Our Summary

This research paper is about a study comparing two types of knee replacement surgeries: Unicompartmental Knee Arthroplasty (UKA) with a fixed bearing (FB) and a mobile bearing (MB). The researchers wanted to find out which type of surgery was better.

To do this, they analyzed 17 previous studies that involved 2612 knee surgeries. They compared the results of both types of surgeries, including the patients’ clinical outcomes (like pain and mobility) and radiological outcomes (like what the x-rays showed).

In the end, they found that there wasn’t a significant difference between the two types of surgeries in terms of clinical and radiological outcomes. However, they did find that the two surgeries had different types of failures and at different times. The mobile bearing surgeries failed earlier due to the bearing dislocation, while the fixed bearing surgeries failed later due to wear and tear on the polyethylene, a type of plastic used in the surgery.

The researchers didn’t find any evidence that the results were biased because of the way the studies they analyzed were published. They concluded that there’s no significant difference between the two types of surgeries, but there are differences in how and when they fail.

FAQs

  1. What is the difference between a fixed bearing (FB) and a mobile bearing (MB) unicompartmental knee arthroplasty (UKA)?
  2. Are there any significant differences in clinical and radiological outcomes between the FB and MB UKAs?
  3. What are the differences in the modes and timing of failures between the FB and MB UKAs?

Doctor’s Tip

A helpful tip a doctor might tell a patient about knee replacement is to follow the post-operative rehabilitation plan carefully, including completing physical therapy exercises as recommended. This can help improve range of motion, strength, and overall function of the knee joint after surgery. It is important to communicate any concerns or changes in symptoms to your healthcare provider to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for knee replacement surgery include those with severe knee pain and stiffness that limits daily activities, those who have not seen improvement with conservative treatments such as medication or physical therapy, and those with advanced osteoarthritis or other degenerative joint diseases. Additionally, patients who have experienced a traumatic injury to the knee or have deformities such as bowed legs may also be recommended for knee replacement surgery.

Timeline

  • Before knee replacement:
  1. Patient experiences chronic knee pain, stiffness, and swelling that limits their daily activities and quality of life.
  2. Patient undergoes a thorough evaluation by a healthcare provider, including physical examination, imaging studies, and possibly a trial of conservative treatments such as physical therapy or medications.
  3. After discussing the risks and benefits, the patient decides to proceed with knee replacement surgery.
  • After knee replacement:
  1. Patient undergoes preoperative preparation, including medical clearance, education on the procedure, and possibly physical conditioning exercises.
  2. Patient undergoes knee replacement surgery, which involves removing damaged parts of the knee joint and replacing them with artificial components.
  3. Patient stays in the hospital for a few days for postoperative care and rehabilitation.
  4. Patient undergoes physical therapy and rehabilitation to regain strength, range of motion, and function in the knee.
  5. Patient gradually resumes daily activities and eventually returns to normal function with reduced pain and improved mobility.

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement include:

  1. What type of knee replacement (FB or MB) do you recommend for me and why?
  2. What are the potential risks and complications associated with the specific type of knee replacement you are recommending?
  3. What is the expected recovery time and rehabilitation process for this type of knee replacement?
  4. How long can I expect the knee replacement to last before needing revision surgery?
  5. What are the differences in modes and timing of failures between FB and MB knee replacements, and how might this impact me in the long term?
  6. Are there any specific factors about my knee condition that make one type of knee replacement more suitable for me than the other?
  7. What is your experience and success rate with performing the specific type of knee replacement you are recommending?
  8. What steps can I take to maximize the success of my knee replacement surgery and ensure a smooth recovery process?
  9. Are there any lifestyle changes or modifications I should consider post-surgery to protect my knee replacement and prolong its lifespan?
  10. Are there any alternative treatment options or conservative measures that I should consider before proceeding with knee replacement surgery?

Reference

Authors: Zhang W, Wang J, Li H, Wang W, George DM, Huang T. Journal: Sci Rep. 2020 Nov 5;10(1):19075. doi: 10.1038/s41598-020-76124-z. PMID: 33154502