title: Midterm Clinical and Radiographic Results of Mobile-Bearing Revision Total Knee Arthroplasty.
abstract: Constrained implants are frequently required in revision total knee arthroplasty (TKA) and are associated with an increase in aseptic component loosening and damage or wear to the constraining mechanisms, compared with primary TKA. The purpose of the following study was to evaluate the midterm clinical and radiographic results including the incidence of bearing complications in a group of patients undergoing revision TKA using mobile-bearing revision TKA implants.
  
  
  
  We retrospectively reviewed 316 consecutive mobile-bearing revision TKAs performed at 2 centers between 2006 and 2010. There were 183 women and 133 men with a mean age of 66 years. The patients were evaluated clinically using the Knee Society scores. A radiographic analysis was performed. Bearing specific complications (ie, instability or dislocation) were recorded.
  
  
  
  Patients were followed-up for a minimum of 24 months and a median of 59.88 months (range 24-121.2). The average Knee Society knee score and function scores increased from 40.8 and 47.9 points preoperatively to 80 points and 70.3 points, respectively (P < .01). The average knee flexion improved from 105.6° preoperatively to 117.4° postoperatively (P < .01). Eight patients required subsequent implant revision. No cases of bearing complications were observed.
  
  
  
  Revision TKA using mobile-bearing revision components demonstrated favorable midterm clinical and radiographic results with no occurrence of bearing instability or dislocation. Longer follow-up is required to evaluate for potential advantages of mobile-bearings over fixed-bearing revision components in terms of polyethylene wear reduction, reduced stress transmission across fixation interfaces, and reduced stress on the polyethylene post.
authors.affiliation: Colorado Joint Replacement, Denver, Colorado; Department of Mechanical and Materials Engineering, University of Denver, Denver, Colorado; Department of Orthopedic Surgery, Marshall University, Huntington, West Virginia.
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Kim
authors.affiliation: Colorado Joint Replacement, Denver, Colorado.
authors.forename: J Ryan
authors.initials: JR
authors.lastname: Martin
authors.affiliation: Colorado Joint Replacement, Denver, Colorado; Department of Mechanical and Materials Engineering, University of Denver, Denver, Colorado; Department of Biomedical Engineering, University of Tennessee, Knoxville, Tennessee; Department of Orthopedics, University of Colorado Health Sciences Center, Aurora, Colorado.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Dennis
authors.affiliation: Colorado Joint Replacement, Denver, Colorado.
authors.forename: Charlie C
authors.initials: CC
authors.lastname: Yang
authors.affiliation: Colorado Joint Replacement, Denver, Colorado.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Jennings
authors.affiliation: Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Gwo-Chin
authors.initials: GC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011183:Postoperative Complications / Q000453:epidemiology*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation / Q000295:instrumentation* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D020959:Polyethylene
keywords: mobile-bearing; outcomes; revision total knee; rotating platform; total knee arthroplasty