No differences between fixed- and mobile-bearing total knee arthroplasty.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Knee Arthroplasty Research

Background:

• The choice between mobile-bearing total knee arthroplasty (MB-TKA) and fixed-bearing total knee arthroplasty (FB-TKA) remains a subject of ongoing debate in orthopedic surgery.
• Previous reviews have often concentrated on a limited number of randomized controlled trials, potentially overlooking valuable data from smaller studies.

Purpose of the Study:

• To conduct a comprehensive literature review comparing mobile-bearing total knee arthroplasty (MB-TKA) and fixed-bearing total knee arthroplasty (FB-TKA).
• To evaluate all available studies examining insert wear, prosthesis loosening, survival rates, and clinical outcomes for both MB-TKA and FB-TKA in treating knee osteoarthritis.

Main Methods:

• An extensive literature search was conducted using the PubMed database.
• Included studies were those that directly compared MB-TKA and FB-TKA and assessed at least one of the following: insert wear, signs of loosening, prosthesis survival rate, or clinical outcome.
• The review encompassed meta-analyses, systematic reviews, randomized controlled trials, comparative studies, and bilateral TKA studies.

Main Results:

• A total of 127 studies were included after an initial screening of 258 articles.
• The aggregated results from all included study types indicated a lack of significant difference between MB-TKA and FB-TKA.
• No discernible variations were found in insert wear, risk of loosening, survivorship, or clinical outcomes between the two bearing designs.

Conclusions:

• This comprehensive review of all available literature, including diverse study types, found no significant differences between MB-TKA and FB-TKA.
• The findings suggest that insert wear, loosening, survivorship, and clinical outcomes are comparable for both mobile-bearing and fixed-bearing designs.
• The selection between MB-TKA and FB-TKA in clinical practice should be guided by surgeon experience and judgment due to the absence of clear scientific evidence favoring one design over the other.