Fixed bearing versus rotating platform total knee replacements - Which one is better?

Abstract

Background: Patella tracking issues and anterior knee pain (AKP) remain a significant cause of dissatisfaction after total knee replacement (TKR). Rotating platform (RP) designs were developed with the aim to decrease polyethylene contact stresses and wear to decrease incidence of aseptic loosening. The aim of this study was to compare the clinical outcomes of patients who have undergone TKR using a fixed bearing (FB) compared to those using a RP design. Methods: This is a prospective study involving 994 PS TKR using the same brand of prosthesis (ATTUNE, DePuy Synthes). 790 replacements of the FB and 204 were of the RP design. 2.7% underwent concurrent patella resurfacing. Mean duration of follow-up was 28.2 months. Results and discussion: There were no revisions required for patella tracking issues and anterior knee pain. 6 patients required revision at an average of 12.3 months due to infection (3), aseptic tibial component loosening (1) and residual stiffness (2). No significant difference was found in the postoperative incidence of AKP, Knee Society knee and functional scores at all time points after operation between the two groups. Conclusion: At short-midterm follow-up, no significant difference was found in the clinical performance of TKR using FB and RP designs. A longer period of follow-up may be necessary to ascertain whether differences truly exist.