Mayo Clinic, Rochester, MN, USA.
J Am Acad Orthop Surg. 2011 Sep;19(9):527-35. doi: 10.5435/00124635-201109000-00003.
Most total knee arthroplasty prostheses have modular tibial components with metal-backed tibial baseplates. Biomechanical studies have demonstrated mechanical advantages to a metal-backed tibial component in terms of tibial load transfer. In addition, tibial component modularity provides intraoperative flexibility and may provide an advantage in the setting of subsequent revision knee surgery. However, clinical evidence does not support the preferential use of metal-backed tibial components. Modularity introduces the potential for backside wear and associated osteolysis. Also, several recent studies have shown no significant differences in clinical and radiographic outcomes between metal-backed and all-polyethylene tibial components. In addition, all-polyethylene tibial components are less expensive than metal-backed components; increased usage of all-polyethylene components could help decrease the cost of health care.
大多数全膝关节置换假体的胫骨部件为带金属后壳的胫骨基板。生物力学研究表明，在胫骨负荷传递方面，带金属后壳的胫骨部件具有机械优势。此外，胫骨部件的模块化设计提供了术中的灵活性，并且在随后的膝关节翻修手术中可能具有优势。然而，临床证据并不支持优先使用带金属后壳的胫骨部件。模块化设计带来了后壳磨损和相关骨溶解的潜在风险。此外，最近的几项研究表明，带金属后壳和全聚乙烯胫骨部件在临床和影像学结果方面没有显著差异。此外，全聚乙烯胫骨部件比带金属后壳的部件更便宜；增加全聚乙烯部件的使用量可能有助于降低医疗保健成本。
