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Similar performance with metal-backed, all-polyethylene tibial TKA components at 2 years

Both groups had similar significant improvements in Short Form-12 and Oxford knee scores at 24 months postop.

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A cruciate-retaining total knee arthroplasty prosthesis with an all-polyethylene tibial component yielded clinical and radiographic results similar to a prosthesis with a metal-backed component at 2 years, a study found.

Scott D. Muller, MD, FRCS(Tr & Orth), and colleagues in the United Kingdom conducted the prospective, randomized study, which compared the performance of the PFC Sigma cruciate-retaining condylar prosthesis (DePuy Orthopaedics, a Johnson & Johnson Company) with either a metal-backed or all-polyethylene tibial component. In addition to clinical assessments, the researchers used radiostereophotogrammetric analysis (RSA) to evaluate prosthesis stability.

The RSA system calculated 3-D coordinates for tantalum markers that had been inserted into various points on each prosthesis, allowing investigators to determine translation and rotation.

The all-polyethylene group included 21 patients with a mean age of 74 years. The metal-backed component group included 20 patients with a mean age of 73 years, although RSA assessments were not possible for one of these patients at 24 months follow-up.

At 24 months, the researchers found no significant differences in translation of the x, y and z planes, and no differences in rotational displacement between the two groups, the authors reported.

Both groups also had similar significant improvements in Short Form-12 (SF-12) scores and Oxford knee scores. At 6 months follow-up, mean SF-12 scores improved from 27 to 35.5, and Oxford knee scores improved from 15 to 33, according to the study.

Investigators found no significant differences between groups in either score out to 24 months follow-up, the authors noted.

They also found no significant change in active range of movement, which averaged 104° preoperatively and averaged 101° at 6 months follow-up. There was also no significant difference between the groups in median varus-valgus tibial alignment out to 24 months postop, according to the study.

For more information:

• Muller SD, Deehan DJ, Holland JP, et al. Should we reconsider all-polyethylene tibial implants in total knee replacement? J Bone Joint Surg Br. 2006;88-B:1596-1602.