A Meta-Analysis Comparing All-Polyethylene Tibial Component to Metal-Backed Tibial Component in Total Knee Arthroplasty: Assessing Survivorship and Functional Outcomes.

BACKGROUND: This meta-analysis compares the clinical performance of all-polyethylene tibial (APT) to the metal-backed tibial (MBT) components. METHODS: We included comparative studies in primary total knee arthroplasty involving APT and MBT implant components. The primary outcomes were function, durability, and reports of adverse events. RESULTS: Twenty-eight articles with 95 847 knees were available for synthesis. The meta-analysis showed an association of APT with lower revision rates (incidence rate ratio, 0.709; P = .002) and adverse events (incidence rate ratio, 0.785; P = .204). Moderator analyses were performed to determine the effect of posterior cruciate ligament status on outcome, and no statistically significant effect was found for revision risk or adverse events incidence. CONCLUSION: All-polyethylene tibial components seem to be an equal option, with less financial burden than the MBT.

Economics of All-Polyethylene Versus Metal-Backed Tibial Prosthesis Designs.

With the large number of total knee arthroplasties being performed and expectations that these numbers will be on the rise over the coming decades, efforts to provide cost-efficient care are of greater interest. The preferred design of knee arthroplasty implants has changed over time, with the original all-polyethylene tibial (APT) design being replaced by metal-backed tibial (MBT) components, as well as more recent considerations of newer APT designs. Modern APT components have been shown to have similar or superior outcomes than MBT components. Despite their limitations, APT components can be used to reduce the economic burden to the provider, medical institution, and health care system as a whole. There is a paucity of evidence-based literature directly comparing the cost associated with APT and MBT components. The purpose of this report is to review the literature to assess the available data regarding direct and indirect costs of both designs so that orthopedic surgeons can account for economic differences in everyday practice. [Orthopedics. 2016; 39(3):S61-S66.].