Excellent Survival of All-polyethylene Tibial Components in a Community Joint Registry

Gioe, Terence J.; Sinner, Penny J.; Mehle, Susan; Ma, Wenjun; Killeen, Kathleen

doi:10.1097/blo.0b013e31812f7879

Cited by 66 publications

(65 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MBT components are the most commonly used tibial implants [13,14]. The largest expense for TKA is the cost of the implant [15,23].…”

Section: Discussionmentioning

confidence: 99%

“…The largest expense for TKA is the cost of the implant [15,23]. One method to reduce individual case expenditures for TKA is the use of APT components, which can provide savings of $300 to $750 per case when compared with MBT components [13][14][15]23]. We therefore determined whether (1) a non-age-and activity-selected patient population had equivalent survivorship and complication rates (reoperation, osteolysis, tibial implant loosening) using APT and MBT tibial implants, (2) BMI would have an effect on tibial implant survivorship, and (3) a historical control population with APT components used in an elderly, lowdemand population would maintain previously reported survivorship at long-term followup.…”

Section: Discussionmentioning

confidence: 99%

“…We also evaluated radiolucencies at each followup interval and noted progressive radiolucencies of greater than 1 mm as evidence of possible loosening. We did not consider lucencies that were greater than 1 mm, but not progressive, as an indication of loosening [14,24]. We recorded major complications, those occurrences that would impact survivorship or cause a reoperation, and reoperations for all patients.…”

Section: Patients and Materialsmentioning

confidence: 99%

“…Consequently, APT components became less frequently utilized, most often being implanted in older or lower-demand patients [1,22,26]. In the late 1990s, the survivorship of APT components in low-demand patients was greater than 95% at 10 or more years of followup, and utilization in non-age-or activityselected patients began [3,5,14,25,29,32,34]. Surgeons implanted APT components fabricated with polyethylene sterilized with gamma irradiation and sealed in a vacuum, designed with a stiff tibial keel, and manufactured in a variety of sizes to cover the proximal tibial cortical surface in patients throughout the demand spectrum.…”

Section: Introductionmentioning

confidence: 99%

“…In the face of rising costs, declining revenues, and increasing demand, there was a renewed interest in assessing APT components in TKA [3, 13-16, 19, 25, 26]. While MBT components offered increased options in terms of stems and augments for complex primary or revision TKAs, the majority of patients undergoing TKA did not require this degree of intraoperative versatility [13,14].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

All-polyethylene and Metal-backed Tibial Components Are Equivalent With BMI of Less Than 37.5

Toman¹,

Iorio²,

Healy³

2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Modular, metal-backed tibial (MBT) components are associated with locking mechanism dysfunction, breakage, backside wear, and osteolysis, which compromise survivorship. All-polyethylene tibial (APT) components eliminate problems associated with MBTs, but, historically, APT utilization has generally been limited to older, less active patients. However, it is unclear whether APT utilization can be expanded to a nonselected patient population. Questions/purposes We therefore determined the survivorship of APT components compared with MBT components in a non-age-or activity-selected population who underwent TKA. Methods Using a longitudinal database, we identified 775 patients with primary TKAs utilizing a single implant design between 1999 and 2007. Of these, 558 (72%) patients had APT components (APT2), while 217 (28%) patients with tibial bone loss or defects, contralateral MBT components, or a BMI of greater than 37.5 received MBT components. We determined the survivorship in the two groups. The minimum followup was 2 years for both groups (mean ± SD: MBT, 80 ± 29 months; APT, 63 ± 27 months). The APT group was older (average age: APT2, 70 years; MBT, 64.7 years) and had a lower BMI than the MBT group (APT2, 30.8; MBT, 33.8).Results Survivorship, as defined by revision for any reason, was 99% for the APT group and 97% for the MBT group. There were four (2%) tibial failures in the MBT group in patients with a BMI of greater than 40. There were no revisions for loosening or osteolysis in the APT group. Conclusion APT implants perform as well as MBT implants in a non-age-or activity-selected TKA population with a BMI of less than 37.5. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

“…MBT components are the most commonly used tibial implants [13,14]. The largest expense for TKA is the cost of the implant [15,23].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patients and Materialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

All-polyethylene and Metal-backed Tibial Components Are Equivalent With BMI of Less Than 37.5

Toman¹,

Iorio²,

Healy³

2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

Comparison of all‐polyethylene and metal‐backed modular tibial components in endoprosthetic reconstruction of the distal femur

Bukowski

Tagliero

Heidenreich

et al. 2020

Journal of Surgical Oncology

View full text Add to dashboard Cite

Introduction All‐polyethylene (AP) tibial components have demonstrated equivalent or improved long‐term survivorship and reduced cost compared with metal‐backed (MB) components in primary total knee arthroplasty; however, there is a lack of data comparing these outcomes in the setting of an oncologic endoprosthetic reconstruction. Methods A total of 115 (88 AP:27 MB) patients undergoing cemented distal femur endoprosthetic reconstruction following oncologic resection were reviewed. Mean age was 40 years and 51% were females. Cumulative incidences of all‐cause revision, tibial component revision, reoperation, and infection were calculated utilizing a competing risk analysis with death as the competitor. Mean follow‐up was 14 years. Results The 10‐year cumulative incidence of all‐cause revision was 19.9% in the AP group and 16.3% in the MB group (hazard ratio [HR] = 0.93, p = 0.88). The cumulative incidence of tibial component revision was significantly lower in AP compared with MB at 10 years (1.1% vs. 12.5%, HR = 0.18, p = 0.03). There was no difference in infection‐free survival when comparing the two groups (p = 0.72). Conclusions Reconstruction utilizing an MB or AP tibia component resulted in equivalent overall outcome; however, the tibial component in the AP group was less likely to be revised. AP tibial component should be considered for all primary oncologic reconstructions in the distal femur. Level of Evidence Level III Therapeutic.

show abstract

Longevity: Characteristics of a Well-Functioning, Long-Lasting Total Knee Arthroplasty

Jennings

Sousa

Abdel

2015

Total Knee Arthroplasty

View full text Add to dashboard Cite

Excellent Survival of All-polyethylene Tibial Components in a Community Joint Registry

Abstract: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 66 publications

References 27 publications

All-polyethylene and Metal-backed Tibial Components Are Equivalent With BMI of Less Than 37.5

All-polyethylene and Metal-backed Tibial Components Are Equivalent With BMI of Less Than 37.5

Comparison of all‐polyethylene and metal‐backed modular tibial components in endoprosthetic reconstruction of the distal femur

Longevity: Characteristics of a Well-Functioning, Long-Lasting Total Knee Arthroplasty

Contact Info

Product

Resources

About