A prospective randomised controlled trial comparing three alternative bearing surfaces in primary total hip replacement. Total Hip Arthroplasty with the Charnley Prosthesis in Patients Fifty-five Years Old and Less. Fifteen to Twenty-one-Year Results* Immediate weight bearing after uncemented total hip arthroplasty with an anteverted stem: A prospective randomized comparison using radiostereometry Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Arthroplasties Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomised, clinical and radiological study with mid-term results at 7 years. Randomized clinical trial of rotating-platform and fixed-bearing total knee arthroplasty: no clinically detectable differences at five years. Long-term results of cemented total hip arthroplasty in patients younger than 30 years and the outcome of subsequent revisions The outcome of primary total hip and knee arthroplasty in patients aged 80 years or more. Revision total hip arthroplasty in patients 80 years or older. Primary Total Hip Arthroplasty with a Second-Generation Cementless Total Hip Prosthesis in Patients Younger Than Fifty Years of Age Ceramic-on-ceramic total hip arthroplasty: update. Prospective study of a cementless total hip arthroplasty with a collum femoris preserving stem and a trabeculae oriented pressfit cup: minimun 6-year follow-up What Can Be Learned From Minimum 20-year Followup Studies of Knee Arthroplasty? No adverse effects of early weight bearing after uncemented total hip arthroplastyA randomized study of 20 patients Clinical outcomes, survivorship and adverse events with mobile-bearings versus fixed-bearings in hip arthroplasty-a prospective comparative cohort study of 143 ADM versus 130 trident cups at 2 to 6-year follow-up. Fixed versus mobile weight-bearing prosthesis in total knee arthroplasty
The ideal bearing surface for young patients undergoing total hip replacement ( THR ) remains controversial . We report the five-year results of a r and omised controlled trial comparing the clinical and radiological outcomes of 102 THRs in 91 patients who were < 65 years of age . These patients were r and omised to receive a cobalt-chrome on ultra-high-molecular-weight polyethylene , cobalt-chrome on highly cross-linked polyethylene , or a ceramic-on-ceramic bearing . In all , 97 hip replacements in 87 patients were available for review at five years . Two hips had been revised , one for infection and one for peri-prosthetic fracture . At the final follow-up there were no significant differences between the groups for the mean Western Ontario and McMaster Universities osteoarthritis index ( pain , p = 0.543 ; function , p = 0.10 ; stiffness , p = 0.99 ) , Short Form-12 ( physical component , p = 0.878 ; mental component , p = 0.818 ) or Harris hip scores ( p = 0.22 ) . Radiological outcomes revealed no significant wear in the ceramic group . Comparison of st and ard and highly cross-linked polyethylene , however , revealed an almost threefold difference in the mean annual linear wear rates ( 0.151 mm/year versus 0.059 mm/year , respectively ) ( p < 0.001 ) Data on 240 primary Charnley total hip arthroplasties , performed in 211 patients from October 1968 to July 1974 , were recorded prospect ively . Fifty-two prostheses were implanted in forty-six patients who were thirty-four to fifty-five years old , and 188 prostheses were implanted in 165 patients who were more than fifty-five years old . The results for the younger patients were compared with those for the older patients . Twenty hips were revised over-all , and all five of the infections and four of the five fractures of the femoral stem that occurred in this group were in the older patients . However , the rate of aseptic loosening was similar for the two age-groups ( three of the hips in the younger patients and five in the older patients ) . The probability of revision after twenty years for the two groups , as determined with Kaplan-Meier analysis , was 11.7 per cent for the younger patients and 10.7 per cent for the older patients . There was no significant difference between the two groups with regard to either the number of revisions or the percentage of patients who had radiographic signs of loosening . The median Charnley hip scores during the course of the study were also similar for the two groups . We recommend that Charnley low-friction arthroplasty be used even in younger patients , as the long-term results were excellent and were comparable with those in the elderly age-group Background In uncemented total hip arthroplasty with hydroxyapatite coating , early weight bearing is frequently practice d but there is still not much evidence to support this recommendation . Method In a prospect i ve r and omized study we evaluated the effect of partial and full weight bearing after  cementless total hip arthroplasty ( ABG ; Stryker-Howmedica ) using radiostereometric analysis ( RSA ) . Between February 1996 and February 2000 , 43 consecutive patients ( mean age 53 ( 41–63 ) years , 23 women ) with hip osteoarthrosis received an uncemented and hydroxyapatite-coated prosthesis with an anteverted stem . All patients were operated in a st and ardized way by three experienced surgeons and they were r and omized to partial ( P ) or full ( F ) weight bearing during the first 6 weeks after surgery . The patients in the partial weight bearing group were equipped with a pressuresensitive insole signaling when their load exceeded the prescribed weight limit . Results At 3-month follow-up , the mean proximal (+)/ distal ( - ) migration of the stem was -0.14 mm ( -1.93– 0.11 ) in group P and -0.31 mm ( -4.30–0.16 ) in group F ( p = 0.6 ) . At 1-year follow-up , the mean migration was –0.17 mm ( -2.18–0.21 ) and -0.28 mm ( -4.31–0.11 ) , respectively ( p = 0.9 ) . There was no significant difference in stem rotations either ( p < 0.2 ) . The cup translations , rotations , and femoral head penetration were similar in the two groups ( p < 0.1 ) . There were no re-operations during the first year . Interpretation We did not find any adverse effect of full weight bearing immediately after operation , which justifies use of this regimen after uncemented total hip arthroplasty of the ABG type The purpose of the current study was to directly compare the results of fixed-bearing and mobile-bearing total knee arthroplasties in the same patient who had bilateral simultaneous total knee replacements . A fixed-bearing total knee prosthesis ( AMK ) was implanted in one knee and a mobile-bearing total knee prosthesis ( LCS ) was implanted in the other knee in 116 patients . The average age of the patients was 65 years ( range , 33–70 years ) . The average followup was 7.4 years ( range , 6–8 years ) .  Clinical and radiographic followup was done using Knee Society and Hospital for Special Surgery knee rating systems at 6 weeks , 3 months , 6 months , 1 year after surgery , and yearly thereafter . Total knee score , pain score , mean functional score , and range of motion were comparable in both groups . Two knee replacements ( 2 % ) in one patient with AMK prostheses were revised because of complete wear of tibial bearing polyethylene . One knee replacement ( 1 % ) in one patient with an LCS prosthesis was revised because of dislocation of the medial tibial bearing polyethylene and one knee replacement ( 1 % ) in one patient with an LCS prosthesis was revised because of complete wear of the medial tibial bearing polyethylene . No knee had aseptic loosening or osteolysis in either group . After a minimum followup of 6 years , the results of fixed- and mobile-bearing total knee prostheses in the current series are favorable . However , there is no evidence to prove the superiority of the mobile-bearing total knee design Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients . The study aims to compare the short-term results of cemented and cementless total hip arthroplasty ( THA ) in active patients > 80 years of age with femoral neck fractures . Methods Sixty-two consecutive patients underwent THA during the study period  ( cemented—31 and cementless—31 ) . The mean age was 84 years ( 81–94 years ) . Patients in both groups were comparable in their preoperative variables . Functional and radiological assessment s were carried out using vali date d outcome measures . Complications were recorded . Results Fifty-one patients were available for final analysis after accounting for deaths and cases lost in follow-up . Of the 51 patients , 25 ( 49 % ) regained their pre-injury mobility status and 36 ( 70 % ) were community ambulant . Cementless THA was associated with significantly less surgical time , blood loss , transfusion rates and hospital stay . The overall mortality rates , complications , functional and radiological results were similar in both groups though the number of deaths in the perioperative period was significantly high in patients undergoing cemented THA . ConclusionS atisfactory improvement in function with low reoperation rates can be achieved irrespective of the technique used . Complication rates are higher when compared to younger patients undergoing the procedure . Risks and benefits should be carefully assessed and explained before subjecting these patients to THA Mobile-bearing ( MB ) total knee arthroplasty ( TKA ) was developed as an alternative to the established fixed-bearing ( FB ) design because of theoretical advantages . Short-term studies comparing these design s have not shown any differences in clinical and radiographic results . We compared the results at 7 years of a r and omised study of patients undergoing TKA using either a FB or a MB variant of the same prosthesis . Fifty-two patients ( 52 knees ) with an average age of 70 years received a FB posterior-stabilized prosthesis , and 50 patients ( 52 knees ) with an average age of 72 years , a MB prosthesis .  All implants were cemented and the patella was routinely resurfaced . Preoperatively , there were no differences between the two groups , and surgical procedure and postoperative protocol were the same for both . At an average follow-up of 7.1 years , no significant differences of FB over MB design could be demonstrated with respect to the American Knee Society score ( AKSS ) , pain score , a question naire of general health ( SF-12 score ) , range of motion ( ROM ) , or complication rates . Radiographs showed no significant difference in prosthetic alignment or evidence of loosening . Two knees with a MB design required reoperation , one for persistent joint stiffness and another to treat septic loosening . One patient with a MB prosthesis with signs of tibial component loosening was asymptomatic . We conclude that at mid-term follow-up there is no evidence to prove the superiority of MB over FB TKA with regard to the clinical and radiographic results BACKGROUND For some surgeons , rotating-platform total knee design s are an intellectually appealing option to use for total knee arthroplasty because of the contention that they can self-align and accommo date small mismatches in the rotational position of the tibial and femoral components . We carried out a r and omized clinical trial to determine if a posterior-stabilized , rotating-platform knee design provided better maximum knee flexion , better function , or better durability at five years of follow-up when compared with a fixed-bearing design . METHODS This r and omized clinical trial of 240 primary total knee arthroplasties involved a single type of distal femoral implant ( posterior-stabilized ) and three different types of tibial implant ( all-polyethylene fixed-bearing , modular-metal-backed fixed-bearing , and rotating-platform ) . The three tibial implant groups were balanced dynamically with a computerized r and omization process that accounted for patient age , sex , and body mass index ; surgeon ; and implant type . Patients returned for examination and radiographs at three months , one year , two years , and five years postoperatively . RESULTS Knee range of motion was not significantly different among the all-polyethylene , modular-metal-backed , and rotating-platform tibial component groups at two years ( mean , 111 ° , 111 ° , and 110 ° , respectively ) or five years ( mean , 110 ° , 109 ° , and 109 ° , respectively ) . Function , as measured with Knee Society scores , was not significantly different among the all-polyethylene , modular-metal-backed , and rotating-platform groups at two years ( mean , 90 , 91 , and 91 points , respectively ) or five years ( mean , 88 , 89 , and 88 points , respectively ) . Stair-climbing scores were not significantly different among the three groups at two years ( mean , 39 , 40 , and 39 points , respectively ) or five years ( mean , 37 , 40 , and 36 points , respectively ) . There were four revisions : one in the all-polyethylene group ( patellar fracture ) , two in the modular-metal-backed group ( aseptic loosening ) , and one in the rotating-platform group ( deep infection ) . CONCLUSIONS In this r and omized clinical trial , the rotating-platform total knee design was reliable and durable but did not provide better maximum knee flexion , better function , or better durability at five years postoperatively when compared with a posterior-stabilized , fixed-bearing design incorporating either an all-polyethylene or a modular-metal-backed tibial component Background The number of total hip arthroplasties in patients under 30 years is increasing over the years . Almost all of them will face at least one or more future revisions in their life . Therefore , the implant used should have a high survival rate , and needs to be easily revisable result ing in a low re-revision rate . Several studies have evaluated the outcome of total hip arthroplasties in patients under 30 years . However , only a few reported on the follow-up outcome of 10 years or more . In addition , none of these reports published data of the subsequent revisions of these implants within their original report . Methods We studied historically prospect i ve collected data of 48 consecutive patients ( 69 hips ) younger than 30 years , treated with a cemented primary total hip prosthesis between 1988 and 2004 . Since the last evaluation of this cohort , two patients were lost to follow-up . For all hip revisions in this cohort , again cemented implants were used , mostly in combination with bone impaction grafting .  Kaplan-Meier survival curves at 10- and 15 years for the primary total hip arthroplasties and revisions were determined . Results The mean age at time of primary surgery was 25 years ( range , 16 to 29 years ) . Mean follow-up of the primary hips was 11.5 years ( range , 7 to 23 years ) . During follow-up 13 revisions were performed ; in 3 cases a two-stage total revision was performed for septic loosening and 9 cups were revised for aseptic loosening . There were no aseptic stem revisions . The 10 and 15-year survival rates with endpoint revision for aseptic loosening of the primary total hip were 90 % ( 95 % CI : 79 to 96 ) and 82 % ( 95 % CI : 65 to 92 ) respectively . None of our 13 subsequent revisions needed a re-revision within 10 years after re-implantation . Conclusions Cemented total hip implants in patients under 30 years have an encouraging outcome at 10 and 15 years after surgery in these young patients . The 13 revised hips , treated with bone grafting and the third generation cement technique , were performing well with no re-revisions within ten years after surgery Primary arthroplasty may be denied to very elderly patients based upon the perceived outcome and risks associated with surgery . This prospect i ve study compared the outcome , complications , and mortality of total hip ( TKR ) and total knee replacement ( TKR )  in a prospect ively selected group of patients aged ≥ 80 years with that of a control group aged between 65 and 74 years . There were 171 and 495 THRs and 185 and 492 TKRs performed in the older and control groups , respectively . No significant difference was observed in the mean improvement of Oxford hip and knee scores between the groups at 12 months ( 0.98 , ( 95 % confidence interval ( CI ) -0.66 to 2.95 ) , p = 0.34 and 1.15 ( 95 % CI -0.65 to 2.94 ) , p = 0.16 , respectively ) . The control group had a significantly ( p = 0.02 and p = 0.04 , respectively ) greater improvement in the physical well being component of their SF-12 score , but the older group was more satisfied with their THR ( p = 0.047 ) . The older group had a longer hospital stay for both THR ( 5.9 versus 9.0 days , p < 0.0001 ) and TKR ( 6.2 versus 8.3 days , p < 0.0001 ) . The rates of post-operative complications and mortality were increased in the older group We evaluated all revisions performed from March 1996 to December 2008 and compared complications , mortality , and clinical outcomes between patients 80 years and older and patients younger than 80 years . Data were collected prospect ively . There were 325 revisions , 84 ( 25.8 % ) in patients 80 years and older and 241 in patients younger than 80 years ( 62 % revision for aseptic loosening in both groups ) . The mean follow-up was 4.3 years . The results , 80 years and older vs younger than 80 years , revealed the following : mortality , 5 % vs 0 % 3 months postoperatively ; medical complications in 23.8 % vs 6.2 % ; postoperative fractures , 9.5 % vs 2.5 % ; and improved Merle d'Aubigné scores from 9.6 to 13.0 vs 10.4 to 14.3 . Revision total hip arthroplasty in patients 80 years and older was associated with substantial clinical improvement and patient satisfaction . However , medical complications and 90-day mortality were higher , and postoperative fractures occurred more frequently Background : The early experience with cementless total hip replacement led to design modifications to increase the initial press-fit and stability of the femoral component , to reduce the diameter of the femoral head , and to improve the acetabular component , including the locking mechanism of the shell and the quality of the polyethylene liner . We performed a prospect i ve study to assess the results in young patients who had been followed for a minimum of eight years after treatment with a primary total hip arthroplasty with a second-generation cementless prosthesis . Methods : Eighty patients ( 118 hips ) were included in the study . There were fifty-eight men and twenty-two women ; the mean age at the time of the operation was 46.8 years ( range , twenty-one to forty-nine years ) . We used a cementless Duraloc series-100 or 1200 acetabular component with or without screw fixation , a polyethylene liner with a 22-mm inner diameter , and a cementless Profile femoral component in all hips . The average duration of follow-up was 9.8 years ( range , eight to eleven years ) . Clinical follow-up ( with use of the Harris hip score ) and radiographic follow-up were performed at six weeks ; at three , six , and twelve months ; and yearly thereafter . Linear and volumetric wear were measured , and bone-remodeling and osteolysis were assessed . Results : The average Harris hip score improved from 48.8 points preoperatively to 92 points at the final follow-up examination . The prevalence of transitory thigh pain was 10 % ( twelve of 118 hips ) . There was no aseptic loosening . One hip was revised because of recurrent dislocation . The average amount of linear wear was 1.18 mm , and the average wear rate was 0.12 mm/yr . Fourteen hips ( 12 % ) had osteolysis in the calcar femorale and eleven hips ( 9 % ) had acetabular osteolysis , but all of the osteolytic lesions were < 1 cm 2 . Conclusions : The mechanical fixation of the anatomic fit cementless Profile stem was excellent in this study of young patients who were particularly difficult to treat because of a high prevalence of osteonecrosis and developmental dysplasia . Although there was no aseptic loosening of the components and a relatively low prevalence of osteolysis , there was a high rate of linear wear of the polyethylene liner . Level of Evidence : Therapeutic study , Level IV ( case series [ no , or historical , control group ] ) . See p. 2 for complete description of levels of evidence This prospect i ve , r and omized , multicenter study of alumina ceramic-on-alumina ceramic bearing couples includes 452 patients ( 475 hips ) . Their average age was 53 years with approximately two thirds men and 82 % with osteoarthritis . At an average 8-year follow-up , clinical results were excellent and cortical erosions significantly less than in the conventional polyethylene-on-metal bearing group . Nine hips have undergone revision of one or both components for any reason . Of the 380 ceramic liners , 2 ( 0.5 % ) have fractured requiring reoperation , and 3 ( 0.8 % ) ceramic patients reported a transient squeaking sound , one of which had a head and liner change due to groin pain secondary to psoas tendinitis at 5 years . With no revisions for aseptic loosening and minimal cortical erosions , alumina-ceramic bearing couples are performing in a manner superior to the polyethylene-on-metal bearing in this young , active patient population Aim Tissue sparing hip prostheses are becoming more and more popular especially for the treatment of younger patients . The objective of this study was to evaluate the clinical and radiological results after insertion of a tissue sparing hip prosthesis . Method In 47 consecutive non-selected patients ( 50 hips ) , the clinical and radiographic results of cementless total hip arthroplasty using a collum femoris preserving stem , a pressfit cup and an alumina – polyethylene pairing were prospect ively evaluated . The mean age at index-surgery was 58 ( 36–82 ) years , there were 38 women and 9 men . After a mean follow-up of 6.8 years ( minimum 6.1 years ) , two patients had died and one patient underwent revision surgery due to aseptic loosening of the stem . Results The overall survival rate of the acetabular component was 100 % and of the femoral component 98 % . The mean Harris hip score at follow-up was 94 points . Conclusion The mid-term survival with this type of total hip arthroplasty is excellent and compares equal with uncemented straight stems in this age group Background Long-term evaluation of knee arthroplasty should provide relevant information concerning the durability and performance of the implant and the procedure . Because most arthroplasties are performed in older patients , most long-term followup studies have been performed in elderly cohorts and have had low patient survivorship to final followup ; the degree to which attrition from patient deaths over time in these studies might influence their results has been poorly characterized . Questions / purpose sThe purpose of this study was to examine the results at 20-year followup of two prospect ively followed knee arthroplasty cohorts to determine the following : ( 1 ) Are there relevant differences among the two implant cohorts in terms of revision for aseptic causes ( osteolysis , or loosening ) ? ( 2 ) How does patient death over the long followup interval influence the comparison , and do the comparisons remain valid despite the high attrition rates ? Methods Two knee arthroplasty cohorts from a single orthopaedic practice were evaluated : a modular tibial tray ( 101 knees ) and a rotating platform ( 119 knees ) design . All patients were followed for a minimum of 20 years or until death ( mean , 14.1 years ; SD 5.0 years ) . Average age at surgery for both cohorts was > 70 years . The indications for the two cohorts were identical ( functionally limiting knee pain ) and was surgeon-specific ( each surgeon performed all surgeries in that cohort ) . Revision rates through a competing risks analysis for implants and survivorship curves for patients were evaluated . Results Both of these elderly cohorts showed excellent implant survivorship at 20 years followup with only small differences in revision rates ( 6 % revision versus 0 % revision for the modular tibial tray and rotating platform , respectively ) . However , attrition from patient deaths was substantial and overall patient survivorship to 20-year followup was only 26 % . Patient survivorship was significantly higher in patients < 65 years of age in both cohorts ( 54 % versus 15 % , p < 0.001 modular tray cohort , and 52 % versus 26 % , p = 0.002 rotating platform cohort ) . Furthermore , in the modular tray cohort , patients < 65 years had significantly higher revision rates ( 15 % versus 3 % , p = 0.0019 ) . Conclusions These two cohorts demonstrate the durability of knee arthroplasty in older patients ( the vast majority older than 65 years ) . Unfortunately , few patients lived to 20-year followup , thus introducing bias into the analysis . These data may be useful as a reference for the design of future prospect i ve studies , and consideration should be given to enrolling younger patients to have robust numbers of living patients  at long-term followup . Level of Evidence Level III , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence BACKGROUND Few guidelines are available whether early weight-bearing after an  uncemented total hip arthroplasty ( THA ) can be recommended or not . Stability and ingrowth may be jeopardized by immediate loading of the implant while functional recovery may be promoted and periprosthetic demineralization reduced . PATIENTS AND METHODS We did a prospect i ve study of 20 patients who were operated on with a hydroxyapatite-coated ( HA ) , uncemented total hip arthroplasty with a tapered stem because of unilateral arthrosis , and r and omized the patients to the immediate ( I ) or late ( L ) weight-bearing ( after 3 months ) group . The shoe on the operated side was equipped with an auditory device signaling when the patient placed a load on the extremity . The clinical assessment was done with the Harris hip score at the time of the operation and after 12 and 24 months . Radiographs and dual-energy x-ray absorptiometry ( DEXA ) were evaluated for migration , femoral remodeling and bone mineral density ( BMD ) after 3 , 6 , 12 and 24 months .  Tc-scintigraphy  was done after 6 , 12 and 24 months . RESULTS Postoperatively , the Harris hip score showed no group difference . After 3 months , we noted a large reduction in BMD around the stem prosthesis . This was most marked in the proximal regions and the bone loss was significantly larger in zone 1 , 4 and 5 in the L group . Distally , the BMD normalized with time , but the loss of bone persisted in the proximal zones after 24 months . An initial increase in the scintigraphic uptake ratio in all zones in both groups declined with time , but it was still increased on the operated side after 24 months . Several radiographic signs of bone remodeling were seen , but the patterns were similar in both groups . INTERPRETATION We found no adverse effect of immediate weight bearing with this prosthesis The principle of dual mobility cups , often called " tripolar " , has been developed to overcome the problem of instability following primary hip arthroplasty . We prospect ively compared two cohorts which differed only by the type of bearings , i.e. " mobile bearing hip " ( MBH ) in a 143- study cohort of ADM cups versus " fixed bearing hip " ( FBH ) of 130 Trident PSL cups  , at a follow-up at 2 - 6years . The survival rates at 4.13-years , with instability as endpoint was significantly ( P=0.0176 ) in favor of mobile bearings at 100 % with no dislocation reported , versus 94.8 % with fixed bearings . These mobile bearings , matching both " modern " dual mobility cups and annealed highly crossed polyethylene , would appear to offer at longer follow-up a valuable solution to clinical outcomes in acetabular arthroplasty Purpose This study was design ed to compare clinical , radiological , and general health results of two prostheses ( mobile vs. fixed weight-bearing devices ) that are used in total knee arthroplasty with a 5-year follow-up . Methods This r and omized controlled study was conducted from 2004 to 2010 in the Department of Orthopedic Surgery at two university hospitals in Isfahan , Iran . Three hundred patients with expected primary total knee arthroplasty ( TKA ) without severe deformity ( a fixed varus or valgus deformity greater than 20 ° ) received fixed weight-bearing ( n = 150 ) or mobile weight-bearing ( n = 150 ) devices . Clinical , radiological , and quality of life outcomes were compared between the two groups at six-month intervals for the first year , after which the comparisons were made annually for the next 4 years . Results Both groups had similar baseline characteristics . Although there was significant improvement in both groups , there was no significant difference between the groups with regard to the means of the Knee Society Scores , which were 92 ( SD : 12.1 ) for the fixed weight-bearing device and 93 ( SD : 14.2 ) for the mobile weight-bearing device ( n.s . ) at the final follow-up point . Radiographs showed that there was no significant difference in prosthetic alignment and no evidence of loosening . After TKA , the SF-36 score increased in both groups , but there was no statistical difference between the groups in quality of life at the final follow-up ( 62 ( 12.2 ) vs. 64 ( 14.3 ) , n.s . ) . There was no revision after 5 years . Conclusions In terms of clinical , radiological or general health outcomes for people who underwent TKA , the results of this study showed no clear advantage of mobile weight-bearing over the fixed weight-bearing prosthesis at the five-year follow-up . Level of evidence
Conclusions Current published evidence does not support survivorship differences among commonly used bearing surfaces in patients younger than age 65 years undergoing THA at short- to mid-term followup .
Background  Total hip arthroplasty ( THA )  is increasingly being performed in patients with long life expectancies and active lifestyles .
Newer implant bearing surfaces , with superior wear characteristics , often are used in this cohort with the goal of improving longevity of the prosthesis , but comparisons across the numerous available bearing surfaces are limited , so the surgeon and patient may have difficulty deciding which implants to use .
Questions / purpose sThe purpose of this study was to answer the following question : Is there a short- to mid-term survivorship difference between common THA bearings used in patients younger than age 65 years ?