ARTHROPLASTY
Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2018;6(11):6 Acta Orthop. 2018 Apr;89(2):190-19648 patients scheduled for total knee arthroplasty with a single radius implant were randomized to either a mobile-bearing or fixed-bearing design. Patients were primarily followed up for tibial component migration after 6 years. Secondary outcomes also included clinical scores and knee range of motion. Results demonstrated no significant differences between groups for any of the assessed outcome measures.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
1/4
Randomization
3/4
Outcome Measurements
0/4
Inclusion / Exclusion
2/4
Therapy Description
3/5
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
Many studies and analyses have been conducted comparing outcomes between mobile-bearing and fixed-bearing total knee implants. However, a number of these studies were completed using older implant designs, and may not reflect the comparative efficacy of newer designs. Furthermore, specific efficacy when considering single radius implants has not been thoroughly investigated previously.
¿Cuál era la pregunta principal de la investigación?
In single-radius total knee arthroplasty, is there a significant difference in mid-term (6-year) migration between a mobile-bearing implant and a fixed-bearing implant?
¿Cuáles fueron los hallazgos importantes?
- Maximum total point motion at 6 years did not significantly differ between the MB group (1.22mm [95%CI 0.75-1.80]) and the FB group (0.90mm [95%CI 0.49-1.41]) (p=0.30).
- Change in range of knee flexion after 6 years did not significantly differ between the MB group and the FB group (p=0.2).
- Change in range of knee extension after 6 years did not significantly differ between the MB group and the FB group (p=0.2).
- Change in Knee Society Knee Scores after 6 years did not significantly differ between the MB group and the FB group (p=0.7).
- Change in Knee Society Function Scores after 6 years did not significantly differ between the MB group and the FB group (p=0.2).
- Revision due to aseptic loosening was performed in no patients of the MB group and 1 patient of the FB group. Revision due to septic loosening was performed in 1 patient of the MB group and 1 patients of the FB group.
- Recruitment was stopped early due to the investigation of one case of mobile bearing insert dislocation.
¿Qué es lo que más debo recordar?
In single-radius total knee arthroplasty, no significant differences in 6-year tibial migration, clinical outcome or revision rate were observed between cases completed using a mobile-bearing design and cases completed using a fixed-bearing design.
¿Cómo afectará esto al cuidado de mis pacientes?
The results of this study suggest that mid-term migration and clinical outcome is similar between mobile-bearing and fixed-bearing single-radius total knee implants. Therefore, it is unknown if there is any clear advantage of one design over the other.
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