Evidence map›Paper›PMID 32197628›Full record

Trial reportJournal of orthopaedic surgery and research2020

Mobile-bearing insert used with total knee arthroplasty does not rotate on the tibial tray during a squatting activity: a cross-sectional study.

Kenji Hoshi, Goro Watanabe, Yasuo Kurose, Ryuji Tanaka, Jiro Fujii, Kazuyoshi Gamada

Abstract readClinical Trial
In one paragraph

Trial report in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed, 1 synthesis or guideline 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
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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

6 authors.

Kenji HoshiGraduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, 555-36 Kurose-Gakuendai, Bldg3, Rm3807, Higashi-Hiroshima, Hiroshima, 739-2695, Japan.ORCID https://orcid.org/0000-0001-9531-6005
Goro WatanabeGraduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, 555-36 Kurose-Gakuendai, Bldg3, Rm3807, Higashi-Hiroshima, Hiroshima, 739-2695, Japan.
Yasuo KuroseHiroshima Prefectural Rehabilitation Center, 295-3 Taguchi, Saijo-cho, Higashi-Hiroshima, Hiroshima, 739-0036, Japan.
Ryuji TanakaHiroshima Prefectural Rehabilitation Center, 295-3 Taguchi, Saijo-cho, Higashi-Hiroshima, Hiroshima, 739-0036, Japan.
Jiro FujiiHiroshima Prefectural Rehabilitation Center, 295-3 Taguchi, Saijo-cho, Higashi-Hiroshima, Hiroshima, 739-0036, Japan.
Kazuyoshi GamadaGraduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, 555-36 Kurose-Gakuendai, Bldg3, Rm3807, Higashi-Hiroshima, Hiroshima, 739-2695, Japan. kazgamada@ortho-pt.com.ORCID http://orcid.org/0000-0001-8141-6865

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTotal knee arthroplasty (TKA) is commonly performed around the world. Implant designs include fixed-bearing and mobile-bearing. Mobile-bearing design was developed as a rotating platform that allows axial rotation of the insert around the longitudinal axis. This phenomenon may limit full exploitation of the characteristics of the mobile-bearing insert, which may cause wearing and reduce longevity. However, there is limited knowledge on rotational behavior of the polyethylene mobile-bearing insert under weight-bearing conditions. We aimed at determining the rotational motion of each component at full extension and flexed positions during a squatting activity after TKA.

methodsThis study was a cross-sectional study (level 4) involving patients with severe knee osteoarthritis scheduled to receive TKA. We examined 13 knees of 11 patients after mobile-bearing TKA (NexGen LPS-Flex, Zimmer Inc.) at 10 weeks and 1 year postoperatively. Four identical metallic beads were embedded into the insert. Wide-base squatting was chosen for analyses. Three-dimensional in vivo poses of the prostheses were created using a 3D-to-2D registration technique. During flexion, rotation of the femoral component relative to the insert (FEM/INS) and tibial component (FEM/TIB) as well as insert rotation relative to the tibial component (INS/TIB) were computed. Repeated measure 2-way ANOVA and post hoc test was used.

resultsIn the fully extended position, FEM/INS was significantly smaller than INS/TIB both at 10 weeks (- 0.3° vs. 6.3°, p = .013) and 1 year (- 0.8° vs. 4.9°, p = .011), respectively. During the squatting activity, rotation motions of FEM/TIB, FEM/INS, INS/TIB were 5.7°, 5.9°, and 1.8° at 10 weeks and 6.3°, 5.5°, and 1.6° at 1 year, respectively. Rotation motion of FEM/INS was significantly greater than that of INS/TIB at both 10 weeks (p < .001) and 1 year (p < .001).

conclusionsThe mobile-bearing insert enhances the compatibility of FEM/INS in extension; the amount of INS/TIB rotation is significantly smaller than that of FEM/INS during a squatting activity. This information will inform surgeons to take caution to perform TKA with a fixed insert in which 6.3° of rotational offset would be added to the rotational alignment at FEM/INS at full extension.

trial registrationUMIN-CTR, UMIN000024196. Retrospectively registered on 9 September 2016.

Indexed as

Knee ProsthesisAgedArthroplasty, Replacement, KneeCohort StudiesCross-Sectional StudiesFemaleHumansMaleProsthesis DesignRange of Motion, ArticularRetrospective StudiesTibiaWeight-BearingKinematicsKnee jointRotationTotal knee arthroplasty

Identifiers

PMID32197628
PMCPMC7085202

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LicenceCC BY
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Registered trials

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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.