Email updates

Keep up to date with the latest news and content from Journal of Orthopaedic Surgery and Research and BioMed Central.

Open Access Highly Accessed Review

Fixed or mobile-bearing total knee arthroplasty

Chun-Hsiung Huang12*, Jiann-Jong Liau3 and Cheng-Kung Cheng2

Author Affiliations

1 Department of Orthopaedic Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Chung-San North Road, Taipei 104, Taiwan

2 Institute of Biomedical Engineering, National Yang Ming University, No. 155, Sec 2, Li-Nung Street, Taipei 112, Taiwan

3 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F, No. 17, Xuzhou Road, Taipei 100, Taiwan

For all author emails, please log on.

Journal of Orthopaedic Surgery and Research 2007, 2:1  doi:10.1186/1749-799X-2-1

Published: 5 January 2007

Abstract

Fixed and mobile-bearing in total knee arthroplasty are still discussed controversially. In this article, biomechanical and clinical aspects in both fixed and mobile-bearing designs were reviewed. In biomechanical aspect, the mobile-bearing design has proved to provide less tibiofemoral contact stresses under tibiofemoral malalignment conditions. It also provides less wear rate in in-vitro simulator test. Patients with posterior stabilized mobile-bearing knees had more axial tibiofemoral rotation than patients with posterior stabilized fixed-bearing knees during gait as well as in a deep knee-bend activity. However, in clinical aspect, the mid-term or long-term survivorship of mobile-bearing knees has no superiority over that of fixed-bearing knees. The theoretical advantages for mobile-bearing design to provide a long-term durability have not been demonstrated by any outcome studies. Finally, the fixed-bearing design with all-polyethylene tibial component is suggested for relatively inactive, elder people. The mobile-bearing design is suggested for younger or higher-demand patients due to the potential for reduced polyethylene wear and more normal kinematics response after joint replacement. For younger surgeon, the fixed-bearing design is suggested due to less demand for surgical technique. For experienced surgeon, one familiar surgical protocol and instrumentation is suggested rather than implant design, either fixed-bearing or mobile-bearing.