical outcomes and survivorship after total knee arthroplasty using a rotating platform knee prosthesis: a meta-analysis. J Arthroplasty 28(1):68–77CrossRefPubMed
23.
24.
Insall JN, Dorr LD et al (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14
25.
Jones DL, Westby MD et al (2005) Update on hip and knee arthroplasty: current state of evidence. Arthritis Rheum 53(5):772–780CrossRefPubMed
26.
Kaptein BL, Valstar ER et al (2005) A new type of model-based Roentgen stereophotogrammetric analysis for solving the occluded marker problem. J Biomech 38(11):2330–2334CrossRefPubMed
27.
28.
Kievit AJ, Schafroth MU et al (2014) Early experience with the vanguard complete total knee system: 2–7 years of follow-up and risk factors for revision. J Arthroplasty 29(2):348–354CrossRefPubMed
29.
Kim Y, Kim J et al (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(10):866–873CrossRefPubMed
30.
Kurita M, Tomita T et al (2012) In vivo kinematics of high-flex mobile-bearing total knee arthroplasty, with a new post-cam design, in deep knee bending motion. Int Orthop 36(12):2465–2471CrossRefPubMedPubMedCentral
31.
Li YL, Wu Q, Ning GZ et al (2014) No difference in clinical outcome between fixed- and mobile-bearing TKA: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 22(3):565–575CrossRefPubMed
32.
Mikulak SA, Mahoney OM et al (2001) Loosening and osteolysis with the press-fit condylar posterior-cruciate substituting total knee replacement. J Bone Joint Surg Am 83(3):398–403CrossRefPubMed
33.
34.
Murray DW, Fitzpatrick R et al (2007) The use of the Oxford hip and knee scores. J Bone Joint Surg Br 89(8):1010–1014CrossRefPubMed
35.
Nilsson KG, Henricson A et al (2006) Uncemented HA-coated implant is the optimum fixation for TKA in the young patient. Clin Orthop Relat Res 448:129–139CrossRefPubMed
36.
Oh KJ, Pandher DS et al (2009) Meta-analysis comparing outcomes of fixed-bearing and mobile-bearing prostheses in total knee arthroplasty. J Arthroplasty 24(6):873–884CrossRefPubMed
37.
Petersen TL, Engh GA (1998) Radiographic assessment of knee alignment after total knee arthroplasty. J Arthroplasty 3(1):67–72CrossRef
38.
Pijls BG, Valstar ER et al (2012) Early migration of tibial components is associated with late revision: a systematic review and meta-analysis of 21,000 knee arthroplasties. Acta Orthop 83(6):614–624CrossRefPubMedPubMedCentral
39.
Post ZD, Matar WY et al (2010) Mobile-bearing total knee arthroplasty. Better than a fixed-bearing? J Arthroplasty 25(6):998–1003CrossRefPubMed
40.
Price AJ, Rees JL et al (2003) A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial. J Bone Joint Surg Br 85(1):62–67CrossRefPubMed
41.
Rand JA, Trousdale RT et al (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85(2):259–265CrossRefPubMed
42.
Ranstam J, Ryd LOI (2000) Accurate accuracy assessment: review of basic principles. Acta Orthop Scand 71(1):106–108CrossRefPubMed
43.
Ritter MA, Worland R et al (1995) Flat-on-flat, nonconstrained, compression molded polyethylene total knee replacement. Clin Orthop Relat Res 321:79–85
44.
Roorda LD, Jones CA et al (2004) Satisfactory cross cultural equivalence of the Dutch WOMAC in patients with hip osteoarthritis waiting for arthroplasty. Ann Rheum Dis 63(1):36–42CrossRefPubMedPubMedCentral
45.
Ryd L, Albrektsson BE et al (1995) Roentgen stereophotogrammetric analysis as a predictor of mechanical loosening of knee prostheses. J Bone Joint Surg Br 77(3):377–383PubMed
46.
Saleh KJ, Mulhall KJ et al (2005) Development and validation of a lower-extremity activity scale. Use for patients treated with revision total knee arthroplasty. J Bone Joint Surg Am 87(9):1985–1994CrossRefPubMed
47.
Schroer WC, Stormont DM, Pietrzak WS (2014) Seven-year survivorship and functional outcomes of the high flexion vanguard complete knee system. J Arthroplasty 29(1):61–65CrossRefPubMed
48.
Schuh R, Dorninger G et al (2012) Validity of published outcome data concerning Anatomic Graduated Component total knee arthroplasty: a structured literature review including arthroplasty register data. Int Orthop 36(1):51–56CrossRefPubMed
49.
Selvik G (1989) Roentgen stereophotogrammetry. A method for the study of the kinematics of the skeletal system. Acta Orthop Scand Suppl 232:1–51CrossRefPubMed
50.
Smith H, Jan M et al (2011) Meta-analysis and systematic review of clinical outcomes comparing mobile bearing and fixed bearing total knee arthroplasty. J Arthroplasty 26(8):1205–1213CrossRefPubMed
51.
Uvehammer J, Kärrholm J, Carlsson L (2007) Cemented versus hydroxyapatite fixation of the femoral component of the Freeman-Samuelson total knee replacement: a radiostereometric analysis. J Bone Joint Surg Br 89(1):39–44CrossRefPubMed
52.
Valstar ER, Gill R et al (2005) Guidelines for standardization of radiostereometry (RSA) of implants. Acta Orthop 76(4):563–572CrossRefPubMed
Metadata
Title
No difference in terms of radiostereometric analysis between fixed- and mobile-bearing total knee arthroplasty: a randomized, single-blind, controlled trial
Authors
M. G. M. Schotanus
P. Pilot
B. L. Kaptein
W. F. Draijer
P. B. J. Tilman
R. Vos
N. P. Kort
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4138-6

Other articles of this Issue 9/2017

Knee Surgery, Sports Traumatology, Arthroscopy 9/2017 Go to the issue

Knee

Periarticular injections with continuous perfusion of local anaesthetics provide better pain relief and better function compared to femoral and sciatic blocks after TKA: a randomized clinical trial

Editorial

Fast track and outpatient surgery in total knee arthroplasty: beneficial for patients, doctors and hospitals

Knee

Patient selection criteria for outpatient joint arthroplasty

Knee

Unconstrained total knee arthroplasty in significant valgus deformity: a modified surgical technique to balance the knee and avoid instability

Knee

Good long-term results following cementless TKA with a titanium plasma coating

Knee

No advantage of adrenaline in the local infiltration analgesia mixture during total knee arthroplasty