ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
All-polyethylene tibial components generate higher stress and micromotions than metal-backed tibial components in total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- All-polyethylene versus metal-backed tibial components in total knee arthroplasty: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Biomechanical analysis of surgical alignment and design in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- [Finite element analysis of tibial and femoral resection configurations on varus alignment in total knee arthroplasty].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2025Article
- Biomechanical optimization study of posterior tilt extension stems in the repair of tibial plateau bone defects.Frontiers in bioengineering and biotechnology · 2025Article
- Effect of design and surgical parameters variations in mobile-bearing versus fixed-bearing unicompartmental knee arthroplasty: A finite element analysis.Journal of experimental orthopaedics · 2024Article
- Biomechanical analysis of patient specific cone vs conventional stem in revision total knee arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- Biomechanical comparison of all-polyethylene total knee replacement and its metal-backed equivalent on periprosthetic tibia using the finite element method.Journal of orthopaedic surgery and research · 2024Article
- Biomechanical analysis of different techniques for residual bone defect from tibial plateau bone cyst in total knee arthroplasty.Frontiers in bioengineering and biotechnology · 2024Article
- Article
- Biomechanical analysis of different levels of constraint in TKA during daily activities.Arthroplasty (London, England) · 2023Article
- Application strategy of finite element analysis in artificial knee arthroplasty.Frontiers in bioengineering and biotechnology · 2023Review
- Article
- The optimal angle of screw for using cement-screw technique to repair tibial defect in total knee arthroplasty: a finite element analysis.Journal of orthopaedic surgery and research · 2022Article
- Biomechanical Analysis of the Use of Stems in Revision Total Knee Arthroplasty.Bioengineering (Basel, Switzerland) · 2022Article
- High congruency MB insert design: stabilizing knee joint even with PCL deficiency.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- Asymmetric polyethylene inserts promote favorable kinematics and better clinical outcome compared to symmetric inserts in a mobile bearing total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- Finite element analysis of the tibial bone graft in cementless total knee arthroplasty.Journal of orthopaedic surgery and research · 2018Article
- Finite element analysis: a comparison of an all-polyethylene tibial implant and its metal-backed equivalent.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Article
- Limb-salvage treatment of en-block resected distal femoral tumors with endoprosthesis of all-polyethylene tibial component: a 9-year follow-up study.OncoTargets and therapy · 2016Article
- Sensitivity analysis of the material properties of different soft-tissues: implications for a subject-specific knee arthroplasty.Muscles, ligaments and tendons journalReview
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMost total knee arthroplasty tibial components are metal-backed, but an alternative tibial component made entirely of polyethylene (all-polyethylene design) exists. While several clinical studies have shown that all-poly design performs similarly to the metal-backed, the objective of this study is to perform a biomechanical comparison.
methodsLoads, constraints and geometries during a squat activity at 120° of flexion were obtained from a validated musculoskeletal model and applied to a finite element model. Stresses in the tibia and micromotions at the bone-implant interface were evaluated for several implant configurations: (1) three different thicknesses of the cement penetration under the baseplate (2, 3 and 4 mm), (2) the presence or absence of a cement layer around the stem of the tibial tray and (3) three different bone conditions (physiological, osteopenic and osteoporotic bone).
resultsAll-polyethylene tibial components resulted in significantly higher (p < 0.001) and more uneven stress distributions in the cancellous bone under the baseplate (peak difference: +128.4 %) and fivefold increased micromotions (p < 0.001). Performance of both implant designs worsened with poorer bone quality with peaks in stress and micromotion variations of +40.8 and +54.0 %, respectively (p < 0.001). Performance improvements when the stem was cemented were not statistically significant (n.s.).
conclusionThe metal-backed design showed better biomechanical performance during a squat activity at 120° of flexion compared to the all-polyethylene design. These results should be considered when selecting the appropriate tibial component for a patient, especially in the presence of osteoporotic bone or if intense physical activity is foreseen.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.