Early clinical outcomes of floating platform mobile-bearing TKA: longitudinal comparison with fixed-bearing TKA

Abstract

This study was conducted to longitudinally compare a new floating platform mobile-bearing (MB) prosthesis with an established fixed-bearing (FB) system with respect to early clinical outcomes in patients with bilateral TKAs using the MB prosthesis in one knee and the FB prosthesis in the other. Clinical outcomes (ROM, AKS and WOMAC scores, and side preference), evaluated at 6, 12 and 24 months postoperatively, were compared between knees fitted with the MB prosthesis (e.motion-FP) or the FB prosthesis (Genesis II) in 66 patients who underwent bilateral TKA. In addition, the same comparisons between the knees fitted with the MB prosthesis and the knees with the FB prosthesis were made separately in the subgroup of 33 patients implanted with a cruciate retaining FB (FB-CR) prosthesis and the other subgroup of 33 patients with a posteriorly stabilized FB (FB-PS) prosthesis in a knee. The floating platform MB prosthesis achieved comparable clinical outcomes to the FB prosthesis. No significant differences were found between the FB- and MB-implanted sides at any time with respect to the outcome scales, and temporal patterns were similar. However, comparisons of FB-CR and FB-PS patient groups revealed different temporal patterns. In the FB-CR group, most outcome scales were improved at 6 months, peaked at 12 months and then remained at this level at 24 months. In contrast, outcomes in the FB-PS group improved much faster to almost peak at 6 months, and then remained at this level. In the FB-CR group, more patients preferred the knee with fitted with a MB prosthesis at 6 months. In contrast, in the FB-PS group, no side preference for the MB prosthesis was observed, and more patients preferred knees implanted with the FB prosthesis at 12 and 24 months. This study demonstrates that this new mobile-bearing prosthesis, designed as a floating platform, provides satisfactory clinical performances that are comparable to those achieved using the established fixed-bearing prosthesis in terms of clinical outcomes.