Dataset Information

Complete 180-Degree Dislocation of a Rotating Platform after Closed Reduction for Mobile Bearing Spinout.

ABSTRACT: Rotating-platform total knee arthroplasty was designed to help decrease backside polyethylene wear and allow maximal conformity between the femoral and tibial components, but there have been multiple reports of dislocation and spinout of these implants. There are 4 case reports in the literature of knee dislocations with 180° rotation of the platform, 3 of which occurred during relocation attempts. This is only the second case in a posterior-stabilized mobile-bearing device. We present a case of complete 180° dislocation of a rotating platform after closed reduction in a posterior-stabilized total knee arthroplasty, with subsequent conversion to hinge knee arthroplasty.

SUBMITTER: Sommi C

PROVIDER: S-EPMC7406978 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Complete 180-Degree Dislocation of a Rotating Platform after Closed Reduction for Mobile Bearing Spinout.

Sommi Corinne C Wu Victor J VJ Heffernan John J Sherman William W

Arthroplasty today 20200804 3

Rotating-platform total knee arthroplasty was designed to help decrease backside polyethylene wear and allow maximal conformity between the femoral and tibial components, but there have been multiple reports of dislocation and spinout of these implants. There are 4 case reports in the literature of knee dislocations with 180° rotation of the platform, 3 of which occurred during relocation attempts. This is only the second case in a posterior-stabilized mobile-bearing device. We present a case of ...[more]

PMID: 32793787

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Project description:BackgroundMobile bearings have been compared with fixed bearings used in TKA. However, rotating platforms, a specific type of mobile bearing, have not been compared with fixed-bearings using meta-analysis.Questions/purposesWe asked whether the performance of a rotating-platform bearing is superior to, comparable to, or worse than a fixed bearing. Four areas were investigated: clinical performance, component alignment, adverse event rates, and revision rates.MethodsSearches of Medline, EMBASE, Google Scholar, and the Cochrane databases, combined with reference lists from published meta-analyses and systematic reviews of mobile-bearing versus fixed-bearing prostheses used in TKAs, provided 17 nonlanguage-restricted studies consisting of 1910 TKAs (966 rotating platform versus 944 fixed bearing). Random-effect modeling was used for all meta-analyses, thereby mitigating possible effects of heterogeneity among studies. All meta-analyses were examined for publication bias using funnel plots; publication bias was not detected for any meta-analysis.ResultsThere were no statistically or clinically significant differences in clinical performance (clinical scores, ROM, and radiographic evaluation), component alignment, revision rates, or adverse event rates except for tibial component alignment in the AP plane, which favored TKA with fixed-bearings (p = 0.020; standardized mean difference, 0.229; 95% CI, 0.035-0.422), but the effect size was small enough that it was not considered clinically important.ConclusionsBased on our findings, which agree substantially with those of prior systematic reviews of TKAs with mobile-bearing versus fixed-bearing prostheses, there is no compelling case for either rotating-platform or fixed-bearing implant design in terms of clinical performance, component alignment, adverse event frequencies, or survivorship. This dataset, which was limited to a maximum 6 years followup, is insufficient to address questions related to wear or late revisions. We therefore suggest that implant choice should be made on the basis of other factors, perhaps including cost or surgeon experience.

Dataset Information

Complete 180-Degree Dislocation of a Rotating Platform after Closed Reduction for Mobile Bearing Spinout.

Publications

Complete 180-Degree Dislocation of a Rotating Platform after Closed Reduction for Mobile Bearing Spinout.

Similar Datasets

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