All-Polyethylene versus Metal-Backed Tibial Components in Total Knee Arthroplasty

AbuMoussa, Samuel; White, Charles C.; Eichinger, Josef K.; Friedman, Richard J.

doi:10.1055/s-0039-1683979

Cited by 8 publications

(4 citation statements)

References 23 publications

(18 reference statements)

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“…In addition, all-polyethylene implants are cheaper, reducing the economic constraints on the healthcare systems. 11 In our study, participants had a mean age of 54.8+8.06 years ranging from 41-68 years. The age group 41-50 years had the greatest number of participants (42%), followed by 61-70 years (30%).…”

Section: Discussionmentioning

confidence: 94%

Comparison of All-Polyethylene Tibial Versus Metal-Backed Tibial Component in Total Knee Replacement Surgery

Khan¹,

Ali²,

Abbas³

et al. 2023

PJMHS

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Introduction: Total knee replacement (TKR) is the most successful procedure in Orthopedics. The selection of an ideal implant relies on better survivorship, restoration of functional activities and cost-effectiveness. This study compared the effectiveness of all-polyethylene (AP) versus metal-backed tibial (MTB) implant in TKR patients in terms of objective and subjective patient related outcomes. Objectives: To compare the effectiveness of all-polyethylene tibial implants versus metal-backed tibial implants in total knee replacement patients in terms of improvement in the American Knee Society Score (AKSS). Methodology: It was a nonrandomized controlled trial done in the Orthopaedic Department of the Sharif Medical City Hospital, Lahore, after approval by the institutional ethical committee. Fifty patients of grade IV knee joint osteoarthritis for greater than six months were included by nonprobability convenient sampling technique. The patients were allocated equally into standard treatment and intervention groups; patients underwent TKR with MTB implants in the standard group and AP implants in the intervention group after taking informed written consent. The AKSS score was calculated pre-operatively, 3 months and 6 months after surgery by the team member not involved in surgical planning. Results: A statistically significant improvement was observed in pre-operative to post-operative knee scores (p-value = 0.004) and functional scores (p-value = 0.001) with TKR. When the means of knee scores were compared between AP and MTB implants, there was no significant difference between the two groups between pre-operative and post-operative knee scores and functional scores. Practical implication Conclusion: There is no significant difference in knee score between the all-polyethylene and metal-backed implants regarding pain and functional status. All-polyethylene implants are a better substitute for MTB implants due to their cost-effectiveness, particularly in countries with financial constraints. The most practical implication of the current study is health economics. In a developing country with a low per capita income, expensive implants can be swapped with low cost implants to bring the cost of the procedure down. Keywords: All-polyethylene tibial, Metal-backed tibial, Total knee replacement, American Knee Society Score, AKSS.

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Section: Discussionmentioning

confidence: 94%

Comparison of All-Polyethylene Tibial Versus Metal-Backed Tibial Component in Total Knee Replacement Surgery

Khan¹,

Ali²,

Abbas³

et al. 2023

PJMHS

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“…The all-polyethylene group demonstrated statistically significant differences in five-year survivorship (OR 0.27; 95% CII0.10--0.75; p-value 0.01) and stairs climbing score (OR -2.07; 95% Cl -3.27 0.87; p-value 0.0007) when compared to the metal-backed group. Based on the results, the all-polyethylene implant should be considered a viable choice for primary knee replacement [23,24].…”

Section: All-poly Tibia (Apt) Versus Metal-backed Tibia (Mbt)mentioning

confidence: 99%

“…The use of APT implants in younger patients and those with a body mass index>35 has not been extensively studied, but the existing literature suggests the use of APT implants in these cohorts to be equally acceptable. With modern implant design and instrumentation, rising utilization of TKA along with the current and future economic strain on health care, the increased use of APT implants could result in massive savings without sacrificing positive patient outcomes [23].…”

Section: All-poly Tibia (Apt) Versus Metal-backed Tibia (Mbt)mentioning

confidence: 99%

The Essential Total Knee

Catan

2024

Surgery of the Knee - From Arthroscopic to Open Approaches and Techniques

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Osteoarthritis (OA) is the single most common cause of disability in older adults. Total Knee Arthroplasty (TKA) is a surgical procedure that is beneficial to a majority of patients suffering from OA. Still many are not able to access TKA because it is expensive. And yet despite advancement in technology that have driven increase in total costs of knee devices many aspects of these newer design and material components continue to be debated. Logic 1.0 is an all-poly, cruciate retaining total knee device that incorporates essential design features that adhere to basic principles of proven long-term results in order to lower down costs. It is potentially a cost-effective device to resource challenged patients without compromising on good clinical outcomes.

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“…Surgeons tend to prefer metal-backed prostheses when selecting the appropriate tibial component for their patients. With advances in material science, all-polyethylene tibial components will have better mechanical properties and value for future applications given their cost and modular design advantages ( Gioe and Maheshwari, 2010 ; AbuMoussa et al, 2019 ). The polyethylene insert between the femoral and tibial plateau plays a buffering role in knee joint movement, and polyethylene inserts of different design types have different biomechanical effects.…”

Section: Application Of Fea In Tkamentioning

confidence: 99%

Application strategy of finite element analysis in artificial knee arthroplasty

Zhang

Wei

et al. 2023

Front. Bioeng. Biotechnol.

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Artificial knee arthroplasty, as the most effective method for the treatment of end-stage joint diseases such as knee osteoarthritis and rheumatoid arthritis, is widely used in the field of joint surgery. At present, Finite element analysis (FEA) has been widely used in artificial knee replacement biomechanical research. This review presents the current hotspots for the application of FEA in the field of artificial knee replacement by reviewing the existing research literature and, by comparison, summarizes guidance and recommendations for artificial knee replacement surgery. We believe that lower contact stress can produce less wear and complications when components move against each other, in the process of total knee arthroplasty (TKA), mobile-bearing prostheses reduce the contact surface stress of the tibial-femoral joint compared with fixed-bearing prostheses, thus reducing the wear of the polyethylene insert. Compared with mechanical alignment, kinematic alignment reduces the maximum stress and maximum strain of the femoral component and polyethylene insert in TKA, and the lower stress reduces the wear of the joint contact surface and prolongs the life of the prosthesis. In the unicompartmental knee arthroplasty (UKA), the femoral and tibial components of mobile-bearing prostheses have better conformity, which can reduce the wear of the components, while local stress concentration caused by excessive overconformity of fixed-bearing prostheses should be avoided in UKA to prevent accelerated wear of the components, the mobile-bearing prosthesis maintained in the coronal position from 4° varus to 4° valgus and the fixed-bearing prosthesis implanted in the neutral position (0°) are recommended. In revision total knee arthroplasty (RTKA), the stem implant design should maintain the best balance between preserving bone and reducing stress around the prosthesis after implantation. Compared with cemented stems, cementless press-fit femoral stems show higher fretting, for tibial plateau bone defects, porous metal blocks are more effective in stress dispersion. Finally, compared with traditional mechanical research methods, FEA methods can yield relatively accurate simulations, which could compensate for the deficiencies of traditional mechanics in knee joint research. Thus, FEA has great potential for applications in the field of medicine.

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All-Polyethylene versus Metal-Backed Tibial Components in Total Knee Arthroplasty

Cited by 8 publications

References 23 publications

Comparison of All-Polyethylene Tibial Versus Metal-Backed Tibial Component in Total Knee Replacement Surgery

Comparison of All-Polyethylene Tibial Versus Metal-Backed Tibial Component in Total Knee Replacement Surgery

The Essential Total Knee

Application strategy of finite element analysis in artificial knee arthroplasty

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