Department of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar.
Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Eur J Orthop Surg Traumatol. 2022 Apr;32(3):481-495. doi: 10.1007/s00590-021-02999-x. Epub 2021 May 22.
The purpose of this study was to perform a meta-analysis comparing mobile-bearing with fixed-bearing total knee arthroplasty (TKA) in terms of all-cause revision rates, aspetic loosening, knee functional scores, range of motion and radiographic lucent lines and osteolysis.
PubMed, Cochrane Library, Google Scholar and Web of Science were searched up to January 2020. Randomized controlled trials that compared primary mobile-bearing with fixed-bearing TKA, reporting at least one of the outcomes of interest, at a minimum follow-up of 12 months were included. All outcomes of interest were pooled at short-term (< 5 years), mid-term (5 to 9 years) and long-term (> = 10 years) follow-up intervals.
A total of 70 eligible articles were included in the qualitative and statistical analyses. There was no difference between mobile-bearing or fixed-bearing TKA at short-term, mid-term and long-term follow-ups in all outcome measures including all-cause revision rate, aseptic loosening, oxford knee score, knee society score, Hospital for Special Surgery score, maximum knee flexion, radiographic lucent lines and radiographic osteolysis.
The current level of evidence demonstrated that both mobile-bearing and fixed-bearing designs achieved excellent outcomes, yet it does not prove the theoretical advantages of the mobile-bearing insert over its fixed-bearing counterpart. The use of either design could therefore be supported based on the outcomes assessed in this study.
Level II, Therapeutic.
本研究旨在通过荟萃分析比较活动衬垫与固定衬垫全膝关节置换术（TKA）在全因翻修率、无菌性松动、膝关节功能评分、活动范围以及影像学透亮线和溶骨方面的差异。
检索了 PubMed、Cochrane 图书馆、Google Scholar 和 Web of Science，检索时间截至 2020 年 1 月。纳入了比较原发性活动衬垫与固定衬垫 TKA 的随机对照试验，这些试验至少报告了一个感兴趣的结果，且随访时间至少为 12 个月。所有感兴趣的结果均在短期（<5 年）、中期（5-9 年）和长期（>10 年）随访间隔进行汇总。
共有 70 篇符合条件的文章纳入了定性和统计学分析。在所有测量结果（包括全因翻修率、无菌性松动、牛津膝关节评分、膝关节学会评分、特殊外科医院评分、最大膝关节屈曲度、影像学透亮线和影像学溶骨）方面，活动衬垫或固定衬垫 TKA 在短期、中期和长期随访中均无差异。
目前的证据水平表明，活动衬垫和固定衬垫设计均取得了优异的结果，但这并不能证明活动衬垫的理论优势超过其固定衬垫的对应物。因此，基于本研究评估的结果，可以支持使用这两种设计中的任何一种。
II 级，治疗性。
