title: Use of All-polyethylene Tibial Components in Unicompartmental Knee Arthroplasty Increases the Risk of Early Failure.
abstract: All-polyethylene (all-poly) tibial designs in primary total knee arthroplasty (TKA) have been reconsidered with excellent clinical outcomes, survivorship, and cost-effectiveness. However, whether all-poly tibial components provided comparable results to metal-backed modular components during unicompartmental knee arthroplasty (UKA) remains unclear. This study compared the clinical outcomes and prevalence of early failure between all-poly and metal-backed modular components in UKA. We retrospectively reviewed the records and radiographs of 101 consecutive UKAs. In total, 51 UKAs were performed using all-poly tibial components; 50 others used metal-backed modular components. Clinical and radiographic outcomes, adaptive bone remodeling assessed by radiographic bone density, and early failure prevalence rates were compared. Despite a lack of group differences in clinical and radiographic outcomes (p> 0.1 in all comparisons), adaptive bone remodeling at 2 years after surgery of all-poly UKAs was more progressive compared with metal-backed UKAs (1.2 in all-poly UKA group vs. 0.9 in metal-backed UKA group,p< 0.001). In addition, 6 of 51 all-poly UKAs failed within 2 years postoperatively, whereas no metal-backed UKAs failed (11% in all-poly UKA group vs. 0% in metal-backed UKA group,p= 0.027). All-poly tibial component use during UKA increased the risk of early failure, which may be due to a failure in tibial loading distribution.
authors.affiliation: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea.|Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: In Jun
authors.initials: IJ
authors.lastname: Koh
authors.affiliation: Department of Orthopaedic Surgery, Goodmadi Hospital, Incheon, Republic of Korea.
authors.forename: Kyung Hwan
authors.initials: KH
authors.lastname: Suhl
authors.affiliation: Department of Orthopaedic Surgery, Seran General Hospital, Seoul, Republic of Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Man Soo
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Keun Young
authors.initials: KY
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea.|Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Yong
authors.initials: Y
authors.lastname: In
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D016723:Bone Remodeling; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery
chemical_list: D020959:Polyethylene