Abstract
BackgroundDespite growing evidence in the literature, there is still a lack of consensus regarding the use of the mobile-bearing (MB) design total knee arthroplasty (TKA).MethodsIn a prospective, comparative, randomised, single centre trial, 106 patients with end-stage osteoarthritis of the knee were randomised to either an MB or fixed-bearing (FB) group to receive posterior stabilised (PS)-TKA using a standard medial parapatellar approach and patellar resurfacing with follow-up (FU) for 5 years. The primary outcome was anterior knee pain (AKP) during the chair rise test and the stair climb test 5 years after surgery. The secondary outcome was the ability to rise from a chair and to climb stairs, range of motion (ROM), Knee Society Score (KSS), RAND-36 scores and radiological analysis of the patellar tilt.ResultsNo statistically significant difference was found between the two groups at 5 years FU in terms of median AKP during the chair rise test and the stair climb test (p = 0.5 and p = 0.8, respectively). There was no significant difference in any of the other secondary outcome parameters between the groups at 5 years FU.ConclusionA mobile-bearing TKA does not decrease AKP compared to fixed bearings.Trial registration numberClinicalTrials.gov NCT02892838.Level of evidenceII
Highlights
Despite growing evidence in the literature, there is still a lack of consensus regarding the use of the mobile-bearing (MB) design total knee arthroplasty (TKA)
The secondary outcome was the ability to rise from a chair and to climb stairs, range of motion (ROM), Knee Society Score (KSS), RAND-36 scores and radiological analysis of the patellar tilt 5 years after surgery
Forty-seven patients in the MB and 50 patients in the FB group were available for the baseline data
Summary
Despite growing evidence in the literature, there is still a lack of consensus regarding the use of the mobile-bearing (MB) design total knee arthroplasty (TKA). Total knee arthroplasty (TKA) is a successful surgical treatment for osteoarthritis of the knee [1,2,3]. This intervention results in excellent long-term survivorship [4,5,6,7] and marked improvement in functional capacity and quality of life for the patients [8]. According to Heergaard [35] TKA leads in most cases to different patellar tracking and increased patellofemoral contact pressures. The question is how to achieve optimal tibio-femoral and patellofemoral kinematics
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