All-polyethylene vs. metal-backed tibial component in total knee arthroplasty—a randomized RSA study comparing early fixation of horizontally and completely cemented tibial components: Part 1. Horizontally cemented components: AP better fixated than MB
Open Access
- 1 January 2005
- journal article
- research article
- Published by Medical Journals Sweden AB in Acta Orthopaedica
- Vol. 76 (6), 769-777
- https://doi.org/10.1080/17453670510045354
Abstract
Controversy still exists as to whether to mount the tibial bearing on a metal baseplate or not. Furthermore, the tibial component can be either horizontally or completely cemented. We evaluated metal backing versus all-polyethylene using horizontal cementing technique. We randomized 40 patients with knee arthrosis (40 knees) to 2 groups: cemented total knee arthroplasty (AGC, Biomet) using either all-polyethylene (AP) or metal-backed (MB) tibial components (n = 20 for each group). All tibial implants had a total thickness of 8 mm. We used proximal cement-ing, including only the horizontal part of the tibia with avoidance of the stem-bone interface. The positioning of the implants, as judged by the HKA angle, showed an average neutral alignment in both groups. Preoperatively and after 2 years, there was no statistically significant difference between the HSS scores in both groups (p = 0.6 and 0.4). After 2 years, the metal-backed components had rotated more around the longitudinal axis, median 0.5 degrees vs. 0.2 degrees (internal or external rotation, p = 0.002), and showed increased maximum total point motion, median 1.0 vs. 0.4 mm (maximum migration or MTPM, p = 0.003). Our study indicates that better fixation can be obtained with the all-polyethylene design if proximally cemented thin components are used.Keywords
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