ObjectiveTo explore the effectiveness of UC ultra-congruent rotating platform prosthesis in the treatment of knee osteoarthritis by comparing with fixed-bearing implant. MethodsThe clinical data were retrospectively analyzed, from 98 patients (98 knees) with knee osteoarthritis undergoing primary total knee arthroplasty between January 2011 and December 2012. The UC ultra-congruent rotating platform prosthesis was used in 56 cases (mobile-bearing group) and fixed-bearing implant was used in 42 cases (fixed-bearing group). There was no significant difference in gender, age, side, weight, disease duration, grading of arthritis, the number of varus and valgus malformation, preoperative range of motion of the knee, the Knee Society Score (KSS) score, the visual analogue scale (VAS) score, femorotibial angle, tibial angle, and articular surface angle between 2 groups (P>0.05). The operation time (including anesthetic time), intraoperative blood loss, hospitalization time, total hospitalization expenses, postoperative range of motion of the knee, the KSS score, and the VAS score were compared. The femorotibial angle, tibial angle, and articular surface angle were measured on the basis of anteroposterior and lateral X-ray films, and prosthesis loosening was observed. ResultsThere was no significant difference in the operation time, intraoperative blood loss, and hospitalization time between 2 groups (P>0.05), while the total hospitalization expenses of fixed-bearing group were significantly lower than those of the mobile-bearing group (t=8.506, P=0.000). The patients were followed up 16-30 months in the mobile-bearing group, and for 16-38 months in the fixed-bearing group. Postoperative complications occurred in 3 cases (7.14%) of the fixed-bearing group (1 case of fat liquefaction of incision, 1 case of joint stiff, and 1 case of anterior knee pain), and in 3 cases (5.36%) of the mobile-bearing group (1 case of delayed wound healing, and 2 cases of anterior knee pain); there was no significant difference in the complication rate between 2 groups (χ2=0.133, P=0.516). At last follow-up, the KSS score, VAS score, range of motion of the knee, femorotibial angle, tibial angle, and articular surface angle were superior significantly to those before operation in both groups (P<0.05), but no significant difference was found between 2 groups (P>0.05). No radiographic signs of radiolucent line, prosthetic dislocation, patellar dislocation, prosthetic loosening, and fracture was found. ConclusionUC ultra-congruent rotating platform prosthesis in the treatment of knee osteoarthritis can effectively improve the knee joint function and relief pain, which has the same short-term effectiveness to fixed-bearing implant.
Objective To compare the clinical results of mobile-bearing and fixed-bearing prostheses in total knee arthroplasty (TKA) during 10 years follow-up so as to provide a reference for clinical selection of TKA prosthesis. Methods Between January 2002 and December 2005, 113 patients with osteoarthritis of the knee joint underwent primary TKA, and the clinical data were retrospectively analyzed. Mobile-bearing prosthesis was used in 47 cases (group A) and fixed-bearing prosthesis in 66 cases (group B). There was no significant difference in age, gender, body mass index, varus and flexion deformity of the knee, range of motion (ROM) of the knee, knee society score (KSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) between 2 groups before operation (P>0.05), so the data were comparable. Results The operation time of groups A and B was (88.1±6.5) and (90.3±7.2) minutes respectively, showing no significant difference (t=1.666,P=0.099). The wounds healed by first intention in all patients of both groups, and no postoperative early complications of incision infection and deep venous thrombosis occurred. The follow-up time was 10.2-12.3 years (mean, 10.8 years) in group A, and was 10.2-12.6 years (mean, 11.3 years) in group B. Revision was performed in 3 cases of group A and 4 cases of group B; the survival rates of prosthesis were 93.6% and 93.9% in groups A and B respectively, showing no significant difference (χ2=0.005,P=0.944). The postoperative knee ROM, KSS score, and WOMAC score were significantly improved when compared with preoperative ones (P<0.05). The knee ROM and KSS score of group B were significantly better than those of group A at 6 weeks after operation (P<0.05), but no significant difference was found between 2 groups at 1, 3, and 10 years after operation (P>0.05). The WOMAC score of group A was significantly better than that of group B at 10 years after operation (t=2.086,P=0.037), but no significant difference was shown at 6 weeks, 1 year, and 3 years after operation (P>0.05). At 10 years after operation, the excellent and good rate of KSS score was 87.2% in group A and was 84.8% in group B, showing no significant difference (χ2=0.018,P=0.893). Conclusion Good medium- and long-term clinical results can be achieved in TKA with both mobile-bearing and fixed-bearing prostheses. The TKA with fixed-bearing prosthesis is relatively simple with better early effectiveness of rehabilitation; and the TKA with mobile-bearing prosthesis could provide better long-term degree of satisfaction in WOMAC score, but a higher surgical skill and soft tissue balance techniques are needed.