Fixed- versus mobile-bearing total knee arthroplasty: technical issues and surgical tips

Mobile-bearing knee arthroplasties have been used clinically for 25 years. The success of this technology depends on strict adherence to the principles of flexion-extension gap technique. The use of the fixed femoral landmarks for the rotational positioning of the femoral component (measured resection technique) is not acceptable if bearing dislocation is to be avoided. The principles of flexion-extension gap balancing, as well as the surgical technique, are reviewed in this article.