Document Detail


Mobile and fixed-bearing (all-polyethylene tibial component) total knee arthroplasty designs. A prospective randomized trial.
MedLine Citation:
PMID:  19723986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Proponents of mobile-bearing total knee arthroplasty believe that it has potential advantages over a fixed-bearing design in terms of diminished wear and improved motion and/or function, but these advantages have not been demonstrated in a randomized clinical comparison to our knowledge. We conducted a patient-blinded, prospective, randomized clinical trial to compare mobile-bearing and fixed-bearing cruciate-substituting total knee arthroplasties of the same design. METHODS: Patients between the ages of sixty and eighty-five years were prospectively randomized to receive a cruciate-substituting rotating-platform design or a fixed-bearing design with an all-polyethylene tibial component. There were no significant differences in the demographic characteristics (mean age, 72.2 years; mean American Society of Anesthesiologists score, 2.7; mean body mass index, 31.8 kg/m(2)) or preoperative clinical or radiographic measures between the groups. Routine clinical and radiographic follow-up measures included the Knee Society score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36) outcome measures. RESULTS: The results of 312 arthroplasties (136 with an all-polyethylene tibial component and 176 rotating-platform designs) in 273 patients were analyzed at a minimum of two years (mean, forty-two months) postoperatively. Although there was significant improvement in both groups, there was no significant difference between the groups with regard to the mean postoperative range of motion (110.9 degrees and 109.1 degrees, respectively; p = 0.21), the mean KSS clinical score (90.4 and 88.2 points; p = 0.168), or the mean KSS pain score (44.9 and 43.1 points; p = 0.108) at this follow-up point. There were ten revisions: seven because of infection, one because of patellar fracture, one because of instability, and one because of aseptic loosening. CONCLUSIONS: The two designs functioned equivalently at the time of early follow-up in this low-to-moderate-demand patient group. The rotating-platform design had no significant clinical advantage over the design with the all-polyethylene tibial component.
Authors:
Terence J Gioe; Jason Glynn; Jonathan Sembrano; Kathleen Suthers; Edward R G Santos; Jasvinder Singh
Related Documents :
1563146 - The effects of implant design on range of motion after total knee arthroplasty. total c...
20803386 - Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthriti...
16129746 - Revision total knee arthroplasty with the total condylar iii system in inflammatory art...
20089336 - Patients with osteoarthritic knees have shorter orientation and tangent indicatrices du...
21571336 - Image guided percutaneous probe ablation for renal tumors in 65 solitary kidneys: funct...
8782256 - A prospective randomized study of medications after silicone intubation.
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  91     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-02     Completed Date:  2009-09-22     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2104-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Veterans Affairs Medical Center, Minneapolis, MN 55417, USA. tjgioe@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee*
Biocompatible Materials
Female
Humans
Knee Joint / surgery*
Knee Prosthesis*
Male
Middle Aged
Osteoarthritis, Knee / surgery*
Polyethylene
Prospective Studies
Prosthesis Design*
Single-Blind Method
Chemical
Reg. No./Substance:
0/Biocompatible Materials; 9002-88-4/Polyethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Geographic mapping of meniscus and cartilage lesions associated with anterior cruciate ligament inju...
Next Document:  Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of c...