A meta-analysis of the fixed-bearing and mobile-bearing prostheses in total knee arthroplasty

Abstract

We asked whether the mobile-bearing knee prostheses could offer clinical and radiographic advantages over the fixed-bearing knee prostheses. We conducted a systematic review and meta-analysis to evaluate the validity of this theory. We searched PubMed, EMBASE, Ovid and the Cochrane Central Register of Controlled Trials from January 1979 to June 2010 for randomized controlled studies comparing the effect of fixed- and mobile-bearing prostheses in TKA. We assessed the methodological quality of the studies and abstracted the relevant data independently. 15 studies involving 1,950 knees were identified in this analysis. No statistically significant difference was present in terms of KSS, patient preference, radiolucent line around implant and prosthesis-related complications as compared to the fixed- and mobile-bearing knee design. Theoretically, mobile-bearing implant design could improve clinical and radiographic outcomes as being compared to fixed-bearing implant design, but the anticipated effectiveness has not been implemented in the current clinical practice at mid-term follow up.