title: A randomised controlled clinical trial and gait analysis of fixed- and mobile-bearing total knee replacements with a five-year follow-up.
abstract: This study compared the outcome of total knee replacement (TKR) in adult patients with fixed- and mobile-bearing prostheses during the first post-operative year and at five years' follow-up, using gait parameters as a new objective measure. This double-blind randomised controlled clinical trial included 55 patients with mobile-bearing (n = 26) and fixed-bearing (n = 29) prostheses of the same design, evaluated pre-operatively and post-operatively at six weeks, three months, six months, one year and five years. Each participant undertook two walking trials of 30 m and completed the EuroQol questionnaire, Western Ontario and McMaster Universities osteoarthritis index, Knee Society score, and visual analogue scales for pain and stiffness. Gait analysis was performed using five miniature angular rate sensors mounted on the trunk (sacrum), each thigh and calf. The study population was divided into two groups according to age (≤ 70 years versus > 70 years). Improvements in most gait parameters at five years' follow-up were greater for fixed-bearing TKRs in older patients (> 70 years), and greater for mobile-bearing TKRs in younger patients (≤ 70 years). These findings should be confirmed by an extended age controlled study, as the ideal choice of prosthesis might depend on the age of the patient at the time of surgery.
authors.affiliation: Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland, Switzerland. brigitte.jolles-haeberli@chuv.ch
authors.forename: B M
authors.initials: BM
authors.lastname: Jolles
authors.forename: A
authors.initials: A
authors.lastname: Grzesiak
authors.forename: A
authors.initials: A
authors.lastname: Eudier
authors.forename: H
authors.initials: H
authors.lastname: Dejnabadi
authors.forename: C
authors.initials: C
authors.lastname: Voracek
authors.forename: C
authors.initials: C
authors.lastname: Pichonnaz
authors.forename: K
authors.initials: K
authors.lastname: Aminian
authors.forename: E
authors.initials: E
authors.lastname: Martin
mesh_terms: D000367:Age Factors; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000534:rehabilitation; D004311:Double-Blind Method; D005260:Female; D005684:Gait; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D010147:Pain Measurement / Q000379:methods; D011474:Prosthesis Design; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome