A systematic review and meta-regression of mobile-bearing versus fixed-bearing total knee replacement in 41 studies.
Bone Joint J
; 95-B(9): 1209-16, 2013 Sep.
Article
en En
| MEDLINE
| ID: mdl-23997134
Mobile-bearing (MB) total knee replacement (TKR) was introduced to reduce the risk of aseptic loosening and wear of polyethylene inserts. However, no consistent clinical advantages of mobile- over fixed-bearing (FB) TKR have been found. In this study we evaluated whether mobile bearings have an advantage over fixed bearings with regard to revision rates and clinical outcome scores. Furthermore, we determined which modifying variables affected the outcome. A systematic search of the literature was conducted to collect clinical trials comparing MB and FB in primary TKR. The primary outcomes were revision rates for any reason, aseptic loosening and wear. Secondary outcomes included range of movement, Knee Society score (KSS), Oxford knee score (OKS), Short-Form 12 (SF-12) score and radiological parameters. Meta-regression techniques were used to explore factors modifying the observed effect. Our search yielded 1827 publications, of which 41 studies met our inclusion criteria, comprising over 6000 TKRs. Meta-analyses showed no clinically relevant differences in terms of revision rates, clinical outcome scores or patient-reported outcome measures between MB and FB TKRs. It appears that theoretical assumptions of superiority of MB over FB TKR are not borne out in clinical practice.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Falla de Prótesis
/
Artroplastia de Reemplazo de Rodilla
/
Osteoartritis de la Rodilla
/
Prótesis de la Rodilla
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Aspecto:
Patient_preference
Límite:
Humans
Idioma:
En
Revista:
Bone Joint J
Año:
2013
Tipo del documento:
Article
País de afiliación:
Países Bajos
Pais de publicación:
Reino Unido