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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 24-08-2023 | KNEE

Wider translations and rotations in posterior-stabilised mobile-bearing total knee arthroplasty compared to fixed-bearing both implanted with mechanical alignment: a dynamic RSA study

Authors: Raffaele Zinno, Domenico Alesi, Stefano Di Paolo, Nicola Pizza, Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli, Laura Bragonzoni

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2023

Abstract

Purpose

The purpose of this study was to investigate the in vivo kinematics of the same femoral design mechanically aligned posterior-stabilised (PS) total knee arthroplasty (TKA) with either fixed-bearing (FB) or mobile-bearing (MB) inlay, implanted by the same surgeon, using model-based dynamic radiostereometric analysis (RSA). The hypothesis of the present study was that the MB design would show wider axial rotation than the FB design, without affecting the clinical outcomes.

Materials and methods

A cohort of 21 non-randomised patients (21 DePuy Attune PS-FB) was evaluated by dynamic RSA analysis at a minimum 9-month follow-up, while performing differently demanding daily living activities such as sit to stand (STS) and deep knee lunge (DKL). Kinematic data were compared with those of a cohort of 22 patients implanted with the same prosthetic design but with MB inlay. Anterior–posterior (AP) translations, varus–valgus (VV) and internal–external (IE) rotations of the femoral component with respect to the tibial baseplate were investigated. Translation of medial and lateral compartment was analysed using the low point method according to Freeman et al. Questionnaires to calculate objective and subjective clinical scores were administered preoperatively and during follow-up visit by the same investigator.

Results

The FB TKA design showed lower AP translation during STS (6.8 ± 3.3 mm in FB vs 9.9 ± 3.7 mm in MB, p = 0.006*), lower VV rotation (1.9 ± 0.8° in FB vs 5.3 ± 3.3° in MB, p = 0.005) and lower IE rotation (2.8 ± 1.1° in FB vs 9.5 ± 4.3° in MB, p = 0.001) during DKL than the mobile-bearing TKA design. Posterior-stabilised FB group showed significant lower translation of the low point of the medial compartment than the MB group (p = 0.008). The percentage of patients performing medial pivot in the FB group was higher compared to MB group in the examined motor tasks. No significant differences in post-operative range of motion (117° ± 16° for FB group and 124° ± 13° for MB group) and in clinical outcomes emerged between the two cohort.

Conclusions

The FB and MB designs differed in AP translations, VV rotations and IE rotations of the femoral component with respect to the tibial component in STS and DKL. Furthermore, FB cohort reported a significant higher percentage of medial pivot with respect to MB cohort. Despite this, no differences in clinical outcomes were detected between groups. Both designs showed stable kinematics and represent a viable option in primary TKA.

Level of evidence

Prospective cohort study, II.

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Title: Wider translations and rotations in posterior-stabilised mobile-bearing total knee arthroplasty compared to fixed-bearing both implanted with mechanical alignment: a dynamic RSA study
Authors: Raffaele Zinno
Domenico Alesi
Stefano Di Paolo
Nicola Pizza
Stefano Zaffagnini
Giulio Maria Marcheggiani Muccioli
Laura Bragonzoni
Publication date: 24-08-2023
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-023-07541-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Wider translations and rotations in posterior-stabilised mobile-bearing total knee arthroplasty compared to fixed-bearing both implanted with mechanical alignment: a dynamic RSA study

Abstract

Purpose

Materials and methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

Level of evidence

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