Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis.
Anterior knee pain is one of the major short-term complaints after TKA. Since the introduction of the mobile-bearing TKA, numerous studies have attempted to confirm the theoretical advantages of a mobile-bearing TKA over a fixed-bearing TKA but most show little or no actual benefits. The concept of self-alignment for the mobile bearing suggests the posterior-stabilized mobile-bearing TKA would provide a lower incidence of anterior knee pain compared with a fixed-bearing TKA. We therefore asked whether the posterior-stabilized mobile-bearing knee would in fact reduce anterior knee pain. We randomized 103 patients scheduled for cemented three-component TKA for osteoarthrosis in a prospective, double-blind clinical trial. With a 1-year followup, more patients experienced persistent anterior knee pain in the posterior-stabilized fixed-bearing group (10 of 53, 18.9%) than in the posterior-stabilized mobile-bearing group (two of 47, 4.3%). No differences were observed for range of motion, visual analog scale for pain, Oxford 12-item questionnaire, SF-36, or the American Knee Society score. The posterior-stabilized mobile-bearing knee therefore seems to provide a short-term advantage compared with the posterior-stabilized fixed-bearing knee.


METHODS
Level I, therapeutic study.
Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. s.j.breugem@amc.uva.nl
Stefan J M
SJ
Breugem
Inger N
IN
Sierevelt
Matthias U
MU
Schafroth
Leendert
L
Blankevoort
Gerard R
GR
Schaap
C Niek
CN
van Dijk
D000328:Adult; D018771:Arthralgia / Q000517:prevention & control*; D019645:Arthroplasty, Replacement, Knee; D004311:Double-Blind Method; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D010147:Pain Measurement; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011474:Prosthesis Design; D016059:Range of Motion, Articular