Research Article: Comparison of efficacy and cost-effectiveness between mobile-bearing and fixed-bearing unicompartmental knee arthroplasty for elderly patients with knee osteoarthritis: a retrospective cohort study
Abstract:
To compare the mid-term efficacy and cost-effectiveness of unicompartmental knee arthroplasty using a Mobile-Bearing and a Fixed-Bearing in elderly patients with knee osteoarthritis.
This study is a multicenter retrospective cohort study. 502 patients who underwent surgery at four joint centers from July 2020 to July 2023 were included and divided into a Mobile-Bearing Group ( n =?251) and a Fixed-Bearing Group ( n =?251) based on the type of prosthesis used. Compare the surgical parameters, visual analog pain scores at multiple postoperative time points (6 weeks, 3 months, 6 months, 1 year, 2 years), knee joint scores, joint range of motion, imaging parameters, complications, and cost-effectiveness between two groups.
The surgical time of the Mobile-Bearing Group was longer than that of the Fixed-Bearing Group, and the difference was statistically significant (t?=?8.524, P <?0.001). During mid-term follow-up (6 months to 2 years), the VAS score of the Mobile-Bearing Group was significantly lower than that of the Fixed-Bearing Group, while the HSS score, joint range of motion, and hip knee ankle angle were significantly higher than those of the Fixed-Bearing Group ( P <?0.05). The incidence of liner dislocation is higher in the Mobile-Bearing Group, while there is an increasing trend of progressive wear in the contralateral compartment in the Fixed-Bearing Group. Cost effectiveness analysis shows that the Mobile-Bearing Group has higher direct medical costs and obtains more quality adjusted life years.
Compared with Fixed-Bearing unicompartmental, Mobile-Bearing unicompartmental can provide better pain relief, functional recovery, and patient satisfaction in the mid-term, but it is accompanied by higher medical costs and specific complication risks; Fixed-Bearing unicompartmental is a more economical alternative.
Introduction:
Unicompartmental knee arthroplasty is a mature surgical procedure for treating isolated medial compartment osteoarthritis of the knee joint. Its purpose is to restore knee joint function to a near physiological state by preserving the cruciate ligament and contralateral compartment structure. In current clinical practice, two main prosthetic design concepts are used: Mobile-Bearing and Fixed-Bearing. There are fundamental differences between these two designs in terms of load transfer, polyethylene wear mechanism,…
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