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Should we reconsider all-polyethylene tibial implants in total knee replacement?

2006; British Editorial Society of Bone & Joint Surgery; Volume: 88-B; Issue: 12 Linguagem: Inglês

10.1302/0301-620x.88b12.17695

2044-5377

Susanne Müller, David J. Deehan, James Holland, S. E. Outterside, L. M. G. Kirk, P. J. Gregg, Andrew W. McCaskie,

Orthopedic Infections and Treatments

The role of modular tibial implants in total knee replacement is not fully defined. We performed a prospective randomised controlled clinical trial using radiostereophotogrammetric analysis to compare the performance of an all-polyethylene tibia with a metal-backed cruciate-retaining condylar design, PFC-∑ total knee replacement for up to 24 months. There were 51 patients who were randomised into two treatment groups. There were 10 subsequent withdrawals, leaving 21 all-polyethylene and 20 metal-backed tibial implants. No patient was lost to follow-up. There were no significant demographic differences between the groups. At two years one metal-backed implant showed migration > 1 mm, but no polyethylene implant reached this level. There was a significant increase in the SF-12 and Oxford knee scores after operation in both groups. In an uncomplicated primary total knee replacement the all-polyethylene PFC-∑ tibial prosthesis showed no statistical difference in migration from that of the metal-backed counterpart. There was no difference in the clinical results as assessed by the SF-12, the Oxford knee score, alignment or range of movement at 24 months, although these assessment measures were not statistically powered in this study.