A randomised controlled clinical trial and gait analysis of fixed- and mobile-bearing total knee replacements with a five-year follow-up

B. M. Jolles, A. Grzesiak, A. Eudier, H. Dejnabadi, C. Voracek, C. Pichonnaz, K. Aminian, E. Martin

Abstract

This study compared the outcome of total knee replacement (TKR) in adult patients with fixed- and mobile-bearing prostheses during the first post-operative year and at five years’ follow-up, using gait parameters as a new objective measure. This double-blind randomised controlled clinical trial included 55 patients with mobile-bearing (n = 26) and fixed-bearing (n = 29) prostheses of the same design, evaluated pre-operatively and post-operatively at six weeks, three months, six months, one year and five years. Each participant undertook two walking trials of 30 m and completed the EuroQol questionnaire, Western Ontario and McMaster Universities osteoarthritis index, Knee Society score, and visual analogue scales for pain and stiffness. Gait analysis was performed using five miniature angular rate sensors mounted on the trunk (sacrum), each thigh and calf. The study population was divided into two groups according to age (≤ 70 years versus > 70 years).

Improvements in most gait parameters at five years’ follow-up were greater for fixed-bearing TKRs in older patients (> 70 years), and greater for mobile-bearing TKRs in younger patients (≤ 70 years). These findings should be confirmed by an extended age controlled study, as the ideal choice of prosthesis might depend on the age of the patient at the time of surgery.

Footnotes

  • The authors would like to thank P.-F. Leyvraz and K. Boulos who performed some of the operations, A. Poloni and P. Widmer for administrative assistance and D. Gross for assistance with preparation of the manuscript. This study was funded by the Swiss National Science Foundation.

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

  • Received May 20, 2011.
  • Accepted January 5, 2012.
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