No differences between fixed- and mobile-bearing total knee arthroplasty.
OBJECTIVE
For years, numerous studies have been performed to determine whether mobile-bearing total knee arthroplasty (MB-TKA) or fixed-bearing total knee arthroplasty (FB-TKA) is the preferential design in total knee arthroplasty. Reviews and meta-analyses on this subject have focused on a relatively small number of randomised controlled trials, possibly missing important results of smaller studies. The goal of this review was to provide a comprehensive overview of all literature comparing MB-TKA and FB-TKA in the treatment of osteoarthritis of the knee.


METHODS
An extensive literature search was performed in the PubMed database. All studies that compared MB-TKA with FB-TKA and looked at one of four theorised advantages (insert wear, signs of loosening, survival rate of the prosthesis and clinical outcome) were included.


RESULTS
The initial search yielded 258 articles, of which 127 were included after the first screening. The included studies consisted of 9 meta-analyses, 3 systematic reviews, 48 RCT's, 44 comparative studies, 10 reviews and 13 studies that examined patients who received bilateral TKA (one MB-TKA and one FB-TKA). Combining the results of all studies showed that almost all studies found no difference between MB-TKA and FB-TKA.


CONCLUSIONS
Even when examining all different types of studies on MB-TKA and FB-TKA, the results of this review showed no difference in insert wear, risk of loosening, survivorship or clinical outcome. In daily practice, the choice between MB-TKA and FB-TKA should be based on the experience and judgment of the surgeon, since no clear differences are observed in the scientific literature.


METHODS
III.
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedics, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands. b.l.fransen@mca.nl.
B L
BL
Fransen
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedics, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
D C
DC
van Duijvenbode
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedics, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.|MOVE Research Institute Amsterdam, VU University Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
M J M
MJM
Hoozemans
CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedics, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
B J
BJ
Burger
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D020370:Osteoarthritis, Knee / Q000601:surgery; D011474:Prosthesis Design
Fixed bearing; Mobile bearing; Review; Total knee arthroplasty