Two-year follow-up on joint stability and muscular function comparing rotating versus fixed bearing TKR

Mobile and fixed bearing in total knee replacement are still discussed controversially. In a retrospective, matched-pair study, we investigated 40 patients with computer-assisted (BrainLAB (R)) primary total knee replacement (PFC Sigma (R), DePuy (R)) performed two years before. Twenty patients each received a mobile bearing and a fixed bearing. We compared Womac Score, Knee Society Score, postoperative ROM, fluoroscopic measurement of knee stability in flexion and extension and isokinetic muscle strength using a Biodex (TM)-3 dynamometer. Both groups showed similar results concerning WOMAC Score (total rotating bearing: 23.05; fixed bearing: 22.57), KSS (rotating bearing: 174.89; fixed bearing: 176.1). Isokinetic muscle force demonstrated statistically significant superior results for knee flexion in the rotating bearing group. Medio-lateral stability revealed statistically significant superior results for the rotating bearing compared to fixed bearing in extension (P > 0.05). In flexion only lateral stability was superior (P > 0.05). Two-year clinical follow-up after computer-assisted total knee replacement resulted in good clinical outcome with high patient satisfaction. Statistically significant better values for the rotating platform group were found for the medio-lateral stability in extension and the peak flexion torque.