Medical Science: Recent Advances and Applications Vol. 9

Background: Osteoarthritis (OA) is the most common chronic degenerative disease in orthopaedic practice. The treatment of Osteoarthritis includes non-pharmacological interventions and surgical interventions such as total knee replacement. Metal-backed (MB) tibial components theoretically offer better load distribution across the implant-bone interface compared to all-polyethylene tibia, potentially reducing the risk of loosening. However, all-polyethylene tibial (APT) components have their own advantages, such as the absence of backside wear and no liner dissociation. However, the literature pertaining to the comparison of the clinical outcome and functional outcome between the metal-backed and all polyethylene prosthesis for the total knee replacement is scant.

Aim: The present study aims to compare the clinical and functional outcomes of metal-backed versus all-polyethylene tibial components in patients undergoing total knee replacement.

Methods: A prospective study was undertaken in a tertiary hospital from April 2018 to June 2019. The final sample size was 32 cases (40 knees) of newly diagnosed primary OA knee cases treated with cemented TKR with metal-backed prosthesis and 29 cases (40 knees) with all polyethylene prosthesis. The patients were followed up at 1st, 3rd and 6th post-operative months. Data were analysed using SPSS version 20, with the chi-square test applied; a p-value < 0.05 was considered statistically significant.

Results: This study showed that the majority of patients undergoing knee replacement surgery are aged above 60 years, male sex and had comorbid conditions. The knee clinical score pre-op was not statistically significant. But after 1 month, after 3 months after 6 months, the knee clinical score was statistically significant. Knee functional score pre-op, after 1 month, after 3 months, and after 6 months was not statistically significant. 87% of patients with metal back total knee replacement and 85% of all poly total knee replacement had no pain or just mild pain.

Conclusions: Total knee arthroplasty resulted in excellent relief of pain, range of motion, restoration of function, and low prevalence of complications and continues to function well during the follow-up period. Improvement in clinical score in the MB group is correlated significantly with all polyethylene groups. The Knee Society scoring system is effective in evaluating clinical, functional outcomes. This study is limited by its short follow-up duration; therefore, future research with a longer follow-up period and more robust methodology is recommended to assess the long-term efficacy and durability of all-polyethylene versus metal-backed prostheses in knee replacement surgery.