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Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

It is preferable to reduce postoperative excessive rotational mismatch between the femur and tibia that causes poor clinical results following total knee arthroplasty (TKA). The aim of this study is to compare postoperative rotational mismatches and clinical outcomes with mobile- and fixed-bearing prostheses.

Materials and methods

This study classified 190 TKAs into two groups equally by propensity score matching: mobile-bearing group (n = 95) and fixed-bearing group (n = 95). Computed tomography images of the whole leg were taken at 2 weeks postoperatively. The component alignments, rotational mismatches between the femur and tibia, and rotations among components were measured three-dimensionally. The knee range of motion, New Knee Society Score (KSS) subjective sores, and Forgotten Joint Score (FJS-12) were assessed at the final follow-up.

Results

Rotational mismatch between the femur and tibia was significantly less in the mobile- (− 0.8° ± 7.3°) than in the fixed-bearing (3.3° ± 8.5°, p < 0.001) group. New KSS functional activity score was significantly poorer in patients with excessive rotational mismatch (61.3 ± 21.4) than in those without it (49.5 ± 20.6, p = 0.02). Comparing mobile-bearing prosthesis, the use of fixed-bearing prosthesis was a risk factor for postoperative excessive rotational mismatch (odds ratio: 2.32, p = 0.03).

Conclusion

When compared to a fixed-bearing prosthesis, TKA using a mobile-bearing prosthesis could suppress the postoperative rotational mismatch between the femur and tibia that causes poor subjective functional activity score. However, since this study was conducted for PS-TKA, the results might not be applicable to other models.

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Acknowledgements

We appreciate the contributions from all group members in the medical stuff at each institution.

Funding

This study was not supported by any funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Orthopedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kitaku, Sakai, Osaka, 591-8025, Japan

    Hideki Ueyama & Susumu Takemura

  2. Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan

    Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta & Hiroaki Nakamura

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  1. Hideki Ueyama
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Correspondence to Hideki Ueyama.

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Ueyama, H., Minoda, Y., Sugama, R. et al. Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty. Arch Orthop Trauma Surg 143, 6781–6790 (2023). https://doi.org/10.1007/s00402-023-04971-2

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