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- Title
Mid-term clinical and radiological results do not differ between fixed- and mobile-bearing total knee arthroplasty using titanium-nitride-coated posterior-stabilized prostheses: a prospective randomized controlled trial.
- Authors
Park, Cheol Hee; Kang, Se Gu; Bae, Dae Kyung; Song, Sang Jun
- Abstract
<bold>Purpose: </bold>This study was performed to prospectively compare the clinical and radiographic results between mobile-bearing (MB) and fixed-bearing (FB) TKAs using ceramic titanium nitride (TiN)-coated prostheses.<bold>Methods: </bold>Seventy MB and 70 FB TKAs using TiN-coated prostheses (ACS®) were prospectively evaluated. There were no differences in demographic characteristics between the two groups. Clinically, the Knee Society knee and function scores, WOMAC, and range of motion (ROM) were compared. Considering the possibility of a kinematic change in the polyethylene (PE) insert and a decrease in ROM following MB TKA, serial changes in the ROM were also compared. The thickness of the PE insert was compared according to the size of the femoral component. Radiographically, the alignment and positions of the components were compared.<bold>Results: </bold>There were no differences between the two groups in clinical scores or ROM (n.s.). The maximum flexion increased from 133.5° ± 8.3° to 137.6° ± 5.5° across all time points in the MB group. The serial maximum flexion angles did not differ between the two groups over time (n.s.). The average thickness of the PE insert was greater in the MB group (12.0 ± 1.9 vs. 11.2 ± 1.6 mm, respectively, p = 0.008), especially when a large femoral component was used (12.7 ± 1.9 vs. 11.0 ± 1.5 mm, p = 0.005). The pre- and postoperative mechanical axes and positions of the components did not differ between the two groups (n.s.).<bold>Conclusions: </bold>TiN-coated MB TKA showed no significant advantage over FB TKA. The selection of bearing design would be clinically insignificant when using the TiN-coated TKA prosthesis.<bold>Level Of Evidence: </bold>II.
- Subjects
RADIOLOGY; TITANIUM nitride; RANDOMIZED controlled trials; ARTICULAR ligaments; STIFLE joint; KNEE surgery; ARTIFICIAL joints; COMPARATIVE studies; RANGE of motion of joints; KINEMATICS; KNEE diseases; LONGITUDINAL method; MATERIALS testing; RESEARCH methodology; MEDICAL cooperation; OSTEOARTHRITIS; POLYETHYLENE; PROSTHETICS; RESEARCH; TITANIUM; TOTAL knee replacement; EVALUATION research; PREOPERATIVE period
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, Vol 27, Issue 4, p1165
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-018-5095-z