Rationale and Long Term Outcome of Rotating Platform Total Knee Replacement
Rotating platform (RP) total knee replacement (TKR) designs, were introduced in the late 1970s aiming to more closely recreate normal knee kinematics and to minimize some of the problems (mainly wear and loosening) seen with early fixed bearing TKR implants. High conformity bearing surfaces without significant increased stresses at the polyethylene-baseplate interfaces and having the potential for self-alignment of the rotating polyethylene with the femoral component, correcting thus possible mistakes of tibial tray positioning, are some of the theoretical advantages of the RP TKR designs. Short and mid-term results have been promising but RP TKA failed to demonstrate significant advantages over the well time-tested fixed bearing designs probably due to the fact that both designs show excellent survivorship in the available to date long term follow-up. Longer follow-up studies in special cohorts of patients (i.e. young patients) are needed to show whether RP designs fare better than their non-RP counterparts. Herein, we present the best available evidence regarding the long term results of RP TKR from selected studies with minimum 10 years follow-up.
KeywordsTotal Knee Replacement Aseptic Loosening Knee Society Score Oxford Knee Score Polyethylene Insert
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