All-Polyethylene Tibial Components in Obese Patients Are Associated With Low Failure at Midterm Followup

Abstract

Background In the United States, the obese population has increased markedly over the last four decades, and this trend continues. High patient weight places additional stress on TKA components, which may lead to increased polyethylene wear, osteolysis, radiolucencies, and clinical failure. Metalbacked tibial components and all-polyethylene tibial components in the general population have comparable osteolysis and failure, but it is unclear whether these components yield similar osteolysis and failure in obese patients.Questions/purposes We therefore determined the (1) function, (2) occurrence of osteolysis, and (3) complications in a cohort of obese patients receiving allpolyethylene tibial components.

Comparative Survivorship of Different Tibial Designs in Primary Total Knee Arthroplasty

“…An important finding of our study that strongly confirms previous observations [15][16][17][18][19][20][21][22][23][24][25][26][27] is that the outcome of total knee arthroplasty with all-polyethylene tibial components is better than those performed with metal-backed modular tibial designs. In our institution, all-polyethylene tibial components were used in 10% to 30% of the primary total knee arthroplasties each year, and PFC Sigma was the most commonly used brand (65%), followed by much smaller categories of other brands.…”

“…Nevertheless, follow-up is limited with some of the more contemporary all-polyethylene tibial designs. Hence, we concur with other investigators 16,18,20,27 that the theoretical advantages of the metal-backing of the tibial component may not necessarily translate into clinical outcomes, and all-polyethylene designs can be successfully used in many patients with substantial cost savings.…”

All-polyethylene Tibial Components are Equal to Metal-backed Components: Systematic Review and Meta-regression

“…We showed that none of the parameters for low-demand status (age, rheumatoid arthritis, weight) influenced the outcome of the comparison. Therefore, the all-polyethylene component could be an option for all patients with an indication for TKA as previously reported [12,31,36]. When there is a need for modular stems or augmentations, there is an indication for metal backing of the tibia since this cannot be added to the all-polyethylene tibial component.…”

All-Polyethylene Versus Metal-Backed Tibial Components—An Analysis of 27,733 Cruciate-Retaining Total Knee Replacements from the Swedish Knee Arthroplasty Register

“…The all-polyethylene tibial component is less expensive than its modular counterpart 6 , and several randomized trials and smaller cohort studies have indicated that the allpolyethylene tibial component is at least equivalent to the modular design in function, knee motion, primary stability, and long-term implant survival [7][8][9][10][11][12] . These favorable findings also apply to patients with rheumatoid arthritis or obesity 13,14 . A recent meta-analysis concluded that ''the AP [all-polyethylene] tibial component was comparable with or better than the MB [metal-backed] tibial component in TKA [total knee arthroplasty].''…”