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Gait, motion analysis reveal no differences between mobile-, fixed-bearing knees

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No differences in gait or motion analysis findings are discernible among patients randomly chosen to receive either fixed- or mobile-bearing total knee implants, according to a recent presentation.

Eric R. Bohm, MD, shared his findings at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.

Previous literature, Bohm noted, had failed to clarify the benefits mobile bearing total knee arthroplasty designs have on postoperative functionality.

“[Randomized controlled trials] have failed to identify any functional superiority with standard self-reported measures,” he said. “So the question we had was: Do fixed and rotating bearing total knee designs result in different improvements in knee joint kinetics as assessed using gait and motion analysis?”

Gait and flexion analysis

Bohm and his team performed a blinded, randomized, controlled trial of 109 patients, accounting for 114 knees. Fifty-three knees were randomized to receive a fixed bearing design. The other 61 knees received a mobile bearing design. The 109 patients, Bohm said, underwent preoperative and 1-year postoperative gait and motion assessment. The investigators paid specific attention to kinetic and kinematic knee joint analysis, as well as spatiotemporal parameters of gait.

The investigators found composite WOMAC, Knee Society Scores and SF-36 PCS scores underwent significant postoperative improvement in both groups. Bohm added, however, there were no differences in these scores between the groups. Gait analysis also demonstrated improvement in speed, knee adduction moment and knee flexion moment in both groups — but no difference could be discerned also.

“When we looked at knee flexion during gait, we found the rotating platform group had higher flexion during the swing phase both preoperatively and postoperatively,” Bohm said. “However, both groups improved postoperatively and we could not detect a difference in that improvement.”

Reference:

• Bohm ER, Deluzio K, Shay B, Rudan JF. An RCT comparing fixed to mobile bearing TKA: Any difference in postoperative gait and motion? Paper #409. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19. San Diego.
• Disclosure: Bohm and/or other investigators on the team have received funding from DePuy.

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