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


Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
02 May 2022
Historique:
received: 02 11 2021
accepted: 25 04 2022
entrez: 3 5 2022
pubmed: 4 5 2022
medline: 6 5 2022
Statut: epublish

Résumé

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. 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. 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). 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.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 35501786
doi: 10.1186/s12891-022-05382-x
pii: 10.1186/s12891-022-05382-x
pmc: PMC9063062
doi:

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

413

Informations de copyright

© 2022. The Author(s).

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Auteurs

Paul Ruckenstuhl (P)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Fabio Revelant (F)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Georg Hauer (G)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Gerwin A Bernhardt (GA)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Lukas Leitner (L)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Gerald Gruber (G)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Andreas Leithner (A)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria.

Patrick Sadoghi (P)

Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, A-8036, Graz, Austria. patricksadoghi@gmx.at.

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