No difference in joint awareness after mobile- and fixed-bearing total knee arthroplasty: 3-year follow-up of a randomized controlled trial

Eur J Orthop Surg Traumatol. 2017 Dec;27(8):1151-1155. doi: 10.1007/s00590-017-1921-0. Epub 2017 Feb 9.


Purpose: To compare the patients ability to forget the artificial knee joint in everyday life who were randomized to be operated for mobile- or fixed-bearing total knee arthroplasty (TKA).

Methods: This single-center randomized controlled trial evaluated the 3-year follow-up of the cemented mobile- and fixed-bearing TKA from the same brand in a series of 41 patients. Clinical examination was during the pre-, 6-week, 6-month, 1-, 2- and 3-year follow-up containing multiple patient-reported outcome measures (PROMs) including the 12-item Forgotten Joint Score (FJS-12) at 3 years. Effect size was calculated for each PROM at 3-year follow-up to quantify the size of the difference between both bearings.

Results: At 3-year follow-up, general linear mixed model analysis showed that there were no significant or clinically relevant differences between the two groups for all outcome measures. Calculated effect sizes were small (<0.3) for all the PROMs except for the FJS-12; these were moderate (0.5).

Conclusion: The results of this study demonstrate that joint awareness was slightly lower in patients operated with the MB TKA with comparable improved clinical outcome and PROMs at 3-year follow-up. Measuring joint awareness with the FJS-12 is useful and provides more stringent information at 3-year follow-up compared to other PROMs and should be the PROM of choice at each follow-up after TKA.

Level of evidence: Level I, randomized controlled trial.

Keywords: Effect size; Fixed-bearing; Forgotten Joint Score; Joint awareness; Mobile-bearing; PROMs; Randomized controlled trial; Total knee arthroplasty.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / instrumentation*
  • Awareness*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint
  • Knee Prosthesis / psychology*
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Postoperative Period
  • Prosthesis Design / psychology*