[Recent clinical comparison of mobile-bearing and fixed-bearing total knee arthroplasty].

OBJECTIVE: To compare the preliminary effectiveness of mobile-bearing prosthesis and fixed-bearing prosthesis by literature review and observation of cases.

METHODS: Ninety-eight knees of 94 patients undergoing total knee arthroplasty (TKA) by using cemented and PCL-substitute prosthesis were reviewed from February 2003 to October 2004. The diagnosis of all patients were osteoarthritis. All cases were followed up at least one year. Group A (fixed-bearing prosthesis): 30 knees of 29 patients, 4 males, 25 females, 20 DePuy Prosthesis, 10 Centerpulse Prosthesis. Group B (mobile-bearing prosthesis): 68 knees of 65 patients, 11 males, 54 females, 68 Centerpulse Prosthesis. Make sure statistical comparability between 2 groups by HSS, age and gender, respectively. Postoperation 6 weeks, 3 months, 6 months, 1 year, all cases were evaluated according to Hss and self-satisfaction.

RESULTS: The grades of Hss in different stage were performed statistical analysis. P value in different stage was 0.414 (6 weeks), 0.108 (3 months), 0.235 (6 months), 0.452 (1 year). There were no significant difference between group A and B in different stage by statistical analysis. In one year after operation, the range of motion in 2 groups, group A: 108 degrees (95 degrees - 118 degrees), group B: 107 degrees (90 degrees - 120 degrees), there were no significant difference by ROM (P > 0.05). At the latest follow-up examination, group A: 13.7% of the patients (4 knee joint) complained mild pain, the percent of the patients' self-satisfaction was 90%; group B: 13.1% of the patients (9 knee joint) complained mild pain, the percent of the patients' self-satisfaction was 88%.

CONCLUSIONS: Although it is certain about the effectiveness of preliminary clinical outcomes with mobile-bearing prosthesis, it is still uncertain about the advantage of mobile-bearing prosthesis over fixed-bearing prosthesis. The reason for preferring to the former still need being demonstrated.