Comparisons between mobile-bearing and fixed-bearing total knee replacement

Cox, James and Tetsworth, Kevin (2009) Comparisons between mobile-bearing and fixed-bearing total knee replacement. Current Orthopaedic Practice, 20 1: 35-39. doi:10.1097/BCO.0b013e3181944d68

Author Cox, James
Tetsworth, Kevin
Title Comparisons between mobile-bearing and fixed-bearing total knee replacement
Journal name Current Orthopaedic Practice   Check publisher's open access policy
ISSN 1940-7041
Publication date 2009-01-01
Year available 2009
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/BCO.0b013e3181944d68
Open Access Status Not Open Access
Volume 20
Issue 1
Start page 35
End page 39
Total pages 5
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Language eng
Subject 2732 Orthopedics and Sports Medicine
Abstract Many articles have discussed the potential benefits of mobile-bearing total knee arthroplasty (TKA) when compared to fixed-bearing designs. Several manuscripts recently have been published that directly compare these two alternative designs. The goal of this review was to determine if the proposed theoretical advantages of mobile-bearing TKA result in any demonstrable improvement in clinical outcome. Mobile-bearing TKA was introduced in an effort to improve prosthetic longevity by minimizing polyethylene wear while reducing strain at the implant-bone interface. Knee simulator studies in vitro reveal superior wear characteristics for mobile-bearing prostheses when compared with fixed-bearing equivalent designs. The mobile-bearing design also has been shown to more closely match the kinematics of normal knees and patellofemoral joints. Suspicions regarding the disadvantages of mobile bearings, including bearing instability and the detrimental effects of backside wear, remain controversial but are not supported by recent literature. Longitudinal studies evaluating clinical outcomes, however, have been unable to reveal any significant advantage for either of these two different TKA designs. Both kinematic studies and in vitro investigations suggest certain theoretical benefits for mobile-bearing TKA when compared to fixed-bearing designs. Most importantly, however, clinicai outcome studies consistently fail to demonstrate the superiority of mobile-bearing TKA with regard to longevity or functional results.
Keyword Kinematics
Polyethylene wear
Total knee arthroplasty
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
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