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- Title
Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact.
- Authors
Stralen, R.; Heesterbeek, P.; Wymenga, A.; van Stralen, R A; Heesterbeek, P J C; Wymenga, A B
- Abstract
<bold>Purpose: </bold>In anteroposterior (AP)-gliding mobile-bearing total knee arthroplasty (TKA), the femoral component can theoretically slide forward resulting in a more anterior contact point, causing pain due to impingement. A lower lever arm of the extensor apparatus can also attribute to higher patella pressures and pain. The goal of this study was to determine the contact point in a cohort of mobile- and fixed-bearing TKAs, to determine whether the contact point lies more anteriorly in mobile-bearing TKA and to confirm whether this results in anterior knee pain.<bold>Methods: </bold>We used 38 fixed-bearing TKA and 40 mobile-bearing TKA from a randomized trial with straight lateral knee X-rays and measured the contact point. The functional outcome was measured by Knee Society Score at 12 months postoperatively. Pain scores were analysed using a VAS score (0-100 mm) in all patients at rest and when moving. Difficulty at rising up out of a chair was also assessed using a VAS score.<bold>Results: </bold>The contact point in mobile-bearing TKA was situated at 59.5 % of the AP distance of the tibia and in the fixed-bearing TKA group at 66.1 % (P< 0.05). Patients with mobile- and fixed-bearing TKAs had similar knee scores, pain scores and difficulty in chair rise. No significant correlation was found between contact point and knee pain.<bold>Conclusion: </bold>The hypothesis of a more anterior contact point in the mobile-bearing cohort was confirmed but no correlation with functional and pain scores in this cohort could be found. The tibiofemoral contact point could not be correlated with a different clinical outcome and higher incidence of anterior knee pain. This study further adds to the knowledge on possible differences between mobile- and fixed-bearing prostheses. Next to that, bad outcomes could not be explained by CP.<bold>Level Of Evidence: </bold>Case series, Level IV.
- Subjects
KNEE surgery; ARTIFICIAL joints; LONGITUDINAL method; PROSTHETICS; TOTAL knee replacement; JOINT pain
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2015, Vol 23, Issue 11, p3368
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-014-3178-z