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Knee

DOES A ROTATING PLATFORM CRUCIATE RETAINING KNEE REPLACEMENT GIVE A BETTER RESULT AT TWO YEARS POST OPERATION THAN A FIXED BEARING PROSTHESIS?

British Association for Surgery of the Knee (BASK)



Abstract

Summary

We report a large study of 331 patients at two years post operation who were prospectively randomised to receive either a rotating platform or a fixed bearing knee replacement of an otherwise identical design.

Introduction

The mobile bearing total knee replacement was developed as there are theoretical benefits in that it may allow a better range of motion, better patella tracking and lower wear rates. This study was designed to see if these potential advantages are borne out in practice when using a cruciate retaining design.

Methods

331 patients undergoing TKR surgery were randomised to receive either a fixed bearing (170 patients) or a mobile bearing (161 patients). The femoral implant design was identical in the two groups. The tibial polyethylene bearing was either fixed in the metallic tibial tray (FB) or of rotating platform design (RP).

All patients were assessed pre-operatively and at two years post-operatively using standard tools (Oxford, AKSS, Patellar Score) by independent nurse specialists.

Results

The groups who received the FB and the RP implants have been assessed and their pre-operative to two year outcomes analysed with regard to the improvement in the range of motion (9.1 v. 10.2 degrees), Oxford Knee Score (-19.2 v. -17.6) and American Knee Society Knee and Function scores (51.3 v. 49.5 and 25.3 v. 23.6) at two years follow up.

Conclusion

This large study shows that there is no statistical difference between a FB and a RP cruciate retaining TKR at two years post operation.