International comparative evaluation of knee replacement with fixed or mobile non-posterior-stabilized implants

摘要: Background: Mobile-bearing total knee prostheses were designed to reduce wear and improve implant survivorship following arthroplasty. However, the benefit of mobile-bearing arthroplasty remains unproven. Both fixed-bearing implants are available in posterior-stabilized non-posteriorstabilized designs. With latter, does not recreate function posterior cruciate ligament (PCL) with a posterior-stabilizing cam mechanism. The purpose present study was compare mobile-bearing, devices fixed-bearing, non-posterior-stabilized used through novel multinational design. Methods: Through use distributed health data network, primary arthroplasties performed for osteoarthritis from 2001 2010 identified six national regional joint registries. Multivariate meta-analysis linear mixed models, outcome interest being revision any reason. Survival probabilities their standard errors extracted each registry unique combination covariates. Results: A 319,616 patients (60% female) underwent fixedbearing, design 258,190 (81%) knees 61,426 (19%) knees. Sixty-nine percent who received over sixty-five years age, compared 63% those implant. designs had higher risk revision, hazard ratio 1.43 (95% confidence interval, 1.36 1.51; p < 0.001). Conclusions: Previous comparisons outcomes have been inconclusive. current utilized an advanced, harmonized analysis jointreplacement To our knowledge, it is largest date. Mobile-bearing, presented greater failure than found nonposterior-stabilized Caution should be selection replacement.