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Fixed- versus mobile-bearing unicondylar knee arthroplasty: are failure modes different?

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

An ongoing controversy exists on whether mobile-bearing design is superior over fixed-bearing design in unicondylar knee arthroplasties (UKAs). The present study conducted a systematic review to ascertain differences in performance between fixed- and mobile-bearing designs in UKAs.

Methods

A literature search was performed in PubMed, Embase, Scopus and the Cochrane Library. A total of 9 comparative studies involving 915 knees comparing outcomes of mobile-bearing UKAs with fixed-bearing UKAs were included in the current analysis. Outcomes of interest included knee function, quality of life, radiographic outcomes, reasons and incidence of reoperation, timing of failures, and survivorship.

Results

The results presented no significant differences between the two designs in terms of knee scores, range of motion, limb alignment, implant positioning, incidence of radiolucent lines and overall reoperation rates. However, their differences have been noted in their modes and timing of failures. Early failures are related to the risk of bearing dislocation in the mobile-bearing design. In contrast, later failures are related to the risk of polyethylene wear in the fixed-bearing design.

Conclusions

The available evidence has not confirmed the advantage of mobile-bearing UKAs over fixed-bearing UKAs but pointed out specific modes of failure.

Level of evidence

Therapeutic study (systematic review and meta-analysis), Level III.

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No benefits or funds were received in support of the study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yisan Road, Shanghai, 200233, People’s Republic of China

    Tao Cheng, Daoyun Chen, Chen Zhu, Xin Mao, Yongyuan Guo & Xianlong Zhang

  2. Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan West Road, Wenzhou, 325027, Zhejiang, People’s Republic of China

    Xiaoyun Pan

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  1. Tao Cheng
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  2. Daoyun Chen
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  3. Chen Zhu
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Correspondence to Xianlong Zhang.

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Cheng, T., Chen, D., Zhu, C. et al. Fixed- versus mobile-bearing unicondylar knee arthroplasty: are failure modes different?. Knee Surg Sports Traumatol Arthrosc 21, 2433–2441 (2013). https://doi.org/10.1007/s00167-012-2208-y

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