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Scientific Articles   |    
The Role of Registry Data in the Evaluation of Mobile-Bearing Total Knee Arthroplasty
Robert S. Namba, MD1; Maria C.S. Inacio, MS2; Elizabeth W. Paxton, MA2; Otto Robertsson, MD, PhD3; Stephen E. Graves, MD, DPhil4
1 Department of Orthopedic Surgery, Southern California Permanente Medical Group, Kaiser Permanente Orange County, 6670 Alton Parkway, Irvine, CA 92618. E-mail address: robert.s.namba@kp.org
2 Department of Surgical Outcomes and Analysis, Kaiser Permanente, 3033 Bunker Hill Street, San Diego, CA 92109
3 The Swedish Knee Arthroplasty Register, Department of Orthopedics and Clinical Sciences, Lund University Hospital, SE 221 85, Lund, Sweden
4 Australian Orthopaedic Association National Joint Replacement Registry, Discipline of Public Health, University of Adelaide, MDP DX650 511, Adelaide SA 5005, Australia
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Disclosure: One or more 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 an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, one or more of the authors has had another relationship, or has engaged in another activity, 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.

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Investigation performed at the Department of Orthopedic Surgery, Southern California Permanente Medical Group, Kaiser Permanente Orange County, Irvine, California

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Dec 21;93(Supplement 3):48-50. doi: 10.2106/JBJS.K.00982
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Abstract

Abstract: 

The conventional wisdom that a mobile-bearing design may offer a benefit compared with a fixed-bearing design in total knee arthroplasty has not been supported by evidence. We reviewed the published literature and annual registry reports of all national and regional registries to determine the differences in clinical outcomes between mobile and fixed-bearing designs. We found only single-center reports and studies with small sample sizes in the published literature. These studies did not demonstrate any advantages of mobile bearings over fixed bearings. Moreover, major national joint registries reported higher failure rates associated with mobile-bearing total knee replacement compared with fixed-bearing total knee replacement. Similar findings from a U.S. national study in a community setting suggest that mobile-bearing knees have an increased risk of revision. After harmonization of methodologies, international collaborations of registries may provide the best insight into the performance of mobile-bearing total knee arthroplasty in real-world settings.

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    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.
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