All-Polyethylene Tibial Component Versus Metal-Backed Tibial Component In Total Knee Arthroplasty: A Systematic Review

Objective:To compare the clinical results of all-polyethylene tibial component with metal-backed tibial component in TKA and to assess the differences between both two groups.Methods:We searched PubMed, EMBASE, the Cochrane Library, and CBM to identify clinical controlled trials comparing all-polyethylene tibial component with metal-backed tibial component in Total knee arthroplasty and searched their references. The quality of the included studies was critically assessed and the data analyses were performed by the Cochrane Collaboration's RevMan 5.0. Results:5 randomized controlled trials were included with a total of 455 knees, 232 knees in all-polyethylene tibial component and 223 knees in metal-backed tibial component. Based on the current evidence, postoperative outcomes were significantly better than preoperative outcomes. The outcomes of Meta-analysis showed that there were no statistical differences in Knee score [MD=-1.90,95%CI (-4.35,0.55),P=0.13],Clinic Function score[MD= 0.78,95%CI(-3.32,4.87),P=0.71],Flexion contracture [MD=-0.01,95%CI(-0.58,0.57),P=0.99],Flexion[MD=-1.73,95%CI(-4.85,1.39), P=0.28],Range of motion[MD=-3.21, 95%CI(-8.58,2.16),P=0.24],Femorotibial angle[MD=0.34,95%CI (-0.27,0.96),P=0.27],Tibial component alignment Frontal plane[MD=-0.31,95%CI(-1.48,0.86), P=0.60],Tibial component alignment Sagittal plane[MD=-0.43,95%CI(-0.94,0.07),P=0.09] and Complications [RR=0.96,95%CI(0.52,1.78),P=0.90] .Conclusion:The results showed that comparing all-polyethylene tibial component with metal-backed tibial component, there were no statistical differences in Knee score, Clinic Function score, Flexion contracture, Flexion, Range of motion, Femorotibial angle, Tibial component alignment Frontal plane, Tibial component alignment Sagittal plane and total Complications. They have the similar effect in short period.