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DOI: 10.1055/s-0040-1709989
Comparative Study of the Function and Quality of Life of Patients Submitted to Total Knee Arthroplasty with Fixed and Mobile Tibial Platforms
Article in several languages: português | English![](https://www.thieme-connect.de/media/10.1055-s-00042410/202101/lookinside/thumbnails/10-1055-s-0040-1709989_1900106_en-1.jpg)
Abstract
Objective To compare the function and quality of life of patients undergoing total knee arthroplasty (TKA) with fixed tibial platform and mobile tibial platform.
Methods We evaluated 240 patients with knee osteoarthritis, randomized into two groups - Group A consisted of 120 patients who underwent TKA with fixed tibial platform, and the B group, consisting of 120 patients who underwent mobile platform arthroplasty. Patients were accessed according to the function and quality of life by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Short Form Health Survey (SF-36), and pain scores by visual analog scale (VAS) of pain, preoperatively and at 6 months, 1 year, 2 years, 4 years and 8 years of surgery.
Results Regarding the various domains of the SF-36, we observed that the average behavior of functional capacity scores, physical aspects, pain and emotional aspects in the patient groups were statistically different during follow-up. The other domains of quality of life showed no mean differences. Regarding the pain assessed by VAS and WOMAC pain scores, we can see that it showed a mean change in follow-up in both patient groups. However, at 2 years of follow-up, they were statistically worse in group A, equaling group B in the other moments.
Conclusion After 2 years of follow-up, we observed that pain scores and VAS were lower in the fixed platform group. However, these differences did not remain in the mid-term, suggesting that the mobile tibial platform arthroplasty has a short-term advantage, and may help in the rehabilitation process.
Publication History
Received: 08 July 2019
Accepted: 27 January 2020
Article published online:
08 July 2020
© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referências
- 1 Lanza IR, Towse TF, Caldwell GE, Wigmore DM, Kent-Braun JA. Effects of age on human muscle torque, velocity, and power in two muscle groups. J Appl Physiol (1985) 2003; 95 (06) 2361-2369
- 2 Narici MV, Maganaris C, Reeves N. Myotendinous alterations and effects of resistive loading in old age. Scand J Med Sci Sports 2005; 15 (06) 392-401
- 3 Herzog W, Longino D. The role of muscles in joint degeneration and osteoarthritis. J Biomech 2007; 40 (Suppl. 01) S54-S63
- 4 Laborde JM, Powers MJ. Life satisfaction, health control orientation, and illness-related factors in persons with osteoarthritis. Res Nurs Health 1985; 8 (02) 183-190
- 5 Downe-Wamboldt B. Coping and life satisfaction in elderly women with osteoarthritis. J Adv Nurs 1991; 16 (11) 1328-1335
- 6 Dickstein R, Heffes Y, Shabtai EI, Markowitz E. Total knee arthroplasty in the elderly: patients' self-appraisal 6 and 12 months postoperatively. Gerontology 1998; 44 (04) 204-210
- 7 Heck DA, Robinson RL, Partridge CM, Lubitz RM, Freund DA. Patient outcomes after knee replacement. Clin Orthop Relat Res 1998; (356) 93-110
- 8 Bachmeier CJ, March LM, Cross MJ. et al. Arthritis Cost and Outcome Project Group. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 2001; 9 (02) 137-146
- 9 Hartley RC, Barton-Hanson NG, Finley R, Parkinson RW. Early patient outcomes after primary and revision total knee arthroplasty. A prospective study. J Bone Joint Surg Br 2002; 84 (07) 994-999
- 10 Mäntyselkä P, Kumpusalo E, Ahonen R, Takala J. Patients' versus general practitioners' assessments of pain intensity in primary care patients with non-cancer pain. Br J Gen Pract 2001; 51 (473) 995-997
- 11 Janse AJ, Gemke RJ, Uiterwaal CS, van der Tweel I, Kimpen JL, Sinnema G. Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol 2004; 57 (07) 653-661
- 12 O'Boyle CA. Assessment of quality of life in surgery. Br J Surg 1992; 79 (05) 395-398
- 13 Givon U, Ginsberg GM, Horoszowski H, Shemer J. Cost-utility analysis of total hip arthroplasties. Technology assessment of surgical procedures by mailed questionnaires. Int J Technol Assess Health Care 1998; 14 (04) 735-742
- 14 Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 2004; 86 (05) 963-974
- 15 Ware Jr J, Kosinski M, Keller SDA. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996; 34 (03) 220-233
- 16 Wylde V, Learmonth I, Potter A, Bettinson K, Lingard E. Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement. J Bone Joint Surg Br 2008; 90 (09) 1172-1179
- 17 Jacobs W, Anderson P, Limbeek J, Wymenga A. Mobile bearing vs fixed bearing prostheses for total knee arthroplasty for post-operative functional status in patients with osteoarthritis and rheumatoid arthritis. Cochrane Database Syst Rev 2004; (02) CD003130
- 18 Núñez M, Núñez E, del Val JL. et al. Health-related quality of life in patients with osteoarthritis after total knee replacement: factors influencing outcomes at 36 months of follow-up. Osteoarthritis Cartilage 2007; 15 (09) 1001-1007
- 19 Kirkwood BR, Sterne JA. Essential medical statistics. 2nd ed. Massachusetts, USA: Blackwell; 2006
- 20 McCullagh P, Nelder JA. Generalized linear models. 2nd ed. New York, USA: Chapman and Hall; 1989
- 21 Neter J, Kutner MH, Nachtsheim CJ, Wasserman W. Applied Linear Statistical Models. 4th ed. Ilinois: Richard D. Irwing; 1996
- 22 Bhan S, Malhotra R, Kiran EK, Shukla S, Bijjawara M. A comparison of fixed-bearing and mobile-bearing total knee arthroplasty at a minimum follow-up of 4.5 years. J Bone Joint Surg Am 2005; 87 (10) 2290-2296
- 23 Matsuda S, Mizu-uchi H, Fukagawa S. et al. Mobile-bearing prosthesis did not improve mid-term clinical results of total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2010; 18 (10) 1311-1316
- 24 Aglietti P, Baldini A, Buzzi R, Lup D, De Luca L. Comparison of mobile-bearing and fixed-bearing total knee arthroplasty: a prospective randomized study. J Arthroplasty 2005; 20 (02) 145-153
- 25 Hofmann S, Seitlinger G, Djahani O, Pietsch M. The painful knee after TKA: a diagnostic algorithm for failure analysis. Knee Surg Sports Traumatol Arthrosc 2011; 19 (09) 1442-1452