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J Knee Surg 2017; 30(08): 807-815
DOI: 10.1055/s-0036-1597979
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Use of All-polyethylene Tibial Components in Unicompartmental Knee Arthroplasty Increases the Risk of Early Failure

In Jun Koh
1   Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea
2   Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
,
Kyung Hwan Suhl
3   Department of Orthopaedic Surgery, Goodmadi Hospital, Incheon, Republic of Korea
,
Min Woo Kim
4   Department of Orthopaedic Surgery, Seran General Hospital, Seoul, Republic of Korea
,
Man Soo Kim
1   Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea
,
Keun Young Choi
1   Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea
,
Yong In
1   Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea
2   Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

17 January 2016

06 December 2016

Publication Date:
13 January 2017 (online)

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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.

Keywords

all-polyethylene tibial components - metal-backed modular components - adaptive bone remodeling - unicompartmental knee arthroplasty
 

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