Excellent survival of all-polyethylene tibial components in a community joint registry.
The advantages of the monoblock design and lower cost have prompted renewed interest in the all-polyethylene tibia in total knee arthroplasty. We prospectively followed patients with all-polyethylene tibial total knee arthroplasties over a 14-year period. Since 1991, 443 total knee arthroplasties using an all-polyethylene tibia component were implanted by 12 surgeons in four hospitals associated with a community registry. One of three designs was used in over 98% of cases. The mean age of the patient population was 77 years and 78% were female. Ninety-three patients died with their prosthesis intact. Three revisions were performed on this population with mean followup of 66.3 months (range, 0-158 months). Kaplan-Meier survival analysis revealed 99.4% survival at 14.3 years with revision for any reason as the end point. With aseptic loosening or wear as the revision reason, survival is 99.7% at 14.3 years. Total knee arthroplasty with one of the three contemporary congruent all-polyethylene tibia designs used in this registry performed extremely well in this population; savings for this group (compared to those with a metal-backed component) was estimated at $729 per case. If all patients older than 75 years of age in our registry had received an all-polyethylene tibia, the estimated savings for the implant alone would have been $1.28 million.


METHODS
Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Gioe
Terence J
TJ
St Anthony Orthopaedic Specialists, St Paul, MN, USA. tjgioe@gmail.com
Sinner
Penny
P
Mehle
Susan
S
Ma
Wenjun
W
Killeen
Kathleen K
KK
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000191:economics / Q000706:statistics & numerical data*; D017046:Cost Savings; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012042:Registries / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
D020959:Polyethylene