Department of Orthopaedic Surgery, Veterans Administration Medical Center, Minneapolis, MN 55417, USA.
J Bone Joint Surg Am. 2010 Feb;92(2):478-87. doi: 10.2106/JBJS.I.00842.
Outcomes of total knee arthroplasties performed with modern all-polyethylene tibial components have been found to be comparable with or better than those of arthroplasties done with metal-backed modular components in numerous mid-to-long-term follow-up studies, radiostereometric analyses, and the few prospective randomized trials available. Advantages of an all-polyethylene tibial component over a metal-backed modular component include lower cost, avoidance of locking-mechanism issues and backside wear, and increased polyethylene thickness after identical bone resections. Disadvantages of an all-polyethylene tibial component compared with a metal-backed modular component include a lack of modularity, limiting intraoperative options; no option for liner removal in the setting of acute irrigation and débridement; and no option for late liner exchange. Primary total knee arthroplasty with a modern all-polyethylene design can be done in many patients, with substantial cost savings across the health-care system.
在众多中期至长期随访研究、放射学体层分析和为数不多的前瞻性随机试验中,采用现代全聚乙烯胫骨组件进行全膝关节置换术的结果被发现与使用金属背衬模块化组件的结果相当或更好。全聚乙烯胫骨组件相对于金属背衬模块化组件的优点包括成本更低、避免锁定机制问题和背面磨损,以及在相同的骨切除后增加聚乙烯厚度。与金属背衬模块化组件相比,全聚乙烯胫骨组件的缺点包括缺乏模块化,限制了术中选择;在急性冲洗和清创的情况下,无法去除衬垫;以及无法进行晚期衬垫更换。在许多患者中,可以进行具有现代全聚乙烯设计的初次全膝关节置换术,整个医疗系统可以节省大量成本。