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)?
Oui = 1
Incertain = 0,5
Non pertinent = 0
Non = 0
L'évaluation des critères de rapport permet d'évaluer la transparence avec laquelle les auteurs rapportent les caractéristiques méthodologiques et les caractéristiques de l'essai dans la publication. L'évaluation est divisée en cinq catégories qui sont présentées ci-dessous.
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
L'indice de fragilité est un outil qui aide à l'interprétation des résultats significatifs, en fournissant une mesure de la force d'un résultat. L'indice de fragilité représente le nombre d'événements consécutifs qui doivent être ajoutés à un résultat dichotomique pour que le résultat ne soit plus significatif. Un petit nombre représente un résultat plus faible et un grand nombre un résultat plus fort.
Pourquoi cette étude était-elle nécessaire maintenant ?
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.
Quelle était la principale question de recherche ?
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?
Quels sont les résultats importants ?
- 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.
De quoi dois-je me souvenir en priorité ?
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.
Comment cela affectera-t-il les soins prodigués à mes patients ?
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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