Welcome!
To use the personalized features of this site, please log in or register.
If you have forgotten your username or password, we can help.
My Menu
Saved Items

Original Article

Improved Early Clinical Outcomes of RP/PS Mobile-Bearing Total Knee Arthroplasties

Tae Kyun Kim1, 2 Contact Information, Hyung Joon Cho1, Yeon Gwi Kang1, Sung Ju Kim3 and Chong Bum Chang1, 2

(1)  Joint Reconstruction Center, Seoul National University Bundang Hospital, 300 Gumidong, Bundangu, Seongnam-si, Gyunggido, 463-707, Korea
(2)  The Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
(3)  Department of Statistics, Korea University, Seoul, Korea

Received: 16 September 2008  Accepted: 3 March 2009  Published online: 19 March 2009

Abstract  The rotating-platform posterior-stabilized (RP/PS) prosthesis was developed to take advantage of the benefits of the traditional RP mobile-bearing system and the posterior-stabilized design. This nonconsecutive cohort study compared the clinical outcomes of TKAs performed using a RP/PS mobile system or a floating-platform (FP) system. The clinical outcomes of 93 TKAs with a RP/PS prosthesis were compared with the same number of TKAs with a FP mobile-bearing prosthesis at 6, 12, and 24 months after surgery. Clinical outcomes differed between the FP and RP/PS groups as a function of length of followup. In the FP group, most outcomes peaked at 12 months and then deteriorated, whereas in the RP/PS group, outcomes stabilized or continued to improve between 12 and 24 months. The RP/PS group had greater maximum flexion throughout followup and better clinical outcomes 24 months after surgery. Patient satisfaction was superior in the RP/RS group. This study suggests the RP/PS prosthesis provides better functional outcomes, including greater maximum flexion and better patient satisfaction. We propose the RP/PS mobile-bearing system is a more attractive option than the FP mobile-bearing system for patient populations of elderly women similar to patients enrolled in our study.
Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
One or more of the authors (TKK) have received funding from the clinical research fund (B-0605/033-032) of Seoul National University Bundang Hospital.
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 was obtained.
This work was performed at Seoul National University Bundang Hospital.

Contact Information Tae Kyun Kim
Email: osktk@snubh.org

References

1. Aichroth P, Freeman MA, Smillie IS, Souter WA. A knee function assessment chart. From the British Orthopaedic Association Research Sub-Committee. J Bone Joint Surg Br. 1978;60:308–309.
 
2. Akagi M. Deep knee flexion in the Asian population. In Bellemans J, Ries MD, Victor J, eds. Total Knee Arthroplasty: A Guide to Get Better Performance. Heidelberg, Germany: Springer; 2005:311–316.
 
3. Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW. Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty. 1996;11:831–840.
PubMed CrossRef ChemPort
 
4. Beard DJ, Pandit H, Price AJ, Butler-Manuel PA, Dodd CA, Murray DW, Goodfellow JW. Introduction of a new mobile-bearing total knee prosthesis: minimum three year follow-up of an RCT comparing it with a fixed-bearing device. Knee. 2007;14:448–451.
PubMed CrossRef ChemPort
 
5. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.
PubMed ChemPort
 
6. Buechel FF Sr. Long-term followup after mobile-bearing total knee replacement. Clin Orthop Relat Res. 2002;404:40–50.
PubMed CrossRef
 
7. Callaghan JJ. Mobile-bearing knee replacement: clinical results: a review of the literature. Clin Orthop Relat Res. 2001;392:221–225.
PubMed CrossRef
 
8. Delport HP, Banks SA, De Schepper J, Bellemans J. A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br. 2006;88:1016–1021.
PubMed CrossRef ChemPort
 
9. Dennis DA, Komistek RD. Mobile-bearing total knee arthroplasty: design factors in minimizing wear. Clin Orthop Relat Res. 2006;452:70–77.
PubMed CrossRef
 
10. Dickstein R, Heffes Y, Shabtai EI, Markowitz E. Total knee arthroplasty in the elderly: patients’ self-appraisal 6 and 12 months postoperatively. Gerontology. 1998;44:204–210.
PubMed CrossRef ChemPort
 
11. Feller JA, Bartlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br. 1996;78:226–228.
PubMed ChemPort
 
12. Gupta SK, Ranawat AS, Shah V, Zikria BA, Zikria JF, Ranawat CS. The P.F.C. Sigma RP-F TKA designed for improved performance: a matched-pair study. Orthopedics. 2006;29:S49–S52.
PubMed
 
13. Hartford JM, Hunt T, Kaufer H. Low contact stress mobile bearing total knee arthroplasty: results at 5 to 13 years. J Arthroplasty. 2001;16:977–983.
PubMed CrossRef ChemPort
 
14. Heim CS, Postak PD, Plaxton NA, Greenwald AS. Classification of mobile-bearing knee designs: mobility and constraint. J Bone Joint Surg Am. 2001;83:32–37.
PubMed
 
15. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–14.
PubMed
 
16. Jones RE. High-flexion, rotating-platform knees: rationale, design, and patient selection. Orthopedics. 2006;29(9 suppl):S76–S79.
PubMed
 
17. Kim TK, Chang CB, Kang YG, Kim SJ, Seong SC. Causes and predictors of patient’s dissatisfaction after uncomplicated total knee arthroplasty J Arthroplasty. 2009;24:263–271.
PubMed CrossRef
 
18. Kop AM, Swarts E. Quantification of polyethylene degradation in mobile bearing knees: a retrieval analysis of the Anterior-Posterior-Glide (APG) and Rotating Platform (RP) Low Contact Stress (LCS) knee. Acta Orthop. 2007;78:364–370.
PubMed CrossRef
 
19. Li G, Schule SL, Zayontz SJ, Maloney WJ, Rubash HE. Improving flexion in total knee arthroplasty. In Callaghan JJ, Rosenberg AG, Rubash HE, Simonian PT, Wickiewicz TL, eds. The Adult Knee. Vol 2. Philadelphia, PA: Lippincott Williams and Wilkins; 2003:1233–1244.
 
20. Maniar R. Rationale for the posterior-stabilized rotating-platform knee. Orthopedics. 2006;29(9 suppl):S23–S27.
PubMed
 
21. McEwen HM, Barnett PI, Bell CJ, Farrar R, Auger DD, Stone MH, Fisher J. The influence of design, materials and kinematics on the in vitro wear of total knee replacements. J Biomech. 2005;38:357–365.
PubMed CrossRef ChemPort
 
22. Most E, Li G, Schule S, Sultan P, Park SE, Zayontz S, Rubash HE. The kinematics of fixed- and mobile-bearing total knee arthroplasty. Clin Orthop Relat Res. 2003;416:197–207.
PubMed CrossRef
 
23. Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006;452:35–43.
PubMed CrossRef
 
24. Pagnano MW, Trousdale RT, Stuart MJ, Hanssen AD, Jacofsky DJ. Rotating platform knees did not improve patellar tracking: a prospective, randomized study of 240 primary total knee arthroplasties. Clin Orthop Relat Res. 2004;428:221–227.
PubMed CrossRef
 
25. Park KK, Chang CB, Kang YG, Seong SC, Kim TK. Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients. J Bone Joint Surg Br. 2007;89:604–608.
PubMed CrossRef ChemPort
 
26. Park KK, Shin KS, Chang CB, Kim SJ, Kim TK. Functional disabilities and issues of concern in female Asian patients before TKA. Clin Orthop Relat Res. 2007;461:143–152.
PubMed
 
27. Ridgeway S, Moskal JT. Early instability with mobile-bearing total knee arthroplasty: a series of 25 cases. J Arthroplasty. 2004;19:686–693.
PubMed CrossRef
 
28. Ritter MA, Harty LD, Davis KE, Meding JB, Berend ME. Predicting range of motion after total knee arthroplasty: clustering, log-linear regression, and regression tree analysis. J Bone Joint Surg Am. 2003;85:1278–1285.
PubMed
 
29. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.
PubMed CrossRef
 
30. Wasielewski RC, Komistek RD, Zingde SM, Sheridan KC, Mahfouz MR. Lack of axial rotation in mobile-bearing knee designs. Clin Orthop Relat Res. 2008;466:2662–2668.
PubMed SpringerLink
 
31. Waters TS, Bentley G. Patellar resurfacing in total knee arthroplasty: a prospective, randomized study. J Bone Joint Surg Am. 2003;85:212–217.
PubMed
 
32. Wohlrab D, Hube R, Zeh A, Hein W. Clinical and radiological results of high flex total knee arthroplasty: a 5 year follow-up. Arch Orthop Trauma Surg. 2009;129:21–24.
PubMed SpringerLink
 


Export this article
Export this article as RIS | Text
 
Remote Address: 38.107.191.104 • Server: mpweb17
HTTP User Agent: CCBot/1.0 (+http://www.commoncrawl.org/bot.html)