Mid-Term Outcomes of Metal-Backed Unicompartmental Knee Arthroplasty Show Superiority to All-Polyethylene Unicompartmental and Total Knee Arthroplasty

Overview

Journal HSS J

Date 2017 Oct 7

PMID 28983215

Citations 13

Authors

Jelle P van der List

Laura J Kleeblad

Hendrik A Zuiderbaan

Andrew D Pearle

Affiliations

Soon will be listed here.

Abstract

Background: Two commonly used tibial designs for unicompartmental knee arthroplasty (UKA) are all-polyethylene "inlay" and metal-backed "onlay" components. Biomechanical studies showed that the metal baseplate in onlay designs better distributes forces over the tibia but studies failed to show differences in functional outcomes between both designs at mid-term follow-up. Furthermore, no studies have compared both designs with total knee arthroplasty (TKA).

Questions/purposes: The goal of this study was to compare outcomes of inlay UKA and onlay UKA at mid-term follow-up and compare these with TKA outcomes.

Methods: In this retrospective study, 52 patients undergoing inlay medial UKA, 59 patients undergoing onlay medial UKA, and 59 patients undergoing TKA were included. Western Ontario and McMaster Universities Arthritis Index scores were collected preoperatively and at mean 5.1-year follow-up (range 4.0-7.0 years).

Results: Preoperatively, no differences were observed in patient characteristics or outcome scores. At mid-term follow-up, patients undergoing onlay medial UKA reported significant better functional outcomes than those of inlay medial UKA (92.0 ± 10.4 vs. 82.4 ± 18.7, = 0.010) and when compared to TKA (92.0 ± 10.4 vs. 79.6 ± 18.5, < 0.001) while no significant differences between inlay medial UKA and TKA were noted. No significant differences in revision rates were found.

Conclusion: Functional outcomes following onlay metal-backed medial UKA were significantly better compared to inlay all-polyethylene medial UKA and to TKA. Based on the results of this study and on biomechanical and survivorship studies in the literature, we recommended using metal-backed onlay tibial components for unicompartmental knee arthroplasty.

Citing Articles

Metal-backed versus all-poly tibia in the original cartier unicompartmental knee arthroplasty: outcomes and survivorship at long-term follow-up.

Montagna A, Andriollo L, Sangaletti R, Benazzo F, Rossi S Arch Orthop Trauma Surg. 2024; 145(1):95.

PMID: 39729090 DOI: 10.1007/s00402-024-05741-4.

Mid-term outcomes of medial metal backed and all-polyethylene unicompartmental knee arthroplasty in obese patients: a retrospective propensity-matched analysis.

De Berardinis L, Piovan G, Screpis D, Senarighi M, Baldini M, Povegliano L J Orthop Surg Res. 2024; 19(1):651.

PMID: 39402592 PMC: 11476603. DOI: 10.1186/s13018-024-05148-2.

All-Polyethylene Tibial Component in Unicompartmental Knee Arthroplasty Offers Excellent Survivorship and Clinical Outcomes at Short-Term Follow-Up: A Multicenter Retrospective Clinical Study.

Bonanzinga T, Adravanti F, Vitale U, Anzillotti G, Iacono F, Marcacci M Medicina (Kaunas). 2024; 60(9).

PMID: 39336492 PMC: 11434418. DOI: 10.3390/medicina60091451.

Metal-backed or all-poly tibial components: which are better for medial unicompartmental knee arthroplasty? A propensity-score-matching retrospective study at the 5-year follow-up.

Piovan G, De Berardinis L, Screpis D, Senarighi M, Povegliano L, Natali S J Orthop Traumatol. 2024; 25(1):24.

PMID: 38704499 PMC: 11069491. DOI: 10.1186/s10195-024-00765-3.

Unicompartmental knee arthroplasties: does the type of tibial component selected influence implant survival?.

Montilla F, Payo-Ollero J, Serrano-Toledano D, Del Rio-Arteaga M, Ribera J, Muela R Arch Orthop Trauma Surg. 2023; 144(1):347-355.

PMID: 37743356 DOI: 10.1007/s00402-023-05055-x.

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