J Knee Surg 2019; 32(07): 590-595
DOI: 10.1055/s-0039-1679924
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rationale and Results for Fixed-Bearing Pivoting Designs in Total Knee Arthroplasty

Scott A. Banks
1  Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida
,
Evan Deckard
2  Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
,
W. Andrew Hodge
3  Department of Orthopaedic Surgery, The Institute for Mobility and Longevity, Phoenix, Arizona
,
R. Michael Meneghini
2  Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
› Author Affiliations
Further Information

Publication History

30 October 2018

10 January 2019

Publication Date:
01 March 2019 (eFirst)

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Abstract

Total knee arthroplasty (TKA) is a maturing technology, and the focus for improvement centers on optimizing patient satisfaction and further reducing revisions. It is commonly assumed that achieving closer-to-normal knee mechanics in a TKA will result in further improvement in outcomes and revision rates. Fixed-bearing TKA designs with asymmetric pivoting articulations are designed to provide more natural joint stability and kinematics. These designs have been used for more than 20 years and there is a substantial body of literature characterizing their performance. This article reviews the various design types of fixed-bearing pivoting TKA designs, and recounts their clinical, functional, and patient-preference performance from peer-reviewed studies. To date, the evidence suggests there is measurable benefit to providing closer-to-normal joint stability and kinematics, and that fixed-bearing, pivoting TKA designs may decrease instability-related revisions and improve patient satisfaction.

Keywords

total knee arthroplasty - implant design - kinematics - function - satisfaction