No difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee arthroplasty: a prospective single-center trial

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Abstract

Background

Despite numerous scientific investigations, the tribological advantages of mobile bearing inserts have not been sustainably confirmed or refuted for modern knee prostheses in clinical studies. The purpose of this study was to compare fixed and mobile bearing inserts in order to draw conclusions regarding clinical benefits.

Methods

The present prospective single center cohort study of 2 non-randomized stratified groups consisted of 67 patients. All included patients received cemented total knee arthroplasty (Attune®) due to osteoarthritis. 34 patients were treated with a mobile and 33 patients with a fixed insert. The WOMAC score and the Visual Analogue Scale was used for the subjective assessment of success, while the Knee-Society-Score was used considering the Range of Motion for the objective assessment. The subjective and the clinical scores showed improvements for both compared groups postoperatively at 2 years of minimum follow-up.

Results

The overall postoperative results of the WOMAC score, the Knee-Society-Score and the Visual Analogue Scale presented no statistically difference between the compared groups ( p > 0,05). The postoperative ROM showed a superior improvement of 13.2° ± 18.4° in the mobile-bearing group versus 4.9° ± 18.4° ( p = 0.017) in the fixed-bearing group. The flexion of the knee joint was 114° ± 10.1° for the mobile-bearings and 109.2° ± 7.2° for fixed bearings ( p = 0.012).

Conclusion

According to the findings, both inserts showed overall promising postoperative results, in terms of objective as well as subjective parameters, without clinically relevant significant differences, except for ROM, which was superior in the mobile bearing group.

The present clinical trial has been registered at the ISRCTN registry with the reverence number ISRCTN15117998 on 04/04/2022.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-022-05382-x.

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Most cited references 34

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Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

N Bellamy, W W Buchanan, C H Goldsmith … (1988)

Within the context of a double blind randomized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs, we validated WOMAC, a new multidimensional, self-administered health status instrument for patients with osteoarthritis of the hip or knee. The pain, stiffness and physical function subscales fulfil conventional criteria for face, content and construct validity, reliability, responsiveness and relative efficiency. WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials.

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Revision surgery after total joint arthroplasty: a complication-based analysis using worldwide arthroplasty registers.

Mark Agreiter, Patrick Sadoghi, Michael Liebensteiner … (2013)

The authors performed a complication-based analysis of total knee (TKA), total hip (THA), and total ankle arthroplasty (TAA) using worldwide arthroplasty registers. We extracted data with respect to reason for revision surgery and pooled causes. The most common causes for revisions in THA were aseptic loosening (55.2%), dislocation (11.8 %), septic loosening (7.5%), periprosthetic fractures (6%), and others. The most common causes in TKA were aseptic loosening (29.8%), septic loosening (14.8%), pain (9.5%), wear (8.2%), and others. The most common causes in TAA were aseptic loosening (38%), technical errors (15%), pain (12%), septic loosening (9.8%), and others. Revisions in TKA and THA differ with respect to type of complication. However, in case of TAA, higher rates of technically related complications are reported. Copyright © 2013 Elsevier Inc. All rights reserved.

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Development of a new Knee Society scoring system.

Kirstin Scott, Geoffrey Noble, P Chadha … (2011)

The Knee Society Clinical Rating System was developed in 1989 and has been widely adopted. However, with the increased demand for TKA, there is a need for a new, validated scoring system to better characterize the expectations, satisfaction, and physical activities of the younger, more diverse population of TKA patients. We developed and validated a new Knee Society Scoring System. We developed the new knee scoring system in two stages. Initially, a comprehensive survey of activities was developed and administered to 101 unilateral TKA patients (53 women, 48 men). A prototype knee scoring instrument was developed from the responses to the survey and administered to 497 patients (204 men, 293 women; 243 postoperatively, 254 preoperatively) at 15 medical institutions within the United States and Canada. Objective and subjective data were analyzed using standard statistical and psychometric procedures and compared to the Knee Injury and Osteoarthritis Score and SF-12 scores for validation. Based on this analysis, minor modifications led to the new Knee Society Scoring System. We found the new Knee Society Scoring System to be broadly applicable and to accurately characterize patient outcomes after TKA. Statistical analysis confirmed the internal consistency, construct and convergent validity, and reliability of the separate subscale measures. The new Knee Society Scoring System is a validated instrument based on surgeon- and patient-generated data, adapted to the diverse lifestyles and activities of contemporary patients with TKA. This assessment tool allows surgeons to appreciate differences in the priorities of individual patients and the interplay among function, expectation, symptoms, and satisfaction after TKA.

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Author and article information

Contributors

Paul Ruckenstuhl: paul.ruckenstuhl@medunigraz.at

Fabio Revelant: revelant.fabio@gmx.at

Georg Hauer: georg.hauer@medunigraz.at

Gerwin A. Bernhardt: wintschgerl@gmail.com

Lukas Leitner: lukas.leitner@medunigraz.at

Gerald Gruber: gerald.gruber@medunigraz.at

Andreas Leithner: andreas.leithner@medunigraz.at

Patrick Sadoghi:

ORCID: https://orcid.org/0000-0003-1767-555X

patricksadoghi@gmx.at , patrick.sadoghi@medunigraz.at

Journal

Journal ID (nlm-ta): BMC Musculoskelet Disord

Journal ID (iso-abbrev): BMC Musculoskelet Disord

Title: BMC Musculoskeletal Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2474

Publication date (Electronic): 2 May 2022

Publication date PMC-release: 2 May 2022

Publication date Collection: 2022

Volume: 23

Electronic Location Identifier: 413

Affiliations

GRID grid.11598.34, ISNI 0000 0000 8988 2476, Department of Orthopedics and Trauma, , Medical University of Graz, ; Auenbruggerplatz 5, A-8036 Graz, Austria

Author information

Patrick Sadoghi https://orcid.org/0000-0003-1767-555X

Article

Publisher ID: 5382

DOI: 10.1186/s12891-022-05382-x

PMC ID: 9063062

PubMed ID: 35501786

SO-VID: 0572b45b-31b8-4d22-83ac-91099dcd0753

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 2 November 2021

Date accepted : 25 April 2022

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: total knee arthroplasty,fixed bearing,mobile bearing

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: total knee arthroplasty, fixed bearing, mobile bearing

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No difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee arthroplasty: a prospective single-center trial

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Abstract

Background

Methods

Results

Conclusion

Supplementary Information

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Orthopedics

Most cited references 34

Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

Revision surgery after total joint arthroplasty: a complication-based analysis using worldwide arthroplasty registers.

Development of a new Knee Society scoring system.

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