No difference between mobile and fixed bearing in primary total knee arthroplasty: a meta-analysis.

Autor: Migliorini F; Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany. migliorini.md@gmail.com., Maffulli N; Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy.; School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, ST4 7QB, Stoke-on-Trent, England.; Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, E1 4DG, London, England., Cuozzo F; Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy., Pilone M; Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy., Elsner K; Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany., Eschweiler J; Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2022 Sep; Vol. 30 (9), pp. 3138-3154. Date of Electronic Publication: 2022 Jul 21.
DOI: 10.1007/s00167-022-07065-5
Abstrakt: Purpose: Both mobile (MB) and fixed (FB) bearing implants are routinely used for total knee arthroplasty (TKA). This meta-analysis compared MB versus FB for TKA in terms of implant positioning, joint function, patient reported outcome measures (PROMs), and complications. It was hypothesised that MB performs better than FB implants in primary TKA.
Methods: This meta-analysis was conducted according to the 2020 PRISMA statement. In February 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar, Embase. All the randomized clinical trials (RCTs) comparing mobile versus fixed bearing for primary TKA were considered.
Results: Data from 74 RCTs (11,116 procedures) were retrieved. The mean follow-up was 58.8 (7.5 to 315.6) months. The MB group demonstrated greater range of motion (ROM) (P = 0.02), Knee Society Score (KSS) score (P < 0.0001), and rate of deep infections (P = 0.02). No difference was found in implant positioning: tibial slope, delta angle, alpha femoral component angle, gamma femoral component angle, beta tibial component angle, tibiofemoral alignment angle, posterior condylar offset, radiolucent lines. No difference was found in duration of the surgical procedure. No difference was found in the following PROMs: Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), function and pain subscales of the KSS score. No difference was found in the rate of anterior knee pain, revision, aseptic loosening, fractures, and deep vein thrombosis.
Conclusion: There is no evidence in support that MB implants promote greater outcomes compared to FB implants in primary TKA.
Level of Evidence: Level I.
(© 2022. The Author(s).)
Databáze: MEDLINE
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