Evidence map›Paper›PMID 24590838›Full record

SynthesisClinical orthopaedics and related research2014

Rotating-platform TKA no different from fixed-bearing TKA regarding survivorship or performance: a meta-analysis.

Joseph T Moskal, Susan G Capps

Erratum issuedAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical orthopaedics and related research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. No difference between mobile and fixed bearing in primary total knee arthroplasty: a meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
    Pooled it
  2. Mobile-bearing versus fixed-bearing total knee arthroplasty: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022
    Pooled it
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  14. High congruency MB insert design: stabilizing knee joint even with PCL deficiency.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
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  17. Understanding the patellofemoral joint in total knee arthroplastyCanadian journal of surgery. Journal canadien de chirurgie · 2019
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Joseph T MoskalVirginia Tech Carilion School of Medicine, Roanoke, VA, USA.
Susan G Capps

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMobile bearings have been compared with fixed bearings used in TKA. However, rotating platforms, a specific type of mobile bearing, have not been compared with fixed-bearings using meta-analysis. QUESTIONS/PURPOSES: We asked whether the performance of a rotating-platform bearing is superior to, comparable to, or worse than a fixed bearing. Four areas were investigated: clinical performance, component alignment, adverse event rates, and revision rates.

methodsSearches of Medline, EMBASE, Google Scholar, and the Cochrane databases, combined with reference lists from published meta-analyses and systematic reviews of mobile-bearing versus fixed-bearing prostheses used in TKAs, provided 17 nonlanguage-restricted studies consisting of 1910 TKAs (966 rotating platform versus 944 fixed bearing). Random-effect modeling was used for all meta-analyses, thereby mitigating possible effects of heterogeneity among studies. All meta-analyses were examined for publication bias using funnel plots; publication bias was not detected for any meta-analysis.

resultsThere were no statistically or clinically significant differences in clinical performance (clinical scores, ROM, and radiographic evaluation), component alignment, revision rates, or adverse event rates except for tibial component alignment in the AP plane, which favored TKA with fixed-bearings (p = 0.020; standardized mean difference, 0.229; 95% CI, 0.035-0.422), but the effect size was small enough that it was not considered clinically important.

conclusionsBased on our findings, which agree substantially with those of prior systematic reviews of TKAs with mobile-bearing versus fixed-bearing prostheses, there is no compelling case for either rotating-platform or fixed-bearing implant design in terms of clinical performance, component alignment, adverse event frequencies, or survivorship. This dataset, which was limited to a maximum 6 years followup, is insufficient to address questions related to wear or late revisions. We therefore suggest that implant choice should be made on the basis of other factors, perhaps including cost or surgeon experience.

Indexed as

Knee ProsthesisArthroplasty, Replacement, KneeBiomechanical PhenomenaHumansKnee JointOdds RatioPostoperative ComplicationsProsthesis DesignProsthesis FailureRadiographyRange of Motion, ArticularRecovery of FunctionReoperationRisk FactorsRotationStress, Mechanical

Identifiers

PMID24590838
PMCPMC4048397

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.