0
Scientific Articles   |    
Long-Term Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Replacements in Patients Younger Than Fifty-one Years of Age with Osteoarthritis
Young-Hoo Kim, MD1; Jun-Shik Kim, MD1; Jin-Woo Choe, MD1; Hyoung-Jin Kim, MD1
1 The Joint Replacement Center of Korea at Ewha Womans University MokDong Hospital, 911-1, MokDong, YangChun-Ku, Seoul, Republic of Korea (158-710). E-mail address for Y.-H. Kim: younghookim@ewha.ac.kr
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Investigation performed at the Joint Replacement Center of Korea, Ewha Womans University School of Medicine, Seoul, Republic of Korea

A commentary by James A. Shaw, MD, is linked to the online version of this article at jbjs.org.



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 May 16;94(10):866-873. doi: 10.2106/JBJS.K.00884
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Background: 

There is limited information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in patients with osteoarthritis who are younger than fifty-one years and who have a fixed-bearing implant in one knee and a mobile-bearing implant in the other. The purpose of this study was to compare our long-term clinical and radiographic results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in a group of patients from this population.

Methods: 

We prospectively compared the results of 108 patients with osteoarthritis who were younger than fifty-one years (mean age, forty-five years) who had received a fixed-bearing prosthesis in one knee and a rotating platform mobile-bearing prosthesis in the other. The mean follow-up was 16.8 years (range, fifteen to eighteen years). The patients were assessed clinically and radiographically. Knee motion and function were assessed as a primary outcome. Patients were assessed with questionnaires, and each knee was assessed separately.

Results: 

Although there was significant improvement in both groups of knees, there was no significant difference between the groups (i.e., fixed-bearing and mobile-bearing knees) with regard to the mean postoperative knee motion (126° and 128°, respectively; p = 0.79), the mean Knee Society knee clinical score (95 and 94 points, respectively; p = 0.79), or the Knee Society knee functional score (84 and 85 points, respectively; p = 0.19) at the latest follow-up. In the fixed-bearing group, one knee was revised because of infection, two for aseptic loosening of the tibial component, and two because of wear of the tibial polyethylene insert. In the rotating platform mobile-bearing group, two knees were revised because of instability and one because of infection. The Kaplan-Meier survivorship for revision at 16.8 years of follow-up was 95% (95% confidence interval, 91 to 100) for the fixed-bearing prosthesis and 97% (95% confidence interval, 93 to 100) for the rotating platform mobile-bearing prosthesis.

Conclusions: 

Long-term results of both fixed and mobile-bearing total knee arthroplasties were encouraging in patients who were younger than fifty-one years of age with osteoarthritis. However, we found no superiority of the mobile-bearing total knee prosthesis over the fixed-bearing total knee prosthesis.

Level of Evidence: 

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    12/31/2013
    SC - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    12/04/2013
    NY - Icahn School of Medicine at Mount Sinai
    03/05/2014
    OK - The University of Oklahoma
    04/16/2014
    CT - Yale University School of Medicine