title: Metal-backed versus all-polyethylene tibial components in primary total knee arthroplasty.
abstract: OBJECTIVE
  The choice of either all-polyethylene (AP) tibial components or metal-backed (MB) tibial components in total knee arthroplasty (TKA) remains controversial. We therefore performed a meta-analysis and systematic review of randomized controlled trials that have evaluated MB and AP tibial components in primary TKA.
  
  
  METHODS
  The search strategy included a computerized literature search (Medline, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials) and a manual search of major orthopedic journals. A meta-analysis and systematic review of randomized or quasi-randomized trials that compared the performance of tibial components in primary TKA was performed using a fixed or random effects model. We assessed the methodological quality of studies using Detsky quality scale.
  
  
  RESULTS
  9 randomized controlled trials (RCTs) published between 2000 and 2009 met the inclusion quality standards for the systematic review. The mean standardized Detsky score was 14 (SD 3). We found that the frequency of radiolucent lines in the MB group was significantly higher than that in the AP group. There were no statistically significant differences between the MB and AP tibial components regarding component positioning, knee score, knee range of motion, quality of life, and postoperative complications.
  
  
  CONCLUSIONS
  Based on evidence obtained from this study, the AP tibial component was comparable with or better than the MB tibial component in TKA. However, high-quality RCTs are required to validate the results.
authors: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai.
authors: Tao
authors: T
authors: Cheng
authors: Guoyou
authors: G
authors: Zhang
authors: Xianlong
authors: X
authors: Zhang
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008670:Metals; D020959:Polyethylene; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013977:Tibia / Q000601:surgery
chemical_list: D008670:Metals; D020959:Polyethylene