All-Polyethylene Tibial Components for Unicompartmental Knee Arthroplasty

Plate, Johannes F.; Augart, Marco Andre; Bracey, Daniel N.; Jinnah, Alex; Jinnah, Riyaz H.; Poehling, Gary G.

doi:10.1053/j.oto.2015.02.003

Cited by 2 publications

(2 citation statements)

References 36 publications

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“…On the other hand, Plate et al concluded that although an all-polyethylene tibial component for a UKA is technically challenging, it does have many advantages including bone preservation, restoration of normal knee kinematics, maintenance of capsular structures, improving proprioception, and allowing for higher activity levels. He also added that robot-assisted techniques will improve component positioning and may lead to more favorable outcomes [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Subsidence of All-Polyethylene Tibial Components Used in Unicondylar Knee Arthroplasty: A Cohort Study

Saleh¹,

Hasan²,

Jiranek³

2023

Cureus

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Introduction: Unicompartmental designs and techniques have been developed to preserve bone stock and minimize soft tissue trauma. Early modern designs and techniques have been introduced with little support in the peer-reviewed literature. Material and methods: From October 2002 to May 2004, 64 consecutive DePuy Preservation unicondylar knee arthroplasties (UKAs) were performed in 56 patients. Two patients died of unrelated consequences, leaving 62 UKAs for review (55 medial, 7 lateral). All procedures were performed through a quadriceps-sparing approach. All components were cemented, including an all polyethylene tibial component. Clinical and radiographic follow-up data were reviewed and analyzed. Results: At an average follow-up of 2.5 years, six (11%) of the medial tibial components have subsided. Of these, four had moderate-to-severe pain, one did require a revision to a total knee arthroplasty (TKA), and another did stabilize. An additional two patients continued to have knee pain (one requiring conversion to TKA), leaving a total of 55 UKAs (89%) functioning well at early follow-up. Additional complications have included four deep vein thromboses, three cardiac issues following the index procedure, one surgical site infection, one intraoperative medial femoral condyle fracture, and one reoperation for loose cement fragments. Conclusion: This study demonstrates a high rate of subsidence for all-polyethylene tibial components used in UKA, resulting in pain and failure of the arthroplasty. Despite the less invasive approach, we found complications that are usually associated with TKA surgery as well as those unique to UKA.

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Section: Discussionmentioning

confidence: 99%

Subsidence of All-Polyethylene Tibial Components Used in Unicondylar Knee Arthroplasty: A Cohort Study

Saleh¹,

Hasan²,

Jiranek³

2023

Cureus

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“…In addition, we extended the research to the reference list of all relevant articles. At this point, a stepwise exclusion of studies not meeting aforementioned inclusion criteria was conducted, such as studies comparing biomechanical behavior in knee model, 11,12 comparative data of implants with different geometry (onlay vs inlay), [14][15][16] and studies with follow-up < 24 months (►Fig. 1); moreover, no data from national registries were included, 8,17 to minimize possible bias, such as different implant design, cementation technique, and surgeons' experience.…”

Section: Search Strategy and Data Collectionmentioning

confidence: 99%

Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

et al. 2019

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Long-term results of unicompartmental knee arthroplasty (UKA) have shown a slightly higher revision rate than total knee arthroplasty (TKA), and implant fixation geometry seems to affect prosthetic survivorship. Whether metal-backed tibial component leads to superior performance over the all-polyethylene design is unclear, and a lack of evidence exists in literature. Our purpose was to demonstrate which implant design of UKA (all-polyethylene or metal-backed tibial component) is clinically superior regarding revision rates and clinical functioning, and investigate the role of potential factors that could affect the revision rate. A systematic review was conducted for clinical studies comparing all-polyethylene and metal-backed tibial components used in primary UKAs in terms of revision rates and clinical scores. Meta-regression techniques were used to explore factors modifying the observed effect. All causes of revision were extracted and analyzed, to find statistically significant differences between the two groups. Our research strategy generated a systematic review of nine studies comprising 1,101 UKAs in 1,088 patients with 87 revisions for any reason. Meta-analysis showed a higher, but not statistically significant, risk of aseptic revision in the all-polyethylene group. Studies with a smaller sample size and higher percentage of female patients were correlated to a higher relative risk of revision in favor of all-polyethylene UKAs. Differently, patients' age and duration of follow-up did not influence the risk ratio. The main cause for revision was aseptic loosening in both implants' component, with no statistically differences in the two groups examined. Our results do not show a superiority of the metal-backed tibial component in UKAs in terms of survivorship, although extreme care must be given for patients with high risk of early failure, such as female patients. However, surgical experience, in combination with careful patient selection, remains paramount and may lead to better long-term outcomes in patients requiring UKA. This is a Level III, therapeutic study.

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All-Polyethylene Tibial Components for Unicompartmental Knee Arthroplasty

Cited by 2 publications

References 36 publications

Subsidence of All-Polyethylene Tibial Components Used in Unicondylar Knee Arthroplasty: A Cohort Study

Subsidence of All-Polyethylene Tibial Components Used in Unicondylar Knee Arthroplasty: A Cohort Study

Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis

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