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Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis

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

Abstract

Purpose

Two design concepts are currently used for unicondylar knee arthroplasty (UKA) prostheses: fixed bearing (FB) and mobile bearing (MB). While MB prostheses have theoretical advantages over their FB counterparts, it is not clear whether they are associated with better outcomes. A systematic review was conducted to examine survivorship differences and differences in failure modes of between FB and MB designs.

Methods

PubMed, Scirus and Cochrane library databases were searched for medial UKA outcome studies. A total of 44 papers, involving 9,463 knees, were eligible. Outcomes examined included knee function, survivorship and the reasons for, and incidence of, revision for FB and MB prostheses. Random effects meta-analysis was employed to obtain pooled revision rate estimates. Where available, cause-specific time to revision was extracted.

Results

Mean follow-up was 8.7 years for FB and 5.9 years for MB prostheses. There were no other relevant baseline differences. The overall crude revision rate for FB and for MB prostheses was 0.90 (95 % confidence interval (CI) 0.65–1.21) and 1.51 (95 % CI 1.11–1.93) per 100 component years, respectively. After stratification on follow-up time and age, the revision rates were not substantially different, aside for younger patients in short term from studies with short-term follow-up.

Conclusion

No essential differences between the two designs were observed. MB and FB UKA designs have comparable revision rates. As our study is based on predominantly observational data, with large variations in reporting standards, inferences should be drawn with caution.

Level of evidence

IV.

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Acknowledgments

The authors thank Biomet Europe BV for an unrestricted grant and Liam Davenport (AMR Advanced Medical Research) for the writing support.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ziekenhuis Netwerk Antwerp, Campus Stuivenberg, Antwerp, Belgium

    Geert Peersman & Tom Vandenlangenbergh

  2. Department of Orthopaedic Surgery, St Augustinus ziekenhuis, Antwerp, Belgium

    Bart Stuyts

  3. Institu du Genou, Clinique Hartmann, Neuilly sur Seine, Paris, France

    Philippe Cartier

  4. AMR Advanced Medical Research, Hofenstrasse 89b, 8708, Männedorf, Switzerland

    Peter Fennema

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  1. Geert Peersman
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Correspondence to Geert Peersman.

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Peersman, G., Stuyts, B., Vandenlangenbergh, T. et al. Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 23, 3296–3305 (2015). https://doi.org/10.1007/s00167-014-3131-1

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