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Current Concepts Review   |    
The All-Polyethylene Tibial Component in Primary Total Knee Arthroplasty
Terence J. Gioe, MD1; Aditya V. Maheshwari, MD2
1 Department of Orthopaedic Surgery, Veterans Administration Medical Center, Section 112E, 1 Veterans Drive, Minneapolis, MN 55417. E-mail address: terence.gioe@va.gov
2 Department of Orthopaedic Surgery, University of Minnesota Medical School, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454
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Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from DePuy, Inc., Warsaw, Indiana. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

A commentary by Thomas Parker Vail, MD, is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Feb 01;92(2):478-487. doi: 10.2106/JBJS.I.00842
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Abstract

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.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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