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SHOULD WE ABANDON FULL POLY TOTAL KNEE PROSTHESES?



Abstract

Purpose of the study: The objective of this study was to compare outcome after total knee arthroplasty (TKA) with a metallic tibial base versus full poly prostheses.

Material and methods: This monocentric retrospective study compared 169 Tornier full poly HLS TKA (group A) with 169 TKA with a fixed metallic tibial base (group B). The two series were matched for age, gender and etiology. Mean age was 71 years and female gender predominated, 80%. Mean follow-up was 66 months. Clinical (IKS score) and radiological outcome was assessed. Statview 5.0™ was used for the statistical analysis, Student’s t test for quantitative variables and chi-square test for qualitative variables. Differences were considered significant for p< 0.05. The beta factor was 0.2.

Results: The main intraoperative incidents were, weakening of the popliteal tendon (n=1) and supra and inter-condylar fracture of the femur (n=1) in group A patients and weakening of the popliteal tendon (n=2) and secondary fracture line of the medial tibial plateau (n=2) in group B patients. For group A, the knee score was 89±10.82 (mean±SD) and for group B 88.28±11.94. The function score was 68±23.75 for group A and 71±24.05 for group B. Mean flexion in both groups was 113°. Non-progressive tibial lucent lines were observed in 27 patients in group A and in 23 in group B. There were 7 replacements of the TKA in group A and 6 in group B. Survival for group A was 94.5% and 93.64% for group B.

Discussion: There were no significant differences concerning function and knee scores, presence of lucent lines and prosthesis replacement between the two series (p> 0.05).

Conclusion: This study did not demonstrate a superiority of the metallic tibial base TKA at five years follow-up. Use of a full poly TKA could decrease the medical cost by more than 30%.

Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.