Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement

S Breeman, M K Campbell, H Dakin, N Fiddian, R Fitzpatrick, A Grant, A Gray, L Johnston, G S MacLennan, R W Morris, D W Murray, KAT Trial Group

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

There is conflicting evidence about the merits of mobile bearings in total knee replacement, partly because most randomised controlled trials (RCTs) have not been adequately powered. We report the results of a multicentre RCT of mobile versus fixed bearings. This was part of the knee arthroplasty trial (KAT), where 539 patients were randomly allocated to mobile or fixed bearings and analysed on an intention-to-treat basis. The primary outcome measure was the Oxford Knee Score (OKS) plus secondary measures including Short Form-12, EuroQol EQ-5D, costs, cost-effectiveness and need for further surgery. There was no significant difference between the groups pre-operatively: mean OKS was 17.18 (sd 7.60) in the mobile-bearing group and 16.49 (sd 7.40) in the fixed-bearing group. At five years mean OKS was 33.19 (sd 16.68) and 33.65 (sd 9.68), respectively. There was no significant difference between trial groups in OKS at five years (-1.12 (95% confidence interval -2.77 to 0.52) or any of the other outcome measures. Furthermore, there was no significant difference in the proportion of patients with knee-related re-operations or in total costs. In this appropriately powered RCT, over the first five years after total knee replacement functional outcomes, re-operation rates and healthcare costs appear to be the same irrespective of whether a mobile or fixed bearing is used.
Original languageEnglish
Pages (from-to)486-492
Number of pages7
JournalJournal of Bone & Joint Surgery (US Volume)
Volume95-B
Issue number4
DOIs
Publication statusPublished - Apr 2013

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Knee Replacement Arthroplasties
Knee
Randomized Controlled Trials
Outcome Assessment (Health Care)
Costs and Cost Analysis
Health Care Costs
Cost-Benefit Analysis
Confidence Intervals

Keywords

  • Aged
  • Arthroplasty, Replacement, Knee
  • Female
  • Humans
  • Knee Prosthesis
  • Male
  • Prospective Studies
  • Prosthesis Design

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Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement. / Breeman, S; Campbell, M K; Dakin, H; Fiddian, N; Fitzpatrick, R; Grant, A; Gray, A; Johnston, L; MacLennan, G S; Morris, R W; Murray, D W; KAT Trial Group.

In: Journal of Bone & Joint Surgery (US Volume), Vol. 95-B, No. 4, 04.2013, p. 486-492.

Research output: Contribution to journalArticle

Breeman, S, Campbell, MK, Dakin, H, Fiddian, N, Fitzpatrick, R, Grant, A, Gray, A, Johnston, L, MacLennan, GS, Morris, RW, Murray, DW & KAT Trial Group 2013, 'Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement', Journal of Bone & Joint Surgery (US Volume), vol. 95-B, no. 4, pp. 486-492. https://doi.org/10.1302/0301-620X.95B4.29454
Breeman, S ; Campbell, M K ; Dakin, H ; Fiddian, N ; Fitzpatrick, R ; Grant, A ; Gray, A ; Johnston, L ; MacLennan, G S ; Morris, R W ; Murray, D W ; KAT Trial Group. / Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement. In: Journal of Bone & Joint Surgery (US Volume). 2013 ; Vol. 95-B, No. 4. pp. 486-492.
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