Skip to main content
SpringerLink
Log in

Mobile-Bearing Knee Prostheses

  • Reference work entry
  • First Online:
European Surgical Orthopaedics and Traumatology

  • 277 Accesses

Abstract

Today’s “gold standard” in Total Knee Arthroplasty is a well-functioning and patient-satisfying implant with a survivorship of more than 85 % after 20 years. In order to achieve this goal the prosthetic design must address decreased polyethylene contact stresses and decreased constraint forces at the implant bone interface at the same time. Mobile bearings in TKA are beneficial in the conflict between articulating congruency versus constraint forces on the polyethylene, thereby reducing polyethylene wear debris, which is the ultimate reason for late failures. However, some mobile-bearing devices showed increased wear patterns, when a multi-directional polyethylene device was utilized. Recent research in this field has demonstrated a significant increase in “multi-directional” devices, whereas “uni-directional” motion of polyethylene onlays lead to reduced wear due to strengthening of the material. Both the LCS and the INNEX UCOR design meet the criteria of favourable uni-directional wear patterns. Potential complications in mobile bearing TKA include “spin-out” and soft tissue impingement. Therefore, exacting surgical technique is required, when mobile-bearing devices are used. Long-term data in the literature suggest, that the longevity of mobile bearing TKA are equal or longer when compared with fixed bearing devices.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 949.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Banks SA, Markovich GD, Hodge WA. In vivo kinematics of cruciate retaining and substituting knee arthroplasties. J Arthroplast. 1997;12:297–304.

    Article  CAS  Google Scholar 

  2. Berger RA, Seel MJ, Crossett LS, Rubash HE. The role of component malrotation in tibial polyethylene wear and failure after TKA. Orthop Trans. 1995;19:527.

    Google Scholar 

  3. Boldt JG, Stiehl JB, Munzinger U, Beverland D, Keblish PA. Femoral component rotation in mobile-bearing total knee arthroplasty. Knee. 2006;13(4):284–9.

    Article  CAS  PubMed  Google Scholar 

  4. Bourne RB, Whitewood CN. The role of rotating platform total knee replacements: design considerations, kinematics, and clinical results. J Knee Surg. 2002;15(4):247–53. Fall.

    PubMed  Google Scholar 

  5. Bourne RB, Masonis J, Anthony M. An analysis of rotating-platform total knee replacements. Clin Orthop. 2003;410:173–80.

    Article  PubMed  Google Scholar 

  6. Bradly J, Goodfellow JW, Oconnor J. Radiographic study of bearing movement in unicompartmental oxford knee replacement. JBJS. 1987;69B:598–601.

    Google Scholar 

  7. Breugem SJ, Sierevelt IN, Schafroth MU, Blankevoort L, Schaap GR, van Dijk CN. Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis. Clin Orthop Relat Res. 2008;466(8):1959–65.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Buechel Sr FF, Buechel Jr FF, Pappas MJ, D’Alessio J. Twenty-year evaluation of meniscal bearing and rotating platform knee replacements. Clin Orthop. 2001;388:41–50.

    Article  PubMed  Google Scholar 

  9. Buechel Sr FF, Buechel Jr FF, Pappas MJ, Dalessio J. Twenty-year evaluation of the New Jersey LCS rotating platform knee replacement. J Knee Surg. 2002;15(2):84–9.

    PubMed  Google Scholar 

  10. Buechel Sr FF, Buechel Jr FF, Pappas MJ. Ten-year evaluation of cementless buechel-pappas meniscal bearing total ankle replacement. Foot Ankle Int. 2003;24(6):462–72.

    PubMed  Google Scholar 

  11. Buechel FF. Recurrent LCS, rotating platform dislocation in revision total knee replacement: mechanism, management, and report of two cases. Orthopedics. 2003;26(6):647–9.

    PubMed  Google Scholar 

  12. Buechel Sr FF. Long-term followup after mobile-bearing total knee replacement. Clin Orthop. 2002;404:40–50.

    Article  PubMed  Google Scholar 

  13. Callaghan JJ. Mobile-bearing knee replacement: clinical results: a review of the literature. Clin Orthop. 2001;392:221–5.

    Article  PubMed  Google Scholar 

  14. Chouteau J, Lerat JL, Testa R, Moyen B, Fessy MH, Banks SA. Mobile-bearing insert translational and rotational kinematics in a PCL-retaining total knee arthroplasty. Orthop Traumatol Surg Res. 2009;95(4):254–9.

    Article  CAS  PubMed  Google Scholar 

  15. Collier JP, Major MB, McNamara JL, Surprenant JA, Jensen RE. Analysis of the failure of 122 polyethylene inserts from uncemented tibial components. Clin Orthop. 1991;273:232–42.

    PubMed  Google Scholar 

  16. Cornwall GB, Rudan J, Bryant JT, Deluzio KJ, Simurda MA, Sorbie C. The distribution of surface degradation mechanisms in TKA. A comparison of fixed bearings versus mobile bearing designs. JBJS. 1998;80B(Suppl):I-37.

    Google Scholar 

  17. Delport HP, Banks SA, De Schepper J, Bellemans J. A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br. 2006;88(8):1016–21.

    Article  CAS  PubMed  Google Scholar 

  18. Dennis DA, Komistek RD, Walker SA, Anderson DT. In vivo analysis of tibiofemoral rotation: does screw home rotation occur after TKA? Trans Orthop Res Soc. 1997;23:386.

    Google Scholar 

  19. Dorr LD. Contrary view: wear is not an issue. Clin Orthop. 2002;404:96–9.

    Article  PubMed  Google Scholar 

  20. Gill GS, Joshi AB, Mills DM. Total condylar knee arthroplasty. 16- To 21-year results. Clin Orthop. 1999;367:210–5.

    Article  PubMed  Google Scholar 

  21. Jordan LR, Olivio JL, Voorhoorst PE. Survival analysis of cementless meniscal bearing total knee arthroplasty. Clin Orthop. 1997;338:119–23.

    Article  PubMed  Google Scholar 

  22. Jordan LR, Dowd JE, Olivo JL, Voorhorst PE. The clinical history of mobile-bearing patella components in total knee arthroplasty. Orthopedics. 2002;25(2 Suppl):s247–50.

    PubMed  Google Scholar 

  23. Jones VC, Williams IR, Auger DD, Walsh W, Barton DC, Stone MH, Fisher J. Quantification of third body damage to the tibial counterface in mobile bearing knees. Proc Inst Mech Eng H. 2001;215(2):171–9.

    Article  CAS  PubMed  Google Scholar 

  24. Kijm H, Pelker PR, Lynch JK, Gibson DH, Irving JF. Radiographic analysis of the “rollback” phenomenon in posterior cruciate retaining total knee arthroplasty. AAOS. 1995;19:1170.

    Google Scholar 

  25. Kramers-de Quervain IA, Stüssi E, Müller R, Drobny T, Munzinger U, Gschwend N. Quantitative gait analysis after bi-lateral TKA with two different systems within each subject. J Arthroplasty. 1997;12:168–79.

    Article  CAS  PubMed  Google Scholar 

  26. Kuster MS, Wood GA, Stachowiak GW, Gächter A. Joint load considerations in total knee replacement. JBJS. 1997;79B:109–13.

    Article  Google Scholar 

  27. McEwen HM, Fisher J, Goldsmith AA, Auger DD, Hardaker C, Stone MH. Wear of fixed bearing and rotating platform mobile bearing knees subjected to high levels of internal and external tibial rotation. J Mater Sci Mater Med. 2001;12(10–12):1049–52.

    Article  CAS  PubMed  Google Scholar 

  28. Moilanen T, Freemann MAR. The case for resection of the posterior cruciate ligament. J Arthroplasty. 1995;10:564–7.

    Article  Google Scholar 

  29. Poilvache PL, Insall JN, Scuderi GR, Font-Rodriguez DE. Rotational landmarks and sizing of the distal femur in total knee arthroplasty. Clin Orthop. 1996;331:35–46.

    Article  PubMed  Google Scholar 

  30. Polyzoides AJ. The rotaglide total knee arthroplasty. Prosthesis, design and early results. J Arthroplasty. 1996;11:453–9.

    Article  CAS  PubMed  Google Scholar 

  31. Price AJ, Rees JL, Beard D, Juszczak E, Carter S, White S, de Steiger R, Dodd CA, Gibbons M, McLardy-Smith P, Goodfellow JW, Murray DW. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial. J Bone Joint Surg Br. 2003;85(1):62–7.

    Article  CAS  PubMed  Google Scholar 

  32. Ranawat CS. History of total knee replacement. J South Orthop Assoc. 2002;11(4):218–26.

    PubMed  Google Scholar 

  33. Rand JA, Trousdale RT, Ilstrup DM, Harmsen WS. Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am. 2003;85-A(2):259–65.

    PubMed  Google Scholar 

  34. Sathavisan S, Walker PS. Optimisation of meniscal knee design to eliminate the stresses which cause delamination wear. JBJS. 1998;80B(Suppl I):37.

    Google Scholar 

  35. Schunck J, Jerosch J. Knee arthroplasty. Mobile- and fixed-bearing design. Orthopade. 2003;32(6):477–83.

    CAS  PubMed  Google Scholar 

  36. Sharma A, Komistek RD, Ranawat CS, Dennis DA, Mahfouz MR. In vivo contact pressures in total knee arthroplasty. J Arthroplasty. 2007;22(3):404–16.

    Article  PubMed  Google Scholar 

  37. Skwara A, Tibesku CO, Ostermeier S, Stukenborg-Colsman C, Fuchs-Winkelmann S. Differences in patellofemoral contact stresses between mobile-bearing and fixed-bearing total knee arthroplasties: a dynamic in vitro measurement. Arch Orthop Trauma Surg. 2009;129(7):901–7.

    Article  PubMed  Google Scholar 

  38. Sorrells RB. The clinical history and development of the low contact stress total knee arthroplasty. Orthopedics. 2002;25(2 Suppl):s207–12.

    PubMed  Google Scholar 

  39. Stiehl JB, Komistek RD, Dennis DA, Paxson RD, Hoff WA. Fluoroscopic analysis of kinematics after posterior cruciate retaining arthroplasty. JBJS. 1995;77B:884–9.

    Google Scholar 

  40. Stiehl JB. Comparison of long-term results with cruciate substituting or sparing mobile bearing cementless total knee arthroplasty. Orthop Trans. 1996;20:928.

    Google Scholar 

  41. Stiehl JB, Abbott B. A morphological analysis of the transepicondylar axis and the relationship of the mechanical axis of the leg. J Arthroplasty. 1995;10:785–9.

    Article  CAS  PubMed  Google Scholar 

  42. Stiel JB, Cheverny PM. Femoral rotational alignment using the tibial shaft axis in total knee arthroplasty. Clin Orthop. 1996;331:47–55.

    Article  Google Scholar 

  43. Stiehl JB. Comparison of tibial rotation in fixed and mobile bearing total knee arthroplasty using computer navigation. Int Orthop. 2009;33(3):679–85.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Tamaki M, Tomita T, Watanabe T, Yamazaki T, Yoshikawa H, Sugamoto K. In vivo kinematic analysis of a high-flexion, posterior-stabilized, mobile-bearing knee prosthesis in deep knee bending motion. J Arthroplast. 2008 Nov 24. [Epub ahead of print]

    Google Scholar 

  45. Tarnowski LE, Andriacchi TP, Berger RA, Galante JO, Rosenberg AG. Three dimensional motion of cruciate retaining and cruciate stabilized knees during walking. Trans Orthop Res Soc. 1998;23:804.

    Google Scholar 

  46. Vertullo CJ, Easley ME, Scott WN, Insall JN. Mobile bearings in primary knee arthroplasty. J Am Acad Orthop Surg. 2001;9(6):355–64.

    CAS  PubMed  Google Scholar 

  47. Yang CC, McFadden LA, Dennis DA, Kim RH, Sharma A. Lateral retinacular release rates in mobile- versus fixed-bearing TKA. Clin Orthop Relat Res. 2008;466(11):2656–61.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Wasielewski RC. The causes of insert backside wear in total knee arthroplasty. Clin Orthop. 2002;404:232–46.

    Article  PubMed  Google Scholar 

  49. Witoolkollachit P, Seubchompoo O. The comparison of femoral component rotational alignment with transepicondylar axis in mobile bearing TKA, CT-scan study. J Med Assoc Thai. 2008;91(7):1051–8.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopädie am Zürichberg, Toblerstr. 51, 8044, Zurich, CH, Switzerland

    Urs K. Munzinger

  2. Siloah Hospital Guemligen, Orthopaedic Centre, Mettlengaessli 4, 8044, Muri/Bern, CH, Switzerland

    Jens G. Boldt

Authors
  1. Urs K. Munzinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jens G. Boldt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Urs K. Munzinger .

Editor information

Editors and Affiliations

  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

Rights and permissions

Reprints and permissions

Copyright information

© 2014 EFORT

About this entry

Cite this entry

Munzinger, U.K., Boldt, J.G. (2014). Mobile-Bearing Knee Prostheses. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_142

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-34746-7_142

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation