Point/Counterpoint: Which Bearing Type Is Best for UKA?

    The question of whether patients undergoing unicompartmental knee arthroplasty do better with a fixed-bearing or a mobile-bearing implant has not been answered to date. Dr. William Long and Dr. John Barrington weigh in.

    Data from large studies of fixed- versus mobile-bearing implants used in uncompartmental knee arthroplasty (UKA) have not shown a clear preference for either bearing type.

    That hasn’t stopped orthopaedic surgeons from promoting their personal preferences in papers and on the podium at national meetings.

    At ICJR’s OrthoLIVE meeting, William J. Long, MD, FRCSC, and John W. Barrington, MD, waded into the debate and shared their thoughts on research and experience with these bearings. Dr. Long is a proponent of fixed-bearing UKA, while Dr. Barrington prefers mobile-bearing UKA.

    Specifically, Dr. Long uses fixed-bearing implants with image-guided UKA, which he said:

    • Help him with sizing and positioning of the implant
    • Provide intraoperative feedback on balance and alignment
    • Allow for minimal bone resection

    Overall, Dr. Long said fixed-bearing implants provide a higher level of patient satisfaction and are easier to revise to a total knee arthroplasty.

    Mobile-bearing implants have their advantages too, said Dr. Barrington. His practice in Texas has collected 20 years of data on mobile-bearing UKAs, and the results have been very positive, with excellent functional outcomes and good survivorship of the implants.

    Dr. Barrington also cited a new patient satisfaction study from the University of Wisconsin that showed a higher level of satisfaction among patients who had undergone a UKA with a mobile-bearing implant than those who had a fixed-bearing implant and those who had undergone a total knee arthroplasty.

    In addition, fewer negative symptoms – such as pain, swelling, and stiffness – were seen in the mobile-bearing implant group.

    At OrthoLIVE, Dr. Long and Dr. Barrington elaborated on their key points in interviews exclusive to ICJR.net. Click on the image below to hear their comments.

    Producer: Michael Szuch; Director: Michael Bugera; Post Production: Charles Maynard