Skip to main content
Log in

Mobile versus fixed-bearing total knee arthroplasty: mid-term comparative clinical results of 216 prostheses

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

Abstract

Since the late 1970s, mobile-bearing total knee designs have been advocated as having theoretical advantages over fixed-bearing total knee replacements. At present there is no consensus as to whether there are any differences in clinical results between the two designs. We present the results of two consecutive cohorts each of over 100 prosthesis. The first cohort underwent a fixed-bearing prosthesis, whilst the second cohort received the mobile bearing variant of the same prosthesis. Both groups were assessed pre- and post-operatively using the American Knee Society knee and function scores as well as range of movement and the presence or absence of anterior knee pain. No difference was found statistically significant between the groups, either for the knee score (P=0.068), the function score (P=0.26), the range of movement (P=0.11) or the proportions of anterior knee pain (P=0.06). It is our opinion that mobile bearing knee prosthesis have still to prove their theoretical advantages in clinical practice

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Banks S, Bellemans J, Nozaki H, Whiteside LA, Harman M, Hodge WA (2003) Knee motions during maximum flexion in fixed and mobile-bearing arthroplasties. Clin Orthop 410:131–138

    PubMed  Google Scholar 

  2. Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L (2001) Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop 392:46–55

    PubMed  Google Scholar 

  3. Berger RA, Rubash HE, Seel MJ, Thompson WH, Crossett LS (1993) Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. Clin Orthop 286:40–47

    PubMed  Google Scholar 

  4. Bert JM (1990) Dislocation/subluxation of meniscal bearing elements after New Jersey low-contact stress total knee arthroplasty. Clin Orthop 254:211–215

    PubMed  Google Scholar 

  5. Briard JL, Hungerford DS (1989) Patellofemoral instability in total knee arthroplasty. J Arthroplasty 4(Suppl):S87–S97

    PubMed  Google Scholar 

  6. Buechel FF, Pappas MJ (1986) The New Jersey Low-Contact-Stress Knee Replacement System: biomechanical rationale and review of the first 123 cemented cases. Arch Orthop Trauma Surg 105(4):197–204

    Article  PubMed  CAS  Google Scholar 

  7. Cheng CK, Huang CH, Liau JJ (2003) The influence of surgical malalignment on the contact pressures of fixed and mobile bearing knee prostheses—a biomechanical study. Clin Biomech (Bristol, Avon) 18(3):231–236

    Article  Google Scholar 

  8. Chiu KY, Ng TP, Tang WM, Lam P (2001) Bilateral total knee arthroplasty: one mobile-bearing and one fixed-bearing. J Orthop Surg (Hong Kong) 9(1):45–50

    Google Scholar 

  9. Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB (2003) Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop 416:37–57

    PubMed  Google Scholar 

  10. D’Lima DD, Trice M, Urquhart AG, Colwell CW Jr (2000) Comparison between the kinematics of fixed and rotating bearing knee prostheses. Clin Orthop 380:151–157

    PubMed  Google Scholar 

  11. Elias JJ, Kumagai M, Mitchell I, Mizuno Y, Mattessich SM, Webb JD, Chao EY (2002) In vitro kinematic patterns are similar for a fixed platform and a mobile bearing prosthesis. J Arthroplasty 17(4):467–474

    Article  PubMed  Google Scholar 

  12. Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop 248:9–12

    PubMed  Google Scholar 

  13. Goodfellow J, O’Connor J (1978) The mechanics of the knee and prosthesis design. J Bone Joint Surg Br 60(B3):358–369

    PubMed  Google Scholar 

  14. Grelsamer RP, Bazos AN, Proctor CS (1993) Radiographic analysis of patellar tilt. J Bone Joint Surg Br 75(5):822–824

    PubMed  CAS  Google Scholar 

  15. Grodzki T, Haak H, Behrendt R, Merk H, Krauspe R, Behrent R (2001) Prospective randomized comparative study of early functional outcome of 2 knee joint endoprosthesis systems–rotation plateau versus fixed polyethylene inlay. Z Orthop Ihre Grenzgeb 139(5):393–396

    Article  PubMed  CAS  Google Scholar 

  16. Haas B, Dennis DA, Komistek RD, Brumley JT II, Hammill C (2001) Range of motion of posterior-cruciate-substituting total knee replacements: the effect of bearing mobility. J Bone Joint Surg Am 83A(Suppl 2-Pt 1):51–55

    Google Scholar 

  17. 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 Arthroplasty 17(6):685–692

    Article  PubMed  Google Scholar 

  18. Higashijima K, Ishida A, Fukuoka Y, Hoshino A, Minamitani H (2002) Kinematic analysis of mobile-bearing and fixed-bearing knee prostheses by simulation. Med Biol Eng Comput 40(1):22–28

    Article  PubMed  CAS  Google Scholar 

  19. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop 248:13–14

    PubMed  Google Scholar 

  20. Kienapfel H, Springorum HP, Ziegler A, Klose KJ, Georg C, Griss P (2003) Effect of rotation of the femoral and tibial components on patellofemoral malalignment in knee arthroplasty. Orthopade 32(4):312–318

    Article  PubMed  CAS  Google Scholar 

  21. Kim YH, Kook HK, Kim JS (2001) Comparison of fixed-bearing and mobile-bearing total knee arthroplasties. Clin Orthop 392:101–115

    PubMed  Google Scholar 

  22. Liow RY, Walker K, Wajid MA, Bedi G, Lennox CM (2000) The reliability of the American Knee Society Score. Acta Orthop Scand 71(6):603–608

    Article  PubMed  CAS  Google Scholar 

  23. Matsuda S, Miura H, Nagamine R, Urabe K, Hirata G, Iwamoto Y (2001) Effect of femoral and tibial component position on patellar tracking following total knee arthroplasty: 10-year follow-up of Miller-Galante I knees. Am J Knee Surg 14(3):152–156

    PubMed  CAS  Google Scholar 

  24. 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 416:197–207

    PubMed  Google Scholar 

  25. Nagamine R, Whiteside LA, White SE, McCarthy DS (1994) Patellar tracking after total knee arthroplasty. The effect of tibial tray malrotation and articular surface configuration. Clin Orthop 304:262–271

    PubMed  Google Scholar 

  26. 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):62–67

    Article  PubMed  CAS  Google Scholar 

  27. 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 Arthroplasty 19(1):35–39

    Article  PubMed  Google Scholar 

  28. Ranawat CS, Komistek RD, Rodriguez JA, Dennis DA, Anderle M (2004) In vivo kinematics for fixed and mobile-bearing posterior stabilized knee prostheses. Clin Orthop 418:184–190

    PubMed  Google Scholar 

  29. Stukenborg-Colsman C, Ostermeier S, Hurschler C, Wirth CJ (2002) Tibiofemoral contact stress after total knee arthroplasty: comparison of fixed and mobile-bearing inlay designs. Acta Orthop Scand 73(6):638–646

    Article  PubMed  Google Scholar 

  30. Waters TS, Bentley G (2003) Patellar resurfacing in total knee arthroplasty. A prospective a prospective, randomised study. J Bone Joint Surg Am 85A(2):212–7

    Google Scholar 

  31. Weale AE, Feikes J, Prothero D, O’Connor JJ, Murray D, Goodfellow J (2002) In vitro evaluation of the resistance to dislocation of a meniscal-bearing total knee prosthesis between 30 degrees and 90 degrees of knee flexion. J Arthroplasty 17(4):475–483

    Article  PubMed  CAS  Google Scholar 

  32. Weaver JK, Derkash RS, Greenwald AS (1993) Difficulties with bearing dislocation and breakage using a movable bearing total knee replacement system. Clin Orthop 290:244–252

    PubMed  Google Scholar 

  33. Woolson ST, Northrop GD (2004) Mobile- vs. fixed-bearing total knee arthroplasty: a clinical and radiologic study. J Arthroplasty 19(2):135–140

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. M. Mullins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Biau, D., Mullins, M.M., Judet, T. et al. Mobile versus fixed-bearing total knee arthroplasty: mid-term comparative clinical results of 216 prostheses. Knee Surg Sports Traumatol Arthrosc 14, 927–933 (2006). https://doi.org/10.1007/s00167-006-0070-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-006-0070-5

Keywords

Navigation