Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty

Introduction:Total Knee Arthroplasty (TKA) is a common surgical procedure aimed at relieving pain and restoring function in advanced knee arthritis. TKA implants are categorized into fixed-bearing and mobile-bearing designs based on polyethylene bearing mobility. Fixed-bearing implants, where the t...

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Main Authors: Sajjad Ali B, Arun Raja C J, Kathiravan Rajendran
Format: Article
Language:English
Published: Bulgarian Orthopaedics and Trauma Association 2025-05-01
Series:Journal of the Bulgarian Orthopaedics and Trauma Association
Subjects:
Online Access:https://www.jbota.org/index.php/jbota/article/view/161
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author Sajjad Ali B
Arun Raja C J
Kathiravan Rajendran
author_facet Sajjad Ali B
Arun Raja C J
Kathiravan Rajendran
author_sort Sajjad Ali B
collection DOAJ
description Introduction:Total Knee Arthroplasty (TKA) is a common surgical procedure aimed at relieving pain and restoring function in advanced knee arthritis. TKA implants are categorized into fixed-bearing and mobile-bearing designs based on polyethylene bearing mobility. Fixed-bearing implants, where the tibial insert is fixed to the tray, show excellent outcomes in older, less active patients. However, issues such as patellofemoral articulation, polyethylene wear, and osteolysis remain. Mobile-bearing designs address these concerns by allowing insert movement, improving articulation conformity, and reducing stress on the tibial interface. This study compares the functional outcomes of fixed- and mobile-bearing TKA designs.Objectives:a) Assessing functional outcomes using the Knee Society Knee Score System (KSKS).b) Comparing postoperative range of motion (ROM) between the two implant designs.Methodology:This comparative study, conducted at Kovai Medical Center and Hospital, included 73 patients (90 knees) who underwent TKA . The fixed-bearing design used a cruciate-substituting posterior-stabilized (PS) prosthesis, while the mobile-bearing design featured a rotating platform (RPF) prosthesis from the same manufacturer. Functional outcomes were assessed using KSKS, WOMAC, and ROM measurements. Most surgeries utilized a medial parapatellar approach, with a lateral approach for select valgus knees. Posterior cruciate ligament (PCL) resection was performed when necessary.Results:Both the fixed-bearing (PS) and mobile-bearing (RPF) cohorts exhibited significant postoperative improvements in ROM and knee scores compared to baseline values. The mean postoperative ROM was recorded as 100.06° in the PS group and 99.63° in the RPF group. The mean improvement in Knee Score was 66.72 in the PS group and 69.85 in the RPF group. Conclusion:This study concludes that functional outcomes following TKA do not exhibit a statistically significant variation between fixed- and mobile-bearing implant designs. Instead, the attainment of optimal surgical outcomes is predominantly influenced by meticulous tissue balancing and surgical technique.
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spelling doaj-art-177b7b9b14b04e5fb037f55d765e92b12025-08-20T02:35:11ZengBulgarian Orthopaedics and Trauma AssociationJournal of the Bulgarian Orthopaedics and Trauma Association0473-43782815-37152025-05-01621 Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplastySajjad Ali B0Arun Raja C J 1Kathiravan Rajendran2Karuna Medical College & Hospital, Chittur, Palakkad, Kerala, IndiaDEPT OF ORTHOPEDICS, Karuna Medical College, Chittur, Kerala, India, 678103Community Medicine PSG Institute of medical sciences and Research, Coimbatore- 641004 Introduction:Total Knee Arthroplasty (TKA) is a common surgical procedure aimed at relieving pain and restoring function in advanced knee arthritis. TKA implants are categorized into fixed-bearing and mobile-bearing designs based on polyethylene bearing mobility. Fixed-bearing implants, where the tibial insert is fixed to the tray, show excellent outcomes in older, less active patients. However, issues such as patellofemoral articulation, polyethylene wear, and osteolysis remain. Mobile-bearing designs address these concerns by allowing insert movement, improving articulation conformity, and reducing stress on the tibial interface. This study compares the functional outcomes of fixed- and mobile-bearing TKA designs.Objectives:a) Assessing functional outcomes using the Knee Society Knee Score System (KSKS).b) Comparing postoperative range of motion (ROM) between the two implant designs.Methodology:This comparative study, conducted at Kovai Medical Center and Hospital, included 73 patients (90 knees) who underwent TKA . The fixed-bearing design used a cruciate-substituting posterior-stabilized (PS) prosthesis, while the mobile-bearing design featured a rotating platform (RPF) prosthesis from the same manufacturer. Functional outcomes were assessed using KSKS, WOMAC, and ROM measurements. Most surgeries utilized a medial parapatellar approach, with a lateral approach for select valgus knees. Posterior cruciate ligament (PCL) resection was performed when necessary.Results:Both the fixed-bearing (PS) and mobile-bearing (RPF) cohorts exhibited significant postoperative improvements in ROM and knee scores compared to baseline values. The mean postoperative ROM was recorded as 100.06° in the PS group and 99.63° in the RPF group. The mean improvement in Knee Score was 66.72 in the PS group and 69.85 in the RPF group. Conclusion:This study concludes that functional outcomes following TKA do not exhibit a statistically significant variation between fixed- and mobile-bearing implant designs. Instead, the attainment of optimal surgical outcomes is predominantly influenced by meticulous tissue balancing and surgical technique. https://www.jbota.org/index.php/jbota/article/view/161Total Knee Arthroplastyfixed-bearingmobile-bearingknee functionsurgical outcomes
spellingShingle Sajjad Ali B
Arun Raja C J
Kathiravan Rajendran
Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
Journal of the Bulgarian Orthopaedics and Trauma Association
Total Knee Arthroplasty
fixed-bearing
mobile-bearing
knee function
surgical outcomes
title Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
title_full Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
title_fullStr Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
title_full_unstemmed Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
title_short Comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
title_sort comparison of functional outcome in fixed bearing versus mobile bearing implant designs in total knee arthroplasty
topic Total Knee Arthroplasty
fixed-bearing
mobile-bearing
knee function
surgical outcomes
url https://www.jbota.org/index.php/jbota/article/view/161
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