Comparison of the clinical results of mobilebearing and fixed-bearing prostheses used for total knee arthroplasty in patients with osteoarthritis

Yıl 2022, Cilt: 3 Sayı: 2, 105 - 112, 31.05.2022

Numan Atılgan , Mehmet Türker Özlem Orhan , Recep Memik

Öz

Background: The aim of this study was to investigate the changes in pain, function, stiffness and complications over time in patients with osteoarthritis who underwent total knee arthroplasty (TKA) with fixed or mobile-bearing.

Methods: This study is a prospective cohort type study performed with gonarthrosis patients that underwent TKA. Western Ontario and McMaster Universities Arthritis Index (WOMAC) and American Knee Society Score (AKSS) were used for clinical evaluation (pain, function and stiffness). The post-treatment measurements of patients were performed at the one-year follow-up.

Results: The study group consisted of 63 patients with a mean age of 63.57 ± 8.13 years. WOMAC and AKSS scores of the patients improved significantly in both groups over time. WOMAC pain score was found to be lower in the fixed-bearing group in the postoperative first year. The WOMAC function score was lower in the mobile-bearing group at 6 months and 1 year postoperatively. The AKSS pain score was significantly lower in the mobile-bearing group in the preoperative period and in the fixed-bearing group at postoperative third month. The AKSS function score was significantly lower in the fixed-bearing group in the third and sixth postoperative months. In the postoperative period, no significant difference was found between groups in terms of radiolucent area size, infection and complication development.

Conclusions: Significant clinical improvements were observed in both types of prostheses during the follow-up of patients. While there were differences in clinical outcomes between the groups during the follow-up period, the two groups were similar in terms of complications.

Anahtar Kelimeler

Osteoarthritis, Knee, Arthroplasty, Replacement, Prostheses and Implants.

Kaynakça

• 1. Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16(2):137-62.
• 2. Mabey T, Honsawek S. Cytokines as biochemical markers for knee osteoarthritis. World J Orthop. 2015;6(1):95-105.
• 3. Raeissadat SA, Tabibian E, Rayegani SM, Rahimi-Dehgolan S, Babaei-Ghazani A. An investigation into the efficacy of intra-articular ozone (O2-O3) injection in patients with knee osteoarthritis: a systematic review and meta-analysis. J Pain Res. 2018;11:2537-2550.
• 4. Blanco FJ. Osteoarthritis: something is moving. Reumatol Clin. 2014;10(1):4-5.
• 5. Roos EM, Arden NK. Strategies for the prevention of knee osteoarthritis. Nat Rev Rheumatol. 2016;12(2):92-101.
• 6. Calunga JL, Menéndez S, León R, Chang S, Guanche D, Balbín A, et al. Application of ozone therapy in patients with knee osteoarthritis. Ozone Sci Eng. 2012;34(6):469-75.
• 7. Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000;133(8):635-46.
• 8. Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al.. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207-13.
• 9. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987;30(8):914-8.
• 10. Kaçar C, Gilgil E, Urhan S, Arikan V, Dündar U, Oksüz MC, et al. The prevalence of symptomatic knee and distal interphalangeal joint osteoarthritis in the urban population of Antalya, Turkey. Rheumatol Int. 2005;25(3):201-4.
• 11. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91-7.
• 12. Yüce A, İğde N, Bayraktar TO, Yerli M, Tekin AÇ, Bayraktar MK, Gürbüz H. Intra-articular Methylprednisolone Injection for Advanced Knee Osteoarthritis in Geriatric Patient Population. Arch Curr Med Res 2021;2(1):19-24
• 13. Ulucaköy C, Yapar A, Vural A, Özer H. Is iliac autogenous graft augmentation in medial open wedge high tibial osteotomies superior to no augmentation in terms of bone healing?. Jt Dis Relat Surg 2020;31(2):360-366.
• 14. Mandl LA. Determining who should be referred for total hip and knee replacements. Nat Rev Rheumatol. 2013;9(6):351-7.
• 15. Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, et al. A Randomized, Controlled Trial of Total Knee Replacement. N Engl J Med. 2016;374(7):692
• 16. Hochberg MC, Altman RD, Brandt KD, Clark BM, Dieppe PA, Griffin MR, et al. Guidelines for the medical management of osteoarthritis. Part II. Osteoarthritis of the knee. American College of Rheumatology. Arthritis Rheum. 1995;38(11):1541-6.
• 17. Atay T, Aksoy O, Aydoğan N. The evaluation of the midterm results of the patients applied knee prosthesis with polyethylene mobile bearing and fixed bearing insert. S.D.Ü. Tıp Fak. Derg. 2007;14(4):1-6
• 18. Buechel FF Sr, Buechel FF Jr, Pappas MJ, D’Alessio J. Twentyyear evaluation of meniscal bearing and rotating platform knee replacements. Clin Orthop Relat Res. 2001;388:41-50.
• 19. Sorrells RB. The rotating platform mobile bearing total knee arthroplasty. Surg Technol Int, 2000; 9:245-51.
• 20. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;79(4):373-4.
• 21. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833-40.
• 22. Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage. 2005;13(1):28-33.
• 23. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248: 13-4.
• 24. Fransen BL, van Duijvenbode DC, Hoozemans MJM, Burger BJ. No differences between fixed- and mobile-bearing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25(6):1757-77.
• 25. Xu H, Wang C, Zhang H, Wang Y. [Effectiveness comparison of mobile-bearing and fixed-bearing prostheses in total knee arthroplasty for ten years follow-up]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017;31(3):271-7.
• 26. Hofstede SN, Nouta KA, Jacobs W, van Hooff ML, Wymenga AB, Pijls BG, et al.. Mobile bearing vs fixed bearing prostheses for posterior cruciate retaining total knee arthroplasty for postoperative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev. 2015;(2):CD003130.
• 27. Abdel MP, Tibbo ME, Stuart MJ, Trousdale RT, Hanssen AD, Pagnano MW. A randomized controlled trial of fixed- versus mobile-bearing total knee arthroplasty: a follow-up at a mean of ten years. Bone Joint J. 2018;100-B(7):925-929.
• 28. Emerson RH Jr, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL. Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res. 2002;404:62-70.
• 29. Kim YH, Park JW, Kim JS. The Long-Term Results of Simultaneous High-Flexion Mobile-Bearing and Fixed-Bearing Total Knee Arthroplasties Performed in the Same Patients. J Arthroplasty. 2019;34(3):501-7.
• 30. Chiu KY, Ng TP, Tang WM, Lam P. Bilateral total knee arthroplasty: One mobile-bearing and one fixed-bearing. J Orthop Surg (Hong Kong). 2001;9(1):45-50.
• 31. Stukenborg-Colsman C, Ostermeier S, Hurschler C, Wirth CJ. Tibiofemoral contact stress after total knee arthroplasty: comparison of fixed and mobile-bearing inlay designs. Acta Orthop Scand. 2002;73(6):638-46.
• 32. Callaghan JJ. Mobile-bearing knee replacement: clinical results: a review of the literature. Clin Orthop Relat Res. 2001;392:221-5