A comparative analysis between fixed bearing total knee arthroplasty (PFC Sigma) and rotating platform total knee arthroplasty (PFC-RP) with minimum 3-year follow-up
- 424 Downloads
Since the introduction of mobile bearing total knee designs nearly 30 years back, many studies have been done to evaluate its long-term result. Comparison with fixed bearing designs has been done in the past, but the studies were confounded by variables such as disease, surgeon, bone quality, pain tolerance, etc. We attempt to eliminate these variables in this study.
A total of 50 patients who had bilateral arthritis of the knee with similar deformity and pre-operative range of motion on both sides agreed to have one knee replaced with mobile bearing total knee design (PFC-RP) and the other with a fixed bearing design (PFC Sigma) were prospectively evaluated. Comparative analysis of both the designs was done at a mean follow-up of 40 months, minimizing patient, surgeon and observer related bias. Clinical and radiographic outcome, survival and complication rates were compared.
At a mean follow-up of 40 months (range 36–47 months), no benefit of mobile bearing (PFC-RP) over fixed bearing design (PFC Sigma) could be demonstrated with respect to Knee Society scores, pain scores, range of flexion, subject preference or patello-femoral complication rates. Radiographs showed no difference in prosthetic alignment. No patient required a revision surgery till last follow-up.
Our study demonstrated no advantage of the mobile-bearing arthroplasty over fixed bearing arthroplasty with regard to clinical results at short-term follow-up. However, longer follow-up is necessary to confirm whether these results are sustained.
KeywordsMobile bearing Fixed bearing Rotating platform Knee score
- 2.Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D (1997) Total knee replacement in young, active patients. Long-term follow-up and functional outcome. J Bone Joint Surg Am 79-A:575–582Google Scholar
- 3.Insall JN, Hood RW, Flawn LB, Sullivan DJ (1983) The total condylar knee prosthesis in gonarthrosis: a five to nine-year follow-up of the first one hundred consecutive replacements. J Bone Joint Surg Am 65-A:619–628Google Scholar
- 4.Ritter M (1998) 15 year results with the AGC knee. Read at the Annual Meeting on Current Concepts in Joint Replacement, Orlando, FloridaGoogle Scholar
- 5.Stern SH, Insall JN (1992) Posterior stabilized prosthesis. Results after follow-up of nine to twelve years. J Bone Joint Surg Am 74-A:980–986Google Scholar
- 8.Werner F, Foster D, Murray DG (1978) The influence of design on transmission of torque across knee prosthesis. J Bone Joint Surg Am 60A:342–348Google Scholar
- 22.Jacobs W, Anderson P, Limbeek J, Wymenga A (2004) Mobile bearing vs fixed bearing prostheses for total knee arthroplasty for post-operative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev (2):CD003130Google Scholar
- 26.Vasdev A, Kumar S, Chadha G, Mandal SP (2009) Fixed- versus mobile-bearing total knee arthroplasty in Indian patients. J Orthop Surg (Hong Kong) 17(2):179–182Google Scholar
- 29.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 (2003) A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial. J Bone Joint Surg Br 85(1):62–67PubMedCrossRefGoogle Scholar
- 31.Wohlrab D, Ditl J, Herrschelmann R, Schietsch U, Hein W, Hube R (2005) Does the NexGen LPS flex mobile knee prosthesis offer advantages compared to the NexGen LPS?—a comparison of clinical and radiological results. Z Orthop Ihre Grenzgeb 143(5):567–572 (article in German)PubMedCrossRefGoogle Scholar
- 35.Callaghan JJ, Squire MW, Goetz DD, Sullivan PM, Johnston RC (2000) Cemented rotating-platform total knee replacement. A nine to twelve-year follow-up study. J Bone Joint Surg 82A:705–711Google Scholar