Abu Al-Rub, Z, Lamb, JN orcid.org/0000-0002-0166-9406, West, RM orcid.org/0000-0001-7305-3654 et al. (3 more authors) (2020) Survivorship of fixed vs mobile bearing unicompartmental knee replacement: A systematic review and meta-analysis of sixty-four studies and National Joint Registries. The Knee, 27 (5). pp. 1635-1644. ISSN 0968-0160
Abstract
Background
Unicompartmental knee replacement (UKR) prostheses can use fixed (FB) or mobile bearing (MB) constructs. We compared survivorship and failure modes of both designs.
Methods
The inclusion criteria were studies published between 2005 and 2020 with minimum average follow-up of five years reporting the survival and/or number of revisions of specific designs in medial and lateral UKRs. Pooled rate of revision per 100 patient years (PTIR) was estimated using a random effects model.
Results
Seventy cohorts of 17,405 UKRs with weighted mean follow-up of 7.3 years (0.1–29.4 years) were included. A total of 170,923 UKRs were identified in registry reports at a weighted mean implant survival time of 15.4 years. PTIR in MB UKR versus FB UKR was similar [1.45 vs 1.40, (p = 0.8)].
In cohort studies, the overall PTIR for MB was also similar to FB [1.03 vs 0.78, (p = 0.1)]. For medial UKR, the PTIR for MB was marginally greater but not significantly different to FB [0.96 vs 0.81, (p = 0.3)], whilst for lateral UKR, the PTIR for MB was significantly worse than for FB [2.20 vs 0.72, (p < 0.01)]. Polyethylene wear is more common in FB implants, whilst MB implants are revised more often for bearing dislocation.
Conclusions
Overall implant survival in mid- to long-term studies is similar for MB versus FB medial UKRs. MB have a four-fold higher risk of revision in comparison to FB when used for lateral UKR.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | Crown Copyright © 2020 Published by Elsevier B.V. All rights reserved. This is an author produced version of an article published in The Knee. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Unicompartmental knee; Revision; Survivorship; Mobile; Fixed; Arthroplasty |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Orthopaedics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Centre for Health Services Research (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Sep 2020 11:45 |
Last Modified: | 30 Sep 2021 00:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.knee.2020.09.004 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:165211 |
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