Background: Osteoarthritis (OA) is the most common chronic
degenerative disease in orthopaedic practice. The treatment of Osteoarthritis
includes non-pharmacological interventions and surgical interventions such as
total knee replacement. Metal-backed (MB) tibial components theoretically offer
better load distribution across the implant-bone interface compared to
all-polyethylene tibia, potentially reducing the risk of loosening. However,
all-polyethylene tibial (APT) components have their own advantages, such as the
absence of backside wear and no liner dissociation. However, the literature
pertaining to the comparison of the clinical outcome and functional outcome
between the metal-backed and all polyethylene prosthesis for the total knee
replacement is scant.
Aim: The present study aims to compare the clinical and
functional outcomes of metal-backed versus all-polyethylene tibial components
in patients undergoing total knee replacement.
Methods: A prospective study was undertaken in a tertiary
hospital from April 2018 to June 2019. The final sample size was 32 cases (40
knees) of newly diagnosed primary OA knee cases treated with cemented TKR with
metal-backed prosthesis and 29 cases (40 knees) with all polyethylene
prosthesis. The patients were followed up at 1st, 3rd and 6th post-operative
months. Data were analysed using SPSS version 20, with the chi-square test
applied; a p-value < 0.05 was considered statistically significant.
Results: This study showed that the majority of patients
undergoing knee replacement surgery are aged above 60 years, male sex and had
comorbid conditions. The knee clinical score pre-op was not statistically
significant. But after 1 month, after 3 months after 6 months, the knee
clinical score was statistically significant. Knee functional score pre-op,
after 1 month, after 3 months, and after 6 months was not statistically
significant. 87% of patients with metal back total knee replacement and 85% of
all poly total knee replacement had no pain or just mild pain.
Conclusions: Total knee arthroplasty resulted in excellent
relief of pain, range of motion, restoration of function, and low prevalence of
complications and continues to function well during the follow-up period.
Improvement in clinical score in the MB group is correlated significantly with
all polyethylene groups. The Knee Society scoring system is effective in
evaluating clinical, functional outcomes. This study is limited by its short
follow-up duration; therefore, future research with a longer follow-up period
and more robust methodology is recommended to assess the long-term efficacy and
durability of all-polyethylene versus metal-backed prostheses in knee
replacement surgery.
Author(s) Details
Suresh Kriplani
Department of Orthopaedics, P.G.I. Swasthiyog Pratishthan,
Miraj, Maharashtra, India.
Tejas Patil
Department of Orthopaedics, P.G.I. Swasthiyog Pratishthan, Miraj,
Maharashtra, India.
Milind Kulkarni
Department of Orthopaedics, P.G.I. Swasthiyog Pratishthan, Miraj,
Maharashtra, India.
G. S. Kulkarni
Department of Orthopaedics, P.G.I. Swasthiyog Pratishthan, Miraj,
Maharashtra, India.
Krishna Kabra
Department of Orthopaedics, P.G.I. Swasthiyog Pratishthan, Miraj,
Maharashtra, India.
Yash Parikh
Department of Orthopaedics, P.G.I. Swasthiyog Pratishthan, Miraj,
Maharashtra, India.
Please see the book here:- https://doi.org/10.9734/bpi/msraa/v9/6100
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