All-Polyethylene Versus Metal-Backed Tibial Components in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials.

RSA TKA all-polyethylene knee meta-analysis

Journal

The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515

Informations de publication

Date de publication:
04 Nov 2023
Historique:
received: 06 06 2023
revised: 30 10 2023
accepted: 31 10 2023
pubmed: 7 11 2023
medline: 7 11 2023
entrez: 6 11 2023
Statut: aheadofprint

Résumé

In the literature, there is no evidence suggesting the superiority in clinical performance between all-polyethylene (AP) and metal-backed (MB) tibial implants in total knee arthroplasty. The aim of this study was to systematically review the literature to collect only high-quality studies investigating the differences in terms of clinical and radiostereometric analysis (RSA) outcomes of AP compared to MB implants. Only randomized controlled trials (RCTs) reporting either clinical or RSA outcomes have been included. Data sources were Embase, Medline, and the Cochrane Central Register of Controlled Trials. We included eleven RCTs evaluating the outcomes of 1,377 patients. Of the RCTs, 9 of them showed a low risk and 2 showed moderate risk of bias. There was no statistically significant difference in terms of clinical outcomes and survival rate between the AP and MB group; however, a statistically significant lower mean lift-off in the AP group (0.19 mm) compared to the MB group (0.3 mm) was observed on RSA. The performance of AP total knee arthroplasty in terms of clinical outcomes and 5-year survival was not statistically different when compared to the MB group. However, the RSA showed a statistically significant lower mean lift-off in the AP group.

Sections du résumé

BACKGROUND BACKGROUND
In the literature, there is no evidence suggesting the superiority in clinical performance between all-polyethylene (AP) and metal-backed (MB) tibial implants in total knee arthroplasty. The aim of this study was to systematically review the literature to collect only high-quality studies investigating the differences in terms of clinical and radiostereometric analysis (RSA) outcomes of AP compared to MB implants.
METHODS METHODS
Only randomized controlled trials (RCTs) reporting either clinical or RSA outcomes have been included. Data sources were Embase, Medline, and the Cochrane Central Register of Controlled Trials.
RESULTS RESULTS
We included eleven RCTs evaluating the outcomes of 1,377 patients. Of the RCTs, 9 of them showed a low risk and 2 showed moderate risk of bias. There was no statistically significant difference in terms of clinical outcomes and survival rate between the AP and MB group; however, a statistically significant lower mean lift-off in the AP group (0.19 mm) compared to the MB group (0.3 mm) was observed on RSA.
CONCLUSIONS CONCLUSIONS
The performance of AP total knee arthroplasty in terms of clinical outcomes and 5-year survival was not statistically different when compared to the MB group. However, the RSA showed a statistically significant lower mean lift-off in the AP group.

Identifiants

pubmed: 37931827
pii: S0883-5403(23)01104-X
doi: 10.1016/j.arth.2023.10.058
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Tommaso Bonanzinga (T)

IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.

Francesco Manlio Gambaro (FM)

IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.

Francesco Iacono (F)

IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.

Federica Leogrande (F)

IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.

Luciana Di Lascio (L)

IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.

Maurilio Marcacci (M)

IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.

Classifications MeSH