Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 6, pp 1669–1675 | Cite as

Survivorship at minimum 10-year follow-up of a rotating-platform, mobile-bearing, posterior-stabilised total knee arthroplasty

  • Michele Ulivi
  • Luca Orlandini
  • Valentina Meroni
  • Olmo Consonni
  • Valerio SansoneEmail author



To evaluate prospectively the long-term clinical and radiographic results and survivorship of a rotating-platform, posterior-stabilised knee prosthesis at minimum 10 years (mean 11.5 ± 1.41 years), and to test the hypothesis that this design would have a mechanical survivorship greater than 95 %.


Between 2000 and 2002, 160 consecutive patients (166 knees) underwent total knee arthroplasty using a rotating-platform, posterior-stabilised prosthesis, and clinical and radiographic follow-up data were gathered prospectively.


One hundred and seven patients (112 knees) were available for final follow-up. Five patients (3 %) had undergone revision surgery, giving a Kaplan–Meier survival rate of 96.6 % for all causes of failure. No spin-out of the polyethylene insert was observed. The mean visual analogue scale, Knee Society and Oxford Knee Scores showed statistically significant improvements (p < 0.001). On radiographs, two cases (2.4 %) had radiolucent lines >2 mm, and no patient had osteolysis.


The absence of osteolysis at minimum 10 years seems to support our hypothesis that this design may be able to reduce peri-prosthetic bone resorption in the long term. The survivorship was greater than 95 % and is comparable to the best results reported for this type of knee prosthesis in the literature. The clinical scores are reasonable, given the presence of various disabling concomitant pathologies and the relatively advanced mean age of the study population. This study is clinically relevant because it adds valuable information to the limited data regarding the long-term survivorship and performance of rotating-platform knee prostheses and, more specifically, of a single knee design.

Level of evidence



Rotating-platform knee Mobile bearing Long-term outcome Survivorship Comorbidities 


  1. 1.
    Bailey O, Ferguson K, Crawfurd E et al (2014) No clinical difference between fixed- and mobile-bearing cruciate-retaining total knee arthroplasty: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00167-014-2877-9 PubMedGoogle Scholar
  2. 2.
    Bert JM (1990) Dislocation/subluxation of meniscal bearing elements after New Jersey lowcontact stress total knee arthroplasty. Clin Orthop Relat Res 254:211–215PubMedGoogle Scholar
  3. 3.
    Blunn GW, Walker PS, Joshi A, Hardinge K (1991) The dominance of cyclic sliding in producing wear in total knee replacements. Clin Orthop Relat Res 273:253–260PubMedGoogle Scholar
  4. 4.
    Bremner-Smith AT, Ewings P, Weale AE (2004) Knee scores in a ‘normal’ elderly population. Knee 11:279–282CrossRefPubMedGoogle Scholar
  5. 5.
    Brinker MR, Lund PJ, Barrack RL (1997) Demographic biases of scoring instruments for the results of total knee arthroplasty. J Bone Joint Surg Am 79A:858–865Google Scholar
  6. 6.
    Buechel FF (2004) Mobile-bearing knee arthroplasty: rotation is our salvation! J Arthroplast 19(4 Suppl. 1):27–30CrossRefGoogle Scholar
  7. 7.
    Callaghan JJ, Insall JN, Greenwald AS et al (2001) Mobile-bearing knee replacement: concepts and results. Instr Course Lect 50:431–449PubMedGoogle Scholar
  8. 8.
    Callaghan JJ, Insall JN, Greenwald AS et al (2000) Mobile-bearing knee replacement: concepts and results. J Bone Joint Surg Am 82:1020–1041Google Scholar
  9. 9.
    Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 80:63–69CrossRefPubMedGoogle Scholar
  10. 10.
    Delport HP, Banks SA, De Schepper J, Bellemans J (2006) A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br 88:1016–1021CrossRefPubMedGoogle Scholar
  11. 11.
    Dennis DA, Komistek RD, Hoff WA, Gabriel SM (1996) In vivo knee kinematics derived using an inverse perspective technique. Clin Orthop Relat Res 331:107–117CrossRefPubMedGoogle Scholar
  12. 12.
    Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB (2003) Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res 416:37–57CrossRefPubMedGoogle Scholar
  13. 13.
    Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12PubMedGoogle Scholar
  14. 14.
    Feng B, Weng X, Lin J, Jin J, Wang W, Qiu G (2013) Long-term follow-up of cemented fixed-bearing total knee arthroplasty in a Chinese population: a survival analysis of more than 10 years. J Arthroplast 28(10):1701–1706CrossRefGoogle Scholar
  15. 15.
    Gioe TJ, Glynn J, Sembrano J, Suthers K, Santos ER, Singh J (2009) Mobile and fixed-bearing (all-polyethylene tibial component) total knee arthroplasty designs. A prospective randomized trial. J Bone Joint Surg Am 91:2104–2112CrossRefPubMedGoogle Scholar
  16. 16.
    Haas BD, Komistek RD, Stiehl JB, Anderson DT, Northcut EJ (2002) Kinematic comparison of posterior cruciate sacrifice versus substitution in a mobile-bearing total knee arthroplasty. J Arthroplast 17:685–692CrossRefGoogle Scholar
  17. 17.
    Hooper G, Rothwell A, Frampton C (2009) The low contact stress mobile-bearing total knee replacement: a prospective study with a minimum follow-up of ten years. J Bone Joint Surg Br 91:58–63CrossRefPubMedGoogle Scholar
  18. 18.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14PubMedGoogle Scholar
  19. 19.
    Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101:101–104CrossRefPubMedGoogle Scholar
  20. 20.
    König A, Scheidler M, Rader C, Eulert J (1997) The need for a dual rating system in total knee arthroplasty. Clin Orthop Relat Res 345:161–167PubMedGoogle Scholar
  21. 21.
    Lädermann A, Lübbeke A, Stern R, Riand N, Fritschy D (2008) Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomised, clinical and radiological study with mid-term results at 7 years. Knee 15:206–210CrossRefPubMedGoogle Scholar
  22. 22.
    Maniar RN, Gupta H, Singh A, Johorey AC, Singhi T (2011) Five- to eight-year results of a prospective study in 118 arthroplasties using posterior-stabilized rotating-platform knee implants. J Arthroplast 26:543–548CrossRefGoogle Scholar
  23. 23.
    McEwen HM, Fisher J, Goldsmith AA, Auger DD, Hardaker C, Stone MH (2001) 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 12:1049–1052CrossRefPubMedGoogle Scholar
  24. 24.
    Meftah M, Ranawat AS, Ranawat CS (2012) Ten-year follow-up of a rotating-platform, posterior-stabilized total knee arthroplasty. J Bone Joint Surg Am 94:426–432PubMedGoogle Scholar
  25. 25.
    Merchant AC, Mercer RL, Jacobsen RH, Cool CR (1974) Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 56:1391–1396PubMedGoogle Scholar
  26. 26.
    Most E, Li G, Schule S, Sultan P, Park SE, Zayontz S, Rubash HE (2003) The kinematics of fixed- and mobile-bearing total knee arthroplasty. Clin Orthop Relat Res 416:197–207CrossRefPubMedGoogle Scholar
  27. 27.
    National Joint Registry of England, Wales and N. Ireland (2013) 10th annual report, p 166.
  28. 28.
    O’Rourke MR, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC (2002) Osteolysis associated with a cemented modular posterior-cruciate-substituting total knee design: five to eight-year follow-up. J Bone Joint Surg Am 84:1362–1371PubMedGoogle Scholar
  29. 29.
    Ranawat AS, Rossi R, Loreti I, Rasquinha VJ, Rodriguez JA, Ranawat CS (2004) Comparison of the PFC Sigma fixed-bearing and rotating-platform total knee arthroplasty in the same patient: short-term results. J Arthroplast 19:35–39CrossRefGoogle Scholar
  30. 30.
    Sansone V, da Gama MalcherM (2004) Mobile-bearing total knee prosthesis. A 5- to 9-year follow-up of the first 110 consecutive arthroplasties. J Arthroplast 19:678–685CrossRefGoogle Scholar
  31. 31.
    Thompson NW, Wilson DS, Cran GW, Beverland DE, Stiehl JB (2004) Dislocation of the rotating-platform after low contact stress total knee arthroplasty. Clin Orthop Relat Res 425:207–211CrossRefPubMedGoogle Scholar
  32. 32.
    Vessely MB, Whaley AL, Harmsen WS, Schleck CD, Berry DJ (2006) The Chitranjan Ranawat Award: long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties. Clin Orthop Relat Res 452:28–34CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Michele Ulivi
    • 1
  • Luca Orlandini
    • 1
  • Valentina Meroni
    • 1
  • Olmo Consonni
    • 2
  • Valerio Sansone
    • 1
    • 2
    Email author
  1. 1.Istituto Ortopedico Galeazzi IRCCSMilanItaly
  2. 2.Università degli Studi di MilanoMilanItaly

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