No difference between fixed- and mobile-bearing total knee arthroplasty in activities of daily living and pain: a randomized clinical trial

Knee Surg Sports Traumatol Arthrosc. 2017 Jun;25(6):1692-1696. doi: 10.1007/s00167-016-4106-1. Epub 2016 Apr 7.

Abstract

Purpose: Until now, there are no definitive conclusions regarding functional differences related to middle- and long-term everyday activities and patient pain following implantation of mobile- and fixed-platform tibial prostheses. The aim of this study was to determine whether there are middle-term differences in knee function and pain in patients undergoing fixed- and mobile-bearing total knee arthroplasty (TKA).

Methods: Eligible patients were randomized into two groups: the first group received TKA implantation with a fixed tibial platform (group A); the second group received TKA with a mobile tibial platform (group B). Patients were followed up (2 years), and their symptoms and limitations in daily living activities were evaluated using the Knee Outcome Survey-Activities of Daily Living Scale (ADLS), in addition to pain evaluation assessed using the pain visual analogue scale (VAS).

Results: There were no significant differences in function and symptoms in the ADLS and VAS between the study groups.

Conclusion: The type of platform used in TKA (fixed vs. mobile) does not change the symptoms, function or pain of patients 2 years post-surgery. Although mobile TKAs may have better short-term results, at medium- and long-term follow-up they do not present important clinical differences compared with fixed-platform TKAs. This information is important so that surgeons can choose the most suitable implant for each patient.

Level of evidence: Randomized clinical trial, Level I.

Keywords: Arthroplasty; Clinical trial; Knee; Pain; Replacement.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Arthroplasty, Replacement, Knee* / methods
  • Double-Blind Method
  • Female
  • Humans
  • Knee Prosthesis*
  • Magnetic Resonance Imaging
  • Male
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / psychology
  • Osteoarthritis, Knee / surgery*
  • Pain Measurement
  • Pain, Postoperative
  • Treatment Outcome