The Journal of Bone and Joint Surgery (American). 2010;92:478-487.
doi:10.2106/JBJS.I.00842
© 2010 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

The All-Polyethylene Tibial Component in Primary Total Knee Arthroplasty

Terence J. Gioe, MD1 and Aditya V. Maheshwari, MD2

1 Department of Orthopaedic Surgery, Veterans Administration Medical Center, Section 112E, 1 Veterans Drive, Minneapolis, MN 55417. E-mail address: terence.gioe{at}va.gov
2 Department of Orthopaedic Surgery, University of Minnesota Medical School, 2450 Riverside Avenue South, Suite R200, Minneapolis, MN 55454

A commentary by Thomas Parker Vail, MD, is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from DePuy, Inc., Warsaw, Indiana. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Outcomes of total knee arthroplasties performed with modern all-polyethylene tibial components have been found to be comparable with or better than those of arthroplasties done with metal-backed modular components in numerous mid-to-long-term follow-up studies, radiostereometric analyses, and the few prospective randomized trials available.

Advantages of an all-polyethylene tibial component over a metal-backed modular component include lower cost, avoidance of locking-mechanism issues and backside wear, and increased polyethylene thickness after identical bone resections.

Disadvantages of an all-polyethylene tibial component compared with a metal-backed modular component include a lack of modularity, limiting intraoperative options; no option for liner removal in the setting of acute irrigation and débridement; and no option for late liner exchange.

Primary total knee arthroplasty with a modern all-polyethylene design can be done in many patients, with substantial cost savings across the health-care system.


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