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Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article

Osteoarthritis of knee is a progressive disease requiring total knee replacement in advanced stage. TKR is being performed in high numbers in developing countries as well. It carries significant economic burden on health system including high cost of implants. Initially, tibial components were cemen...

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Detalles Bibliográficos
Autores principales: Kumar, Vickash, Hasan, Obada, Umer, Masood, Baloch, Naveed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796550/
https://www.ncbi.nlm.nih.gov/pubmed/31641501
http://dx.doi.org/10.1016/j.amsu.2019.09.010
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author Kumar, Vickash
Hasan, Obada
Umer, Masood
Baloch, Naveed
author_facet Kumar, Vickash
Hasan, Obada
Umer, Masood
Baloch, Naveed
author_sort Kumar, Vickash
collection PubMed
description Osteoarthritis of knee is a progressive disease requiring total knee replacement in advanced stage. TKR is being performed in high numbers in developing countries as well. It carries significant economic burden on health system including high cost of implants. Initially, tibial components were cemented all polyethylene monoblock constructs. Subsequent studies showed excellent long term follow up in terms of durability up to 20 years.Successive studies reported aseptic loosening as the cause of failure but such studies failed to address factors responsible for failure other than implant. Cemented metal-backed non-modular tibial components (MBT) are implants in current use. They provide modularity in terms of polyethylene thickness, stems wedges. A literature reported cost saving of $1.17 million, by operating 16,500 total joints using all poly-tibial tibial component rather than metal backed tibial component. studies have reported no significant difference in terms of survivorship, function and backside wear. METHODS: For this study only English written articles were included. Studies included case reports, case series, RCTs and systemic reviews related to all polyethylene tibial components. Articles reporting all levels of evidence – Level I to IV- were included as part of our research. PubMed, Google Scholar and Cochrane Reviews databases from 2000 to 2016 were searched for studies. RESULTS: Information was gathered and thoroughly studied from 30 articles with overall result in favor of the APTC implant. CONCLUSION: All polyethylene tibial component (APTC) is an appealing and cost effective alternative, and is associated with the excellent survivorship and lower risk of revision. In light of the present-day economic evidence and long-term functional outcome, all-polyethylene should be in more use than metal backed especially in resource-constrained setting.
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spelling pubmed-67965502019-10-22 Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article Kumar, Vickash Hasan, Obada Umer, Masood Baloch, Naveed Ann Med Surg (Lond) Review Article Osteoarthritis of knee is a progressive disease requiring total knee replacement in advanced stage. TKR is being performed in high numbers in developing countries as well. It carries significant economic burden on health system including high cost of implants. Initially, tibial components were cemented all polyethylene monoblock constructs. Subsequent studies showed excellent long term follow up in terms of durability up to 20 years.Successive studies reported aseptic loosening as the cause of failure but such studies failed to address factors responsible for failure other than implant. Cemented metal-backed non-modular tibial components (MBT) are implants in current use. They provide modularity in terms of polyethylene thickness, stems wedges. A literature reported cost saving of $1.17 million, by operating 16,500 total joints using all poly-tibial tibial component rather than metal backed tibial component. studies have reported no significant difference in terms of survivorship, function and backside wear. METHODS: For this study only English written articles were included. Studies included case reports, case series, RCTs and systemic reviews related to all polyethylene tibial components. Articles reporting all levels of evidence – Level I to IV- were included as part of our research. PubMed, Google Scholar and Cochrane Reviews databases from 2000 to 2016 were searched for studies. RESULTS: Information was gathered and thoroughly studied from 30 articles with overall result in favor of the APTC implant. CONCLUSION: All polyethylene tibial component (APTC) is an appealing and cost effective alternative, and is associated with the excellent survivorship and lower risk of revision. In light of the present-day economic evidence and long-term functional outcome, all-polyethylene should be in more use than metal backed especially in resource-constrained setting. Elsevier 2019-09-27 /pmc/articles/PMC6796550/ /pubmed/31641501 http://dx.doi.org/10.1016/j.amsu.2019.09.010 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review Article
Kumar, Vickash
Hasan, Obada
Umer, Masood
Baloch, Naveed
Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article
title Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article
title_full Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article
title_fullStr Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article
title_full_unstemmed Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article
title_short Cemented all-poly tibia in resource constrained country, affordable and cost-effective care. Is it applicable at this era? Review article
title_sort cemented all-poly tibia in resource constrained country, affordable and cost-effective care. is it applicable at this era? review article
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796550/
https://www.ncbi.nlm.nih.gov/pubmed/31641501
http://dx.doi.org/10.1016/j.amsu.2019.09.010
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