Top

Journal of Orthopaedics and Traumatology

Published in:

Open Access 01-12-2018 | Original Article

Fixed-bearing versus high-flexion RP total knee arthroplasty (TKA): midterm results of a randomized controlled trial

Authors: Amit Chaudhry, V. K. Goyal

Published in: Journal of Orthopaedics and Traumatology | Issue 1/2018

Abstract

Background

We compared the midterm results after total knee arthroplasty (TKA) using PFC Sigma RP-F mobile model with PFC Sigma PS fixed model.

Materials and methods

In this randomized controlled trial, we analyzed 50 knees that underwent TKA with PFC Sigma RP-F and 60 knees with PFC Sigma PS fixed model. The follow-up period ranged from 76 to 104 months.

Results

The knee score, function score, and radiographic evaluation were significantly not different between the two groups at final follow-up. No revisions, subluxations, dislocations, or infections were seen. Also, no radiographic evidence of component loosening, osteolysis, or malalignment was observed in any knee. The results for both groups show good patient satisfaction.

Conclusions

The midterm clinical and radiographic results of the two prostheses did not show significant differences between the two groups.

Level of evidence

Level of evidence is level II.

Ha CW, Ravichandran C, Lee CH, Kim JH, Park YB (2015) Performing high flexion activities does not seem to be crucial in developing early femoral component loosening after high-flexion TKA. BMC Musculoskelet Disord 16:353CrossRefPubMedPubMedCentral

Huang CH, Liau JJ, Cheng CK (2007) Fixed or mobile-bearing total knee arthroplasty. J Orthop Surg Res 2:1CrossRefPubMedPubMedCentral

Kim YH, Yoon SH, Kim JS (2007) The long-term results of simultaneous fixed bearing and mobile-bearing total knee replacements performed in the same patient. J Bone Joint Surg (Br) 89:1317–1323CrossRef

Huang CH, Ma HM, Lee YM, Ho FY (2003) Long-term results of low contact stress mobile-bearing total knee replacements. Clin Orthop Relat Res 416:265–270CrossRef

Jacobs W, Anderson P, Limbeek J, Wymenga A (2004) Mobile bearing vs. fixed bearing prostheses for total knee arthroplasty for postoperative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev 2:CD003130

Price AJ, Rees JL, Beard D, Juszczak E, Carter S, White S et al (2003) A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomized controlled trial. J Bone Joint Surg Br 85:62–67CrossRefPubMed

Kim YH, Kook HK, Kim JS (2001) Comparison of fixed-bearing and mobile-bearing total knee arthroplasties. Clin Orthop 392:101–105CrossRef

Kim MS, Koh IJ, Jang SW, Jeon NH, In Y (2016) Two- to four-year follow-up results of total knee arthroplasty using a new high-flexion prosthesis. Knee Surg Relat Res 28(1):39–45CrossRefPubMedPubMedCentral

Dennis DA, Komistek RD, Scuderi GR, Zingde S (2007) Factors affecting flexion after total knee arthroplasty. Clin Orthop Relat Res 464:53–60PubMed

10.

Kim JY, Cheon SH, Kyung HS (2012) Mid-term results of total knee arthroplasty using PFC Sigma RP-F. Knee Surg Relat Res 24:221–226CrossRefPubMedPubMedCentral

11.

Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14

12.

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

13.

Ranawat AS, Rossi R, Loreti I, Rasquinha VJ, Rodriguez JA, Ranawat CS (2004) Comparison of the PFC Sigma fixed-bearing and rotating-platform total knee arthroplasty in the same patient: short-term results. J Arthroplasty 19:35–39CrossRefPubMed

14.

Hamilton WG, Sritulanondha S, Engh CA Jr (2011) Results of prospective, randomized clinical trials comparing standard and high-flexion posterior-stabilized TKA: a focused review. Orthopedics 34:e500–e503CrossRefPubMed

15.

Hooper G, Rothwell A, Frampton C (2009) The low contact stress mobile-bearing total knee replacement: a prospective study with a minimum follow-up of ten years. J Bone Joint Surg Br 9:58–63CrossRef

16.

Capella M, Dolfin M, Saccia F (2016) Mobile bearing and fixed bearing total knee arthroplasty: no clinical differences between mobile and fixed bearing TKA. Ann Transl Med 4:127CrossRefPubMedPubMedCentral

17.

Mehin R, Burnett RS, Brasher PM (2010) Does the new generation of high-flex knee prostheses improve the post-operative range of movement?: a meta-analaysis. J Bone Joint Surg Br 92:1429–1434CrossRefPubMed

18.

Choi WC, Lee S, Seong SC, Jung JH, Lee MC (2010) Comparison between standard and high flexion posterior-stabilized rotating-platform mobile-bearing total knee arthroplasties: a randomized controlled study. J Bone Joint Surg Am 92:2634–2642CrossRefPubMed

19.

Nutton RW, van der Linden ML, Rowe PJ, Gaston P, Wade FA (2008) A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the nexgen standard and high flexion components. J Bone Joint Surg Br 90:37–42CrossRefPubMed

20.

McCalden RW, MacDonald SJ, Bourne RB, Marr JT (2009) A randomized controlled trial comparing “high-flex” vs “standard” posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty. J Arthroplasty 24:33–38CrossRefPubMed

21.

Gupta SK, Ranawat AS, Shah V, Zikria BA, Zikria JF, Ranawat CS (2006) The P.F.C. sigma RP-F TKA designed for improved performance: a matched-pair study. Orthopedics 29:S49–S52PubMed

22.

Maniar RN, Singhi T (2012) High-flex rotating platform knee implants: two- to 6-year results of a prospective study. J Arthroplasty 27:598–603CrossRefPubMed

23.

Massin P, Dupuy FR, Khlifi H, Fornasieri C, De Polignac T, Schifrine P et al (2010) Does hyperflex total knee design improve postoperative active flexion? Orthop Traumatol Surg Res 96:376–380CrossRefPubMed

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 94:1051–1057CrossRefPubMed

25.

Suh JT, Shin WC, Ahn TY (2008) The total knee arthroplasty with PFC Sigma RP-F(R): two year short-term results. J Korean Orthop Assoc 43:57–64CrossRef

26.

Malik A, Salas A, Ben Ari J, Ma Y, Gonzalez Della Valle A (2010) Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts. Int Orthop 34:965–972CrossRefPubMed

27.

Gandhi R, Tso P, Davey JR, Mahomed NN (2009) High-flexion implants in primary total knee arthroplasty: a meta-analysis. Knee 16:14–17CrossRefPubMed

28.

Murphy M, Journeaux S, Russell T (2009) High-flexion total knee arthroplasty: a systematic review. Int Orthop 33:887–893CrossRefPubMedPubMedCentral

29.

Sumino T, Gadikota HR, Varadarajan KM, Kwon YM, Rubash HE, Li G (2011) Do high flexion posterior stabilised total knee arthroplasty designs increase knee flexion? A meta-analysis. Int Orthop (SICOT) 35:1309–1319CrossRef

30.

Patel K, Raut V (2011) Patella in total knee arthroplasty: to resurface or not to–a cohort study of staged bilateral total knee arthroplasty. Int Orthop 35:349–353CrossRefPubMed

31.

Kim SH, Lee S, du Ro H, Cho Y, Lee YM, Chung KY et al (2015) Comparison of patellar resurfacing versus preservation in high flexion total knee arthroplasty: no significant difference in post-operative high flexion activities between patellar resurfacing and patellar preservation groups. Knee Surg Sports Traumatol Arthrosc 23:1782–1790CrossRefPubMed

32.

Helmy N, Anglin C, Greidanus NV, Masri BA (2008) To resurface or not to resurface the patella in total knee arthroplasty. Clin Orthop 466:2775–2783CrossRefPubMed

33.

Cho SD, Youm YS, Park KB (2011) Three- to six-year follow-up results after high-flexion total knee arthroplasty: can we allow passive deep knee bending? Knee Surg Sports Traumatol Arthrosc 19:899–903CrossRefPubMed

34.

Boese CK, Gallo TJ, Plantikow CJ (2011) Range of motion and patient satisfaction with traditional and high-flexion rotating-platform knees. Iowa Orthop J 31:73–77PubMedPubMedCentral

Title: Fixed-bearing versus high-flexion RP total knee arthroplasty (TKA): midterm results of a randomized controlled trial
Authors: Amit Chaudhry
V. K. Goyal
Publication date: 01-12-2018
Publisher: Springer International Publishing
Published in: Journal of Orthopaedics and Traumatology / Issue 1/2018
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI: https://doi.org/10.1186/s10195-018-0493-z

At a glance: The STEP trials

Springer Medicine

Fixed-bearing versus high-flexion RP total knee arthroplasty (TKA): midterm results of a randomized controlled trial

Abstract

Background

Materials and methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Level of evidence

Please log in to get access to this content

Other articles of this Issue 1/2018

Quantitative correlation of mechanoreceptors in tibial remnant of ruptured human anterior cruciate ligament with duration of injury and its significance: an immunohistochemistry-based observational study

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

The loading patterns of a short femoral stem in total hip arthroplasty: gait analysis at increasing walking speeds and inclines

Pyrocarbon arthroplasty in acute unreconstructable radial head fractures: mid-term to long term results

Revision total knee arthroplasty: hybrid vs standard cemented fixation

Cross-cultural adaptation and validation of the Italian versions of the Kujala, Larsen, Lysholm and Fulkerson scores in patients with patellofemoral disorders