Matched-pair analysis of all-polyethylene versus metal-backed tibial components

Forty-eight matched pairs of osteoarthritic knees from patients who underwe nt primary total knee arthroplasty with a round-on-round, Apollo Knee Syste m were studied to evaluate the outcome between all-polyethylene and metal-b acked tibial components. Patients were matched for patient factors, preoper ative deformities, cruciate salvage or sacrifice, and surgical technique. A t the last follow-up (average, 38.4 months), there was no statistically sig nificant difference in terms of knee scores, patient self-assessment, and r adiographic outcomes. No component required revision, and no revisions were pending. Maintenance of these results over time would project into better long-term success for all-polyethylene tibial components because of the amo unt of wear and osteolysis with current modular metal-backed tibial compone nts. We advocate the use of a more cost-effective all-polyethylene tibial c omponent in elderly patients (> 70 years old) who are not likely to need th e versatility of exchange of a modular polyethylene insert because of wear.