IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy; Humanitas University, Pieve Emanuele, Milan, Italy.
J Arthroplasty. 2024 May;39(5):1353-1360. doi: 10.1016/j.arth.2023.10.058. Epub 2023 Nov 4.
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.
在文献中，没有证据表明全聚乙烯（AP）和金属背衬（MB）胫骨植入物在全膝关节置换术中的临床性能有优势。本研究旨在系统地回顾文献，仅收集高质量的研究，以比较 AP 与 MB 植入物在临床和放射立体测量分析（RSA）结果方面的差异。
仅纳入报告临床或 RSA 结果的随机对照试验（RCT）。数据来源为 Embase、Medline 和 Cochrane 对照试验中心注册库。
我们纳入了 11 项评估 1377 例患者结局的 RCT。其中 9 项 RCT 显示低风险，2 项显示中风险偏倚。AP 组和 MB 组在临床结局和生存率方面无统计学差异；然而，RSA 显示 AP 组的平均抬起（0.19mm）显著低于 MB 组（0.3mm）。
与 MB 组相比，AP 全膝关节置换术在临床结局和 5 年生存率方面的性能无统计学差异。然而，RSA 显示 AP 组的平均抬起显著较低。
