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Total knee arthroplasty: all-poly or metal-backed?
Author(s):
Canata G. (Italy)
,
Canata G. (Italy)
Affiliations:
Casale Valentina
Casale Valentina
Affiliations:
ESSKA Academy. Canata G. May 9, 2018; 209593; P10-1789 Topic: Joint Replacement
Dr. Gian Luigi Canata
Dr. Gian Luigi Canata
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Abstract
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Objectives: In literature, there is still paucity of evidence about the use of polyethylene tibial components in total knee arthroplasties (TKA).
In a prospective randomized study, patients undergoing total knee arthroplasty have been observed: the results after the use of a polyethylene (all-poly) tibial components were compared to those obtained using metal-backed tibial inserts.

Methods: 92 patients, mean age 71 years (r. 50-79), 16 males and 76 females, undergoing TKA between 2013 and 2016, were randomized into two groups.
In group A (43 patients, 8 males and 35 females), mean age 73 years (r. 55-79), all-poly tibial inserts were used.
In group B (49 patients, 8 men and 41 females), mean age 70 years (r. 50-79), a metal-backed component was implanted.
The mean follow-up was 24 months (r. 12-44).
The pre- and postopeartive evaluation used methods were the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Visual Analogue Scale (VAS) and the Range Of Motion (ROM). We statistically compared the postoperative KOOS outcomes of the two groups with the Student t test and the Kolmogorov-Smirnov test.

Results: Group A: mean preoperative KOOS score 42 (SD 17,4), postoperative 80,3 (SD 18,5). Mean preoperative VAS score 7,4 (SD 2,5), postoperative 0,1 (SD 0,4). Mean postoperative ROM 0-0-127.
Group B: mean preoperative KOOS score 37,7 (SD 17,3), postoperative 83,9 (SD 17,2). Mean preoperative VAS score 7 (SD 2,1), postoperative 0,6 (SD 1,6). Mean postoperative ROM 0-0-123.
In group A, 3 (8,6%) patients showed residual symptoms, but no revision surgery was needed. In group B, 5 (10%) patients were symptomatic, but no revision surgery was needed.
The statistical analysis showed no significant differences (p > .05) between the two groups in postoperative KOOS results with the t test, even among every single category with the Kolmogorov-Smirnov test (symptoms, pain, daily living, sports, quality of life).

Conclusions: The use of all-poly components is rising because of the similar clinical results and the low rates of revisions.
This randomized study demonstrated an excellent tolerability when using the all-poly tibial insert in TKA.
There are no significant differences between the all-poly tibial components and the metal-backed inserts.

Keywords:
all-poly, metal-backed, total knee arthroplasty, osteoarthritis
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