Our study determined the long-term clinical, radiographic, and computed tomography scanning results of high-flexion mobile-bearing and fixed-bearing total knee arthroplasties (TKAs) in the same younger patients. In addition, the survivorship and complication rates of both groups were evaluated.
Bilateral simultaneous sequential TKAs were performed in 164 patients (328 knees). There were 142 women and 22 men with a mean age of 63 ± 9 years (range 41-65), who received a high-flexion mobile-bearing prosthesis in one knee and a high-flexion fixed-bearing prosthesis in the other. The mean follow-up was 16.9 years (range 15-18).
At the latest follow-up, the mean Knee Society knee scores (94 ± 8 vs 95 ± 9 points, P = .7), Western Ontario and McMaster Universities Osteoarthritis Index (20 ± 11 vs 20 ± 11 points, P = 1.0), range of knee motion (125° ± 10° vs 127° ± 9°, P = .8), and University of California, Los Angeles activity scores (7.8 vs 7.8 points, P = 1.0) were below the level of clinical significance between the 2 groups. Survival rate of high-flexion mobile-bearing TKA was 98.2% and that of high-flexion fixed-bearing TKA was 97% at 16 years. No osteolysis was identified in either group.
After a minimum duration of follow-up of 13 years, we found no significant difference between these 2 groups with regard to functional outcome, knee motion, prevalence of osteolysis, or survivorship. This study does not clearly direct the surgeon toward either arm of treatment. Longer term follow-up is needed to prove the superiority of one type of implant over the other one.