Evidence map›Paper›PMID 28389879›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Superior long-term survival for fixed bearing compared with mobile bearing in ligament-balanced total knee arthroplasty.

P J C Heesterbeek, A H van Houten, J S Klenk, H Eijer, B Christen, A B Wymenga, A J Schuster

Abstract read
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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. 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
  2. Trial
  3. Are current total knee arthroplasty implants tested and approved for personalised alignment?Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Prior unilateral total hip arthroplasty does not influence the outcome of ipsilateral total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
    Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

P J C HeesterbeekSint Maartenskliniek, Nijmegen, The Netherlands. P.heesterbeek@maartenskliniek.nl.ORCID http://orcid.org/0000-0003-2873-8907
A H van HoutenSint Maartenskliniek, Nijmegen, The Netherlands.
J S KlenkOrthopädische Klinik orthosiloah Bern-Gümligen, Bern, Switzerland.
H EijerRegionalspital Emmental AG, Burgdorf, Switzerland.
B ChristenOrthopädische Klinik Bern, Bern, Switzerland.
A B WymengaSint Maartenskliniek, Nijmegen, The Netherlands.
A J SchusterOrthopädische Klinik orthosiloah Bern-Gümligen, Bern, Switzerland.

Funding

Mathys Ltd Institutional research grant
6 · The paper itself

Abstract

purposeOnly few long-term data on ligament-balanced cruciate-retaining total knee arthroplasty (CR TKA) are currently available. Either a mobile- or fixed-bearing insert can be chosen, which showed good mid-term outcome and few complications and revisions. This multi-centre retrospective cross-sectional cohort study investigated the 12-year results of primary TKA using a balancing gap technique and compared survival and clinical outcome between fixed and mobile inserts.

methodsIn this retrospective cross-sectional cohort study, 557 cases of three clinics (2 Swiss, 1 Dutch) operated between 1998 and 2003 with the first series of a TKA implanted with a balanced gap technique (433 (77.7%) fixed, 124 (22.3%) mobile (anterior-posterior gliding (7-9 mm) and rotational (15°) degrees of freedom) inserts) were included for survival analysis (Kaplan-Meier, by insert type). At the 12-year follow-up (FU) examination of 189 cases, range of motion, knee society score (KSS), numeric rating scale (NRS) for pain and satisfaction were determined and radiographs were evaluated by median tests, by insert type.

resultsOf 521 cases available for analysis, 28 (5.4%; 11 fixed, 17 mobile bearing) were revised. Mean cumulative survival after 12.4 years was 97.0% (95% CI 94.7-98.4) for fixed bearings and 85.4% (95% CI 77.5-90.7) after 12.2 years for mobile bearings, p < 0.0001. Patients' mean age at 11.0 years FU (n = 189) was 78.0 (range 54.5-97.3) years. Mean total KSS was 157.8 (24-200) points, and mean passive flexion was 114° (45-150); no clinical score differed significantly between fixed and mobile bearings.

conclusionThis study showed a superior survival for fixed bearing compared with mobile bearing in a CR TKA using a ligament-balanced technique after more than 12 years. Clinical outcomes are excellent to good after long-term follow-up, and similar for fixed and mobile bearing. LEVEL OF EVIDENCE: Therapeutic studies-retrospective cohort study, Level III.

Indexed as

Knee ProsthesisProsthesis DesignAdultAgedAged, 80 and overArthroplasty, Replacement, KneeCross-Sectional StudiesFemaleHumansLigamentsMaleMiddle AgedOsteoarthritis, KneeOutcome Assessment, Health CareRange of Motion, ArticularRetrospective StudiesBalanced gap techniqueClinical outcomeDependent gap total knee arthroplastyFixed bearingLigament balancingLong-term follow-upMobile bearingSurvivalTotal knee arthroplasty

Identifiers

PMID28389879

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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.