• Arch Orthop Trauma Surg · Nov 2023

    Mobile-bearing prosthesis suppresses the postoperative rotational mismatch and improves patient-reported outcome measurements better than fixed-bearing prosthesis: rotational analysis by 3D measurement in total knee arthroplasty.

    • Hideki Ueyama, Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Susumu Takemura, and Hiroaki Nakamura.
    • Orthopedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kitaku, Sakai, Osaka, 591-8025, Japan. ueyama.b@gmail.com.
    • Arch Orthop Trauma Surg. 2023 Nov 1; 143 (11): 678167906781-6790.

    IntroductionIt is preferable to reduce postoperative excessive rotational mismatch between the femur and tibia that causes poor clinical results following total knee arthroplasty (TKA). The aim of this study is to compare postoperative rotational mismatches and clinical outcomes with mobile- and fixed-bearing prostheses.Materials And MethodsThis study classified 190 TKAs into two groups equally by propensity score matching: mobile-bearing group (n = 95) and fixed-bearing group (n = 95). Computed tomography images of the whole leg were taken at 2 weeks postoperatively. The component alignments, rotational mismatches between the femur and tibia, and rotations among components were measured three-dimensionally. The knee range of motion, New Knee Society Score (KSS) subjective sores, and Forgotten Joint Score (FJS-12) were assessed at the final follow-up.ResultsRotational mismatch between the femur and tibia was significantly less in the mobile- (- 0.8° ± 7.3°) than in the fixed-bearing (3.3° ± 8.5°, p < 0.001) group. New KSS functional activity score was significantly poorer in patients with excessive rotational mismatch (61.3 ± 21.4) than in those without it (49.5 ± 20.6, p = 0.02). Comparing mobile-bearing prosthesis, the use of fixed-bearing prosthesis was a risk factor for postoperative excessive rotational mismatch (odds ratio: 2.32, p = 0.03).ConclusionWhen compared to a fixed-bearing prosthesis, TKA using a mobile-bearing prosthesis could suppress the postoperative rotational mismatch between the femur and tibia that causes poor subjective functional activity score. However, since this study was conducted for PS-TKA, the results might not be applicable to other models.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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