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J Knee Surg 2020; 33(05): 474-480
DOI: 10.1055/s-0039-1678675
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Higher Axial Tibiofemoral Rotation and Functional Outcomes with Mobile-Bearing Compared with Fixed-Bearing Total Knee Arthroplasty at 1- but Not at 2-Year Follow-Up—A Randomized Clinical Trial

Authors

  • Joicemar Tarouco Amaro

    1   Cohen Institute, São Paulo, Brazil

  • João Victor Novaretti 

    2   Department of Orthopaedics and Traumatology, Orthopaedics and Traumatology Sports Center (CETE), Paulista School of Medicine (EPM), Federal University of São Paulo, São Paulo, Brazil

  • Diego Costa Astur

    2   Department of Orthopaedics and Traumatology, Orthopaedics and Traumatology Sports Center (CETE), Paulista School of Medicine (EPM), Federal University of São Paulo, São Paulo, Brazil

  • Elton Luiz Batista Cavalcante

    1   Cohen Institute, São Paulo, Brazil

  • Adilson Góes Rodrigues Junior

    1   Cohen Institute, São Paulo, Brazil

  • Pedro Debieux

    3   Paulista School of Medicine (EPM), Federal University of São Paulo, Brazil Hospital Albert Einstein, São Paulo, Brazil

  • Camila Cohen Kaleka

    1   Cohen Institute, São Paulo, Brazil

  • Moisés Cohen

    2   Department of Orthopaedics and Traumatology, Orthopaedics and Traumatology Sports Center (CETE), Paulista School of Medicine (EPM), Federal University of São Paulo, São Paulo, Brazil
Further Information

Publication History

27 August 2018

27 December 2018

Publication Date:
12 February 2019 (online)

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Abstract

The objective of this study was to determine in vivo knee kinematics and clinical outcomes of patients who underwent fixed- and mobile-bearing total knee arthroplasty (TKA) at 1- and 2-year follow-up. This prospective double-blinded randomized controlled trial was performed from November 2011 to December 2012. A total of 64 patients were randomized to fixed- and mobile-bearing TKA groups (32 patients in each group). All patients were evaluated with the following: three-dimensional in vivo knee kinematics analysis during gait, stepping up and stepping down stair steps, and getting up from and sitting on a chair; and knee range of motion and patient-reported outcome measures (Knee Outcome Survey Activities of Daily Living Scale [KOS-ADLS] and pain visual analog scale [VAS]) at 1- and 2-year follow-up. Descriptive statistics (means, standard deviations, and percentages) were calculated for all variables. The Kolmogorov–Smirnov test was used to test if variables were normally distributed. A Student's t-test was used to compare continuous variables between patients in the two groups. The chi-square test was used to compare the groups with respect to categorical variables. The α level for statistical significance was set at p < 0.05. The mean axial tibiofemoral rotation in patients who underwent mobile-bearing TKA was significantly higher during gait (13.3 vs. 10.7), stepping up (12.8 vs. 10) stair steps, and getting up (16.1 vs. 12.1) from a chair compared with fixed-bearing TKA patients at 1-year follow-up (p < 0.05). KOS-ADLS function score was significantly higher in the mobile-bearing compared with the fixed-bearing TKA group (32 vs. 27.7) at 1-year follow-up (p < 0.05). No significant difference in kinematics and clinical outcomes between fixed- and mobile-bearing TKA groups was observed at 2-year follow-up (p > 0.05). Based on the results of this study, mobile-bearing TKA allowed a higher degree of rotation when walking, stepping up stair steps, and standing up from a chair, and had higher functional outcomes compared with fixed-bearing TKA at 1-year follow-up. However, no difference in in vivo kinematics or in clinical outcomes was observed between fixed- and mobile-bearing prostheses at 2-year follow-up.

Keywords

knee - arthroplasty - fixed-bearing prosthesis - mobile-bearing prosthesis - in vivo kinematics