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- Title
No difference in patellar position between mobile-bearing and fixed-bearing total knee arthroplasty for medial osteoarthritis: a prospective randomized study.
- Authors
Sappey-Marinier, Elliot; de Abreu, Felipe Galvão A.; O'Loughlin, Padhraig; Gaillard, Romain; Neyret, Philippe; Lustig, Sebastien; Servien, Elvire
- Abstract
<bold>Purpose: </bold>Total knee arthroplasty (TKA) is the treatment of choice for severe osteoarthritis of the knee. Many studies have been performed comparing mobile- and fixed-bearing designs; however, there are insufficient data regarding the patellar position in either system. This study aimed to compare the resultant patellar position with a mobile- versus a fixed-bearing TKA and the influence of both designs on clinical outcomes.<bold>Materials and Methods: </bold>In this prospective randomized study, between 2007 and 2009, 160 TKA patients were assessed; 79 received a mobile-bearing and 81 received a fixed-bearing implant, for medial compartment osteoarthritis. A posteriorly stabilized, HLS Noetos knee prosthesis (Tornier, Saint-Ismier, France) was used in all cases. The only difference between the groups was whether the tibial component incorporated a fixed or mobile bearing. The patella was resurfaced in all cases. The International Knee Society Score (KSS) and the patellar tilt and translation were compared post-operatively. Patellar translation and patellar tilt analyses were subdivided into two subgroups (< 5 mm vs > 5 mm and < 5° vs > 5°).<bold>Results: </bold>The KSS was not statistically different between the groups at a mean follow-up of 7.4 years (range 5-11 years). Patellar translation and patellar tilt were not statistically different between the groups. When considering the patellar translation subgroup analysis, a significantly increased risk of patellar translation, greater than 5 mm, was found in the mobile-bearing group compared to fixed-bearing group (OR = 2.3; p = 0.048) without generating any meaningful difference in clinical outcomes.<bold>Conclusion: </bold>The theoretical advantages of mobile-bearing implants compared to fixed-bearing implants were not demonstrated in this randomized study, at mid-term follow-up. In daily practice, the choice between mobile-bearing and fixed-bearing designs should be based on the experience and clinical judgment of the surgeon.<bold>Level Of Evidence: </bold>Prospective randomized study, level I.
- Subjects
TOTAL knee replacement; OSTEOARTHRITIS; KNEE; SURGEONS; PATELLAR tendon; KNEE surgery; TIBIA surgery; KNEE diseases; PROSTHETICS; RESEARCH; PATELLA; RANGE of motion of joints; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; ARTIFICIAL joints; COMPARATIVE studies; RANDOMIZED controlled trials; LONGITUDINAL method
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2020, Vol 28, Issue 5, p1542
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-019-05565-5