Role of primary bearing type in revision total knee arthroplasty

Although it has been shown that mobile- and fixed-bearing (FB) prostheses yield equivalent functional outcomes, wear patterns and debris types associated with mobile-bearing (MB) knees have been correlated to an increased prevalence of osteolysis. The complexity of revision surgery was compared between both designs. Several markers, including operative time, use of augmentation, bone grafts, and level of constraint, were analyzed. Data support that for failed total knee arthroplasty, there is a significant difference in mean time to revision between the MB (54.7 months) and FB types (80.6 months) (p ≤ 0.0001). MB knees more frequently required hinged implants during revision, potentially increasing the complexity of the procedure. This study raises concern for use of the MB implants, especially in younger patients who are more likely to require a future revision.