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DOI :10.26650/IUITFD.1347402   IUP :10.26650/IUITFD.1347402    Full Text (PDF)

EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY

Mehmet Fevzi Çakmak, Levent Horoz

Objective: Total knee replacement (TKR) procedures are widely used in cases of advanced knee osteoarthritis, and satisfactory results are achieved. Although the fixed-bearing (FB) design has been reported as the gold standard by many authors, the mobile-bearing (MB) design has been argued to have more harmonious articulation and to cause less contact stress on the joint surface. This study aims to compare mobile-bearing and fixed-bearing total knee replacement designs and presenting the clinical outcomes.

Material and Methods: The study includes 212 patients who’ve undergone MB and FB implants with identical design, had at least three years of follow-ups, and had their range of motion, pain scores, implant survival, and functional scores recorded.

Result: When comparing the MB and FB designs, the MB group has 106 cases with an average age of 63.1±8.0, and the FB group has 116 cases with an average age of 63.9±7.0 years; no significant difference was observed between the groups. Also, no significant difference was observed regarding Knee Society scores (KSS), range of motion (ROM), or visual analogue scales (VAS) between the first year and last follow-up. The mean follow-up times of the two groups are 62.4 months (range=38-92) for the MB group and 66.8 months (range=40-88) for the FB group. Each group also had similar complication rates.

Conclusion: The clinical and functional results for both the MB and FB-design total knee prostheses are excellent. Despite the many theoretical advantages of MB total knee replacement, this study shows little significant difference in the early functional outcomes between MB and FB prostheses. The study concludes neither MB- or FB-design TKR to have clinically superiority.

Keywords: Total knee replacement, mobile bearing, fixed bearing, prosthesis loosening, prosthesis survival
DOI :10.26650/IUITFD.1347402   IUP :10.26650/IUITFD.1347402    Full Text (PDF)

TOTAL DİZ ARTROPLASTİSİNDE, HAREKETLİ VE SABİT TASARIMLI TİBİAL İNSERT KULLANIMININ KLİNİK SONUÇLARA ETKİSİ: RETROSPEKTİF ÇALIŞMA

Mehmet Fevzi Çakmak, Levent Horoz

Amaç: Total diz replasmanı prosedürü ileri evre diz osteoartriti vakalarında yaygın olarak kullanılmakta ve tatmin edici sonuçlara ulaşılmaktadır. Sabit tasarımlı dizaynlar birçok yazar tarafından altın standart olarak bildirilmişken, hareketli tasarımlı dizaynların daha uyumlu eklemleşmesi ve buna bağlı eklem yüzeyinde düşük temas stresinin olduğu düşünülmektedir. Bu çalışmanın amacı, mobil ve sabit insert total diz protezi tasarımlarını karşılaştırmak ve klinik sonuçları bildirmektir.

Gereç ve Yöntem: Çalışmaya hareketli ve sabit tasarımlı özdeş implantlar uygulanan ve en az üç yıl takip edilen 212 hasta dahil edildi. Hastaların eklem hareket açıklığı, ağrı skorları, implant sağ kalımı ve fonksiyonel skorları kaydedildi.

Bulgular: Hareketli ve sabit tasarımlı dizaynlar karşılaştırıldığında sırasıyla gruplardaki olgu sayısı 106 ve 116 iken, ortalama yaş 63,1±8,0 ve 63,9±7,0 idi ve anlamlı fark izlenmedi. Birinci yıl ve son takipte Diz cemiyeti skoru (KSS), eklem hareket açıklığı and vizuel analog skala (VAS) açısından anlamlı fark izlenmedi. İki grubun ortalama takip süreleri sırasıyla 62,4 (38-92) ve 66,8 (40- 88) ay idi. Komplikasyon oranları her grup için benzerdi.

Sonuç: Hareketli ve sabit tasarımlı total diz protezlerinin klinik ve fonksiyonel sonuçları mükemmeldir. Hareketli insert tasarımlı total diz protezinin birçok teorik avantajına rağmen, bu çalışma iki grup arasında erken fonksiyonel sonuçlarda çok az anlamlı fark gösterdi. Çalışma sonucunda, hareketli ve sabit tasarımlı total diz protezlerinin klinik olarak birbirinden üstün olmadığı görüşüne varılmıştır. 

Keywords: Total diz protezi, hareketli insert, sabit insert, protez aşınması, protez sağkalımı

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References

  • Bachmann M, Bolliger L, Ilchmann T, Clauss M. Long-term survival and radiological results of the Duracon™ total knee arthroplasty. Int Orthop 2014;38(4):747-52. [CrossRef] google scholar
  • Bae DK, Song SJ, Heo DB, Lee SH, Song WJ. Long-term survival rate of implants and modes of failure after revision total knee arthroplasty by a single surgeon. J Arthroplasty 2013;28(7):1130-4. [CrossRef] google scholar
  • Schai PA, Thornhill TS, Scott RD. Total knee arthroplasty with the PFC system results at a minimum of ten years and survivorship analysis. J Bone Joint Surg Br 1998;80(5):850-8. [CrossRef] google scholar
  • Callaghan JJ, Squire MW, Goetz DD, Sullivan PM, Johnston RC. Cemented rotating-platform total knee replacement a nine to twelve-year follow-up study. J Bone Joint Surg Am 2000;82(5):705-11. [CrossRef] google scholar
  • Kim YH, Kim JS. Comparison of anterior-posterior-glide and rotating-platform low contact stress mobile-bearing total knee arthroplasties. J Bone Joint Surg Am 2004;86(6):1239-47. [CrossRef] google scholar
  • Bhan S, Malhotra R, Kiran EK, Shukla S, Bijjawara M. 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 2005;87(10):2290-6. [CrossRef] google scholar
  • Ranawat AS, Rossi R, Loreti I, Rasquinha VJ, Rodriguez JA, Ranawat CS. Comparison of the PFC Sigma fixed-bearing and rotating-platform total knee arthroplasty in the same patient: short-term results. J Arthroplasty 2004;19(1):35-9. [CrossRef] google scholar
  • Aglietti P, Baldini A, Buzzi R, Lup D, De Luca L. Comparison of mobile-bearing and fixed-bearing total knee arthroplasty: a prospective randomized study. J Arthroplasty 2005;20(2):145-53. [CrossRef] google scholar
  • O’Connor JJ, Goodfellow JW. Theory and practice of meniscal knee replacement: designing against wear. Proc Inst Mech Eng H 1996;210(3):217-22. [CrossRef] google scholar
  • Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 1989;(248):9-12. [CrossRef] google scholar
  • Engh GA, Ammeen DJ. Classification and preoperative radiographic evaluation: knee. Orthop Clin North Am 1998;29(2):205-17. [CrossRef] google scholar
  • Khaw FM, Kirk LM, Gregg PJ. Survival analysis of cemented Press-Fit Condylar total knee arthroplasty. J Arthroplasty 2001;16(2):161-7. [CrossRef] google scholar
  • Rasquinha VJ, Ranawat CS, Cervieri CL, Rodriguez JA. The press-fit condylar modular total knee system with a posterior cruciate-substituting design. A concise follow-up of a previous report. J Bone Joint Surg Am 2006;88(5):1006-10. [CrossRef] google scholar
  • Rodricks DJ, Patil S, Pulido P, Colwell CW Jr. Press-fit condylar design total knee arthroplasty. Fourteen to seventeen-year follow-up. J Bone Joint Surg Am 2007;89(1):89-95. [CrossRef] google scholar
  • Schai PA, Thornhill TS, Scott RD. Total knee arthroplasty with the PFC system. Results at a minimum of ten years and survivorship analysis. J Bone Joint Surg Br 1998;80(5):850-8. [CrossRef] google scholar
  • Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D. Total knee replacement in young, active patients. Long-term follow-up and functional outcome. J Bone Joint Surg Am 1997;79(4):575-82. [CrossRef] google scholar
  • Duffy GP, Trousdale RT, Stuart MJ. Total knee arthroplasty in patients 55 years old or younger. 10- to 17-year results. Clin Orthop Relat Res 1998;(356):22-7. [CrossRef] google scholar
  • Ezzet KA, Garcia R, Barrack RL. Effect of component fixation method on osteolysis in total knee arthroplasty. Clin Orthop Relat Res 1995;(321):86-91. [CrossRef] google scholar
  • Buechel FF, Pappas MJ. The New Jersey Low-Contact-Stress Knee Replacement System: biomechanical rationale and review of the first 123 cemented cases. Arch Orthop Trauma Surg (1978) 1986;105(4):197-204. [CrossRef] google scholar
  • Goodfellow JW, O’Connor J. Clinical results of the Oxford knee. Surface arthroplasty of the tibiofemoral joint with a meniscal bearing prosthesis. Clin Orthop Relat Res 1986;(205):21-42. [CrossRef] google scholar
  • Chiu KY, Ng TP, Tang WM, Lam P. Bilateral total knee arthroplasty: One mobile-bearing and one fixed-bearing. J Orthop Surg (Hong Kong) 2001;9(1):45-50. [CrossRef] google scholar
  • Kim YH, Kim DY, Kim JS. Simultaneous mobile and fixed-bearing total knee replacement in the same patients. A prospective comparison of mid-term outcomes using a similar design of prosthesis. J Bone Joint Surg Br 2007;89(7):904-10. [CrossRef] google scholar
  • Kim YH, Kook HK, Kim JS. Comparison of fixed-bearing and mobile-bearing total knee arthroplasties. Clin Orthop Relat Res 2001;(392):101-15. [CrossRef] google scholar
  • Price AJ, Rees JL, Beard D, Juszczak E, Carter S, White S, et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial. J Bone Joint Surg Br 2003;85(1):62-7. [CrossRef] google scholar
  • Ranawat CS, Komistek RD, Rodriguez JA, Dennis DA, Anderle M. In vivo kinematics for fixed and mobile-bearing posterior stabilized knee prostheses. Clin Orthop Relat Res 2004;(418):184-90. [CrossRef] google scholar
  • Harrington MA, Hopkinson WJ, Hsu P, Manion L. Fixed-vs mobile-bearing total knee arthroplasty: does it make a difference? a prospective randomized study. J Arthroplasty 2009;24(6):24-7. [CrossRef] google scholar
  • Huang CH, Liau JJ, Cheng CK. Fixed or mobile-bearing total knee arthroplasty. J Orthop Surg 2007;2:1. [CrossRef] google scholar
  • Grupp TM, Kaddick C, Schwiesau J, Maas A, Stulberg SD. Fixed and mobile bearing total knee arthroplasty influence on wear generation, corresponding wear areas, knee kinematics and particle composition. Clin Biomech (Bristol, Avon) 2009;24(2):210-7. [CrossRef] google scholar
  • Khosrow Sehat, Devane PA, Horne G. Fixed-bearing or mobile-bearing total knee arthroplasty? A review of the recent literature 2007;18(1):66-70. [CrossRef] google scholar
  • Cox J, Tetsworth K. Comparisons between mobilebearing and fixed-bearing total knee replacement. Current Orthopaedic Practice 2009;20(1):35-9. [CrossRef] google scholar
  • Woolson ST, Northrop GD. Mobile- vs. fixed-bearing total knee arthroplasty: a clinical and radiologic study. J Arthroplasty 2004;19(2):135-40. [CrossRef] google scholar
  • Watanabe T, Tomita T, Fujii M, Hashimoto J, Sugamoto K, Yoshikawa H. Comparison between mobile-bearing and fixed-bearing knees in bilateral total knee replacements. Int Orthop 2005;29(3):179-81. [CrossRef] google scholar
  • Lädermann A, Lübbeke A, Stern R, Riand N, Fritschy D. Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomised, clinical and radiological study with mid-term results at 7 years. Knee 2008;15(3):206-10. [CrossRef] google scholar
  • Wylde V, Learmonth I, Potter A, Bettinson K, Lingard E. Patient-reported outcomes after fixed- versus mobilebearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement J Bone Joint Surg Br 2008;90(9):1172-9. [CrossRef] google scholar
  • Breugem SJ, Sierevelt IN, Schafroth MU, Blankevoort L, Schaap GR, van Dijk CN. Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis. Clin Orthop Relat Res 2008;466(8):1959-65. [CrossRef] google scholar
  • Kim YH, Yoon SH, Kim JS. Early outcome of TKA with a medial pivot fixed-bearing prosthesis is worse than with a PFC mobile-bearing prosthesis. Clin Orthop Relat Res 2009;467(2):493-503. [CrossRef] google scholar

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APA

Çakmak, M.F., & Horoz, L. (2024). EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY. Journal of Istanbul Faculty of Medicine, 87(1), 81-86. https://doi.org/10.26650/IUITFD.1347402


AMA

Çakmak M F, Horoz L. EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY. Journal of Istanbul Faculty of Medicine. 2024;87(1):81-86. https://doi.org/10.26650/IUITFD.1347402


ABNT

Çakmak, M.F.; Horoz, L. EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY. Journal of Istanbul Faculty of Medicine, [Publisher Location], v. 87, n. 1, p. 81-86, 2024.


Chicago: Author-Date Style

Çakmak, Mehmet Fevzi, and Levent Horoz. 2024. “EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY.” Journal of Istanbul Faculty of Medicine 87, no. 1: 81-86. https://doi.org/10.26650/IUITFD.1347402


Chicago: Humanities Style

Çakmak, Mehmet Fevzi, and Levent Horoz. “EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY.” Journal of Istanbul Faculty of Medicine 87, no. 1 (Dec. 2024): 81-86. https://doi.org/10.26650/IUITFD.1347402


Harvard: Australian Style

Çakmak, MF & Horoz, L 2024, 'EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY', Journal of Istanbul Faculty of Medicine, vol. 87, no. 1, pp. 81-86, viewed 23 Dec. 2024, https://doi.org/10.26650/IUITFD.1347402


Harvard: Author-Date Style

Çakmak, M.F. and Horoz, L. (2024) ‘EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY’, Journal of Istanbul Faculty of Medicine, 87(1), pp. 81-86. https://doi.org/10.26650/IUITFD.1347402 (23 Dec. 2024).


MLA

Çakmak, Mehmet Fevzi, and Levent Horoz. “EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY.” Journal of Istanbul Faculty of Medicine, vol. 87, no. 1, 2024, pp. 81-86. [Database Container], https://doi.org/10.26650/IUITFD.1347402


Vancouver

Çakmak MF, Horoz L. EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY. Journal of Istanbul Faculty of Medicine [Internet]. 23 Dec. 2024 [cited 23 Dec. 2024];87(1):81-86. Available from: https://doi.org/10.26650/IUITFD.1347402 doi: 10.26650/IUITFD.1347402


ISNAD

Çakmak, MehmetFevzi - Horoz, Levent. “EFFECTS OF MOBILE- AND FIXED-BEARING TIBIAL INSERTS ON CLINICAL RESULTS OF KNEE ARTHROPLASTY: A RETROSPECTIVE STUDY”. Journal of Istanbul Faculty of Medicine 87/1 (Dec. 2024): 81-86. https://doi.org/10.26650/IUITFD.1347402



TIMELINE


Submitted22.08.2023
Accepted23.10.2023
Published Online23.01.2024

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