title: All-polyethylene tibial components in TKA in rheumatoid arthritis: a 25-year follow-up study.
abstract: OBJECTIVE
  There is renewed interest in the all-polyethylene tibial component in total knee arthroplasty (TKA). Long-term results of this prosthesis in rheumatoid arthritis (RA) patients, however, are limited. Therefore, we studied 104 primary cemented all-polyethylene tibial TKA in 80 consecutive RA patients for up to 25 years to determine the long-term survival of all-polyethylene tibial components in patients suffering from end stage RA.
  
  
  METHODS
  We estimated revision rates according the revision rate per 100 observed component years used in national joint registries. Kaplan-Meier was used to estimate survival curves.
  
  
  RESULTS
  During the 25-year follow-up, three revisions for tibial component loosening were performed. The mean revision rate of all-polyethylene tibial components with revision for aseptic loosening as the endpoint was 0.09 per 100 observed component years. This corresponds to a revision rate of 0.9% after ten years and 2.25% after 25 years. Survivorship according to Kaplan-Meier was 100% at ten years and 87.5% at 25 years [95% confidence interval (CI) 64.6-100)].
  
  
  CONCLUSIONS
  This study shows good long-term results of all-polyethylene tibial TKA in patients with RA. RA patients with multiple-joint inflammation may be less physically active than osteoarthritis patients, resulting in a lower demand on the prosthesis, and these patients may, indeed, be good candidates for all-polyethylene tibial TKA. Our results suggest that all-polyethylene tibial TKA could be a successful and cost-saving treatment for end-stage knee arthritis in RA patients.
authors: Department of Orthopaedics, Leiden University Medical Center, Postzone J11R, P. O. Box 9600, 2300 RC, Leiden, the Netherlands. K.A.Nouta@lumc.nl
authors: Klaas-Auke
authors: KA
authors: Nouta
authors: Bart G
authors: BG
authors: Pijls
authors: Rob G H H
authors: RG
authors: Nelissen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D001843:Bone Cements; D002484:Cementation; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D020959:Polyethylene / Q000009:adverse effects; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015996:Survival Rate; D013977:Tibia / Q000601:surgery*
chemical_list: D001843:Bone Cements; D020959:Polyethylene