title: A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. A multicentre single-blind randomised controlled trial.
abstract: Before proceeding to longer-term studies, we have studied the early clinical results of a new mobile-bearing total knee prosthesis in comparison with an established fixed-bearing device. Patients requiring bilateral knee replacement consented to have their operations under one anaesthetic using one of each prosthesis. They also agreed to accept the random choice of knee (right or left) and to remain ignorant as to which side had which implant. Outcomes were measured using the American Knee Society Score (AKSS), the Oxford Knee Score (OKS), and determination of the range of movement and pain scores before and at one year after operation. Preoperatively, there was no systematic difference between the right and left knees. One patient died in the perioperative period and one mobile-bearing prosthesis required early revision for dislocation of the meniscal component. At one year the mean AKSS, OKS and pain scores for the new device were slightly better (p < 0.025) than those for the fixed-bearing device. There was no difference in the range of movement. We believe that this is the first controlled, blinded trial to compare early function of a new knee prosthesis with that of a standard implant. It demonstrates a small but significant clinical advantage for the mobile-bearing design.
authors.affiliation: Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford, Headington, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Price
authors.forename: J L
authors.initials: JL
authors.lastname: Rees
authors.forename: D
authors.initials: D
authors.lastname: Beard
authors.forename: E
authors.initials: E
authors.lastname: Juszczak
authors.forename: S
authors.initials: S
authors.lastname: Carter
authors.forename: S
authors.initials: S
authors.lastname: White
authors.forename: R
authors.initials: R
authors.lastname: de Steiger
authors.forename: C A F
authors.initials: CA
authors.lastname: Dodd
authors.forename: M
authors.initials: M
authors.lastname: Gibbons
authors.forename: P
authors.initials: P
authors.lastname: McLardy-Smith
authors.forename: J W
authors.initials: JW
authors.lastname: Goodfellow
authors.forename: D W
authors.initials: DW
authors.lastname: Murray
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016037:Single-Blind Method