Mobile- versus fixed-bearing modern total knee replacements- which is the more patella-friendly design?: The 11-year New Zealand Joint Registry study.
2013
Objectives Our study aimed to examine if a mobile-bearing total knee replacement
(TKR) offered an advantage over fixed-bearing designs with respect
to rates of secondary resurfacing of the patella in knees in which
it was initially left unresurfaced. Methods We examined the 11-year report of the New Zealand Joint Registry
and identified all primary TKR designs that had been implanted in
> 500 knees without primary resurfacing of the patella. We examined
how many of these were mobile-bearing, fixed-bearing cruciate-retaining
and fixed-bearing posterior-stabilised designs. We assessed the rates
of secondary resurfacing of the patella for each group and constructed
Kaplan-Meier survival curves. Results Our study showed a significantly higher rate of revision for
secondary resurfacing of the patella in the fixed-bearing posterior-stabilised
TKR designs compared with either fixed-bearing cruciate-retaining
or mobile-bearing designs (p = 0.001 and p = 0.036, respectively). Conclusions This New Zealand Registry study shows that during the last 11
years, revision procedures to resurface an unresurfaced patella
in primary TKR occurred at a higher rate in fixed-bearing posterior-stabilised
designs.
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