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01.11.2010 | Clinical Research | Ausgabe 11/2010

Clinical Orthopaedics and Related Research® 11/2010

Osteolysis in Well-functioning Fixed- and Mobile-bearing TKAs in Younger Patients

Zeitschrift:
Clinical Orthopaedics and Related Research® > Ausgabe 11/2010
Autoren:
MD Young-Hoo Kim, MD Yoowang Choi, MD Jun-Shik Kim
Wichtige Hinweise
Each author certifies that he or she has no commercial association (eg, consultancies, stock ownership, equity interest, patent, licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Abstract

Background

Periprosthetic osteolysis is an increasingly prevalent complication of TKA. To reduce the polyethylene wear and periprosthetic osteolysis, particularly in young patients, the design of the contemporary fixed-bearing TKAs has been modified and mobile-bearing TKAs have been introduced.

Questions/purposes

We asked whether the prevalence of osteolysis would be less in well-functioning mobile-bearing TKAs than in well-functioning contemporary fixed-bearing TKAs in young patients.

Patients and Methods

We compared 488 patients (894 knees) who received fixed-bearing knee prostheses with 445 patients (816 knees) who received mobile-bearing knee prostheses. There were 187 men and 301 women (mean age, 58.6 years; range, 33-65 years) in the fixed-bearing group and 167 men and 278 women (mean age, 55.7 years; range, 33-65 years) in the mobile-bearing group. The mean followup was 12.6 years (range, 10–17 years) in the fixed-bearing group and 12.9 years (range, 10–17 years) in the mobile-bearing group.

Results

The incidence of osteolysis was 1.6% (14 of 894 knees) in the fixed-bearing group and 2.2% (18 of 816 knees) in the mobile-bearing group at the final review. The mean postoperative Knee Society knee and function scores were 92.9 points and 83.5 points, respectively, in the fixed-bearing group and 90.7 points and 83.8 points, respectively, in the mobile-bearing group. The revision rates were 3.7% (33 of 894 knees) in the fixed-bearing group and 2.7% (22 of 816 knees) in the mobile-bearing group.

Conclusions

We found the incidence of osteolysis, rate of revision, and implant survivorship were similar between fixed-bearing and mobile-bearing TKAs in younger patients.

Level of Evidence

Level III, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.

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