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17507 Higher axial tibiofemoral rotation and functional outcomes with mobile-bearing total knee arthroplasty compared to fixed-bearing at one- but not at two-year follow-up: a randomized clinical trial
Paulista School of Medicine (EPM), Federal University of São Paulo, São Paulo, Brazil
Fixed-bearing TKA, despite excellent clinical results, still exhibits polyethylene wear-related problems, such as osteolysis around the implants, especially in younger patients. Meanwhile, the main interest of using mobile-bearing TKA is to reduce polyethylene wear and osteolysis by allowing freedom of the tibial polyethylene insert to rotate around a central post, generating less stress between components. Three-dimensional (3D) in vivo knee kinematics analysis is a valuable method to evaluate physiological and pathological processes that may occur in a prosthetic knee. Changes in knee kinematics during gait and daily living activities can develop after knee arthroplasty, thus a better understanding of the in vivo knee kinematics after these procedures is critical for a better understanding of how these implants behave postoperatively and may help determine the diagnosis of implant failures.
Therefore, the objective of the present study was to determine in vivo knee kinematics and clinical outcomes of patients who underwent fixed- and mobile-bearing TKA at one- and two-year follow-up. Considering the theoretical advantages of mobile-bearing TKA, it was hypothesized that mobile-bearing TKA would have higher axial rotation during gait, stepping up and stepping down stair steps, getting up from a chair and sitting on a chair, and higher range of motion and patient reported outcome measures compared to fixed-bearing TKA at one- and two-year follow-up.
This prospective double-blinded randomized controlled trial was carried out from November 2011 to December 2012 in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guideline for clinical trials. Sixty-four patients were randomized to fixed- and mobile-bearing TKA groups (32 patients in each group). All patients were evaluated with: three-dimensional …
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