No differences between fixed- and mobile-bearing total knee arthroplasty

B.L. Fransen, D.C. van Duijvenbode, M.J.M. Hoozemans, B.J. Burger

Research output: Contribution to JournalArticleAcademicpeer-review

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Purpose: For years, numerous studies have been performed to determine whether mobile-bearing total knee arthroplasty (MB-TKA) or fixed-bearing total knee arthroplasty (FB-TKA) is the preferential design in total knee arthroplasty. Reviews and meta-analyses on this subject have focused on a relatively small number of randomised controlled trials, possibly missing important results of smaller studies. The goal of this review was to provide a comprehensive overview of all literature comparing MB-TKA and FB-TKA in the treatment of osteoarthritis of the knee. Methods: An extensive literature search was performed in the PubMed database. All studies that compared MB-TKA with FB-TKA and looked at one of four theorised advantages (insert wear, signs of loosening, survival rate of the prosthesis and clinical outcome) were included. Results: The initial search yielded 258 articles, of which 127 were included after the first screening. The included studies consisted of 9 meta-analyses, 3 systematic reviews, 48 RCT’s, 44 comparative studies, 10 reviews and 13 studies that examined patients who received bilateral TKA (one MB-TKA and one FB-TKA). Combining the results of all studies showed that almost all studies found no difference between MB-TKA and FB-TKA. Conclusions: Even when examining all different types of studies on MB-TKA and FB-TKA, the results of this review showed no difference in insert wear, risk of loosening, survivorship or clinical outcome. In daily practice, the choice between MB-TKA and FB-TKA should be based on the experience and judgment of the surgeon, since no clear differences are observed in the scientific literature. Level of evidence: III.
Original languageEnglish
Pages (from-to)1757-1777
Number of pages21
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number6
Early online date20 Jun 2016
Publication statusPublished - Jun 2017


  • fixed bearing
  • mobile bearing
  • reveiw
  • total knee arthroplasty


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