Is there reduced polyethylene wear and longer survival when using a mobile-bearing design in total knee replacement? A meta-analysis of randomised and non-randomised controlled trials

Bone Joint J. 2013 Aug;95-B(8):1057-63. doi: 10.1302/0301-620X.95B8.31310.

Abstract

The purpose of this study was to undertake a meta-analysis to determine whether there is lower polyethylene wear and longer survival when using mobile-bearing implants in total knee replacement when compared with fixed-bearing implants. Of 975 papers identified, 34 trials were eligible for data extraction and meta-analysis comprising 4754 patients (6861 knees). We found no statistically significant differences between the two designs in terms of the incidence of radiolucent lines, osteolysis, aseptic loosening or survival. There is thus currently no evidence to suggest that the use of mobile-bearing designs reduce polyethylene wear and prolong survival after total knee replacement.

Keywords: Fixed-bearing; Meta-analysis; Mobile-bearing; Polyethylene wear; Prosthetic survival; Total knee arthroplasty.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / instrumentation*
  • Arthroplasty, Replacement, Knee / methods
  • Humans
  • Knee Prosthesis* / adverse effects
  • Osteolysis / etiology
  • Polyethylene*
  • Prosthesis Design
  • Prosthesis Failure / etiology
  • Randomized Controlled Trials as Topic
  • Surface Properties

Substances

  • Polyethylene