All-polyethylene tibial components in octogenarians: survivorship, performance, and cost

The ideal recipient for an all-polyethylene tibial (APT) component continues to be controversial. Several recent randomized clinical studies have demonstrated clinical efficacy of APT when compared to metal backed tibial (MBT) components in relation to survival and clinical outcomes measures, particularly in an elderly population. In this retrospective series, 166 knees in 130 patients (age > 80 years) received an APT component. Average follow-up for the living and deceased was 5.7 and 5.2 years, respectively. There were no APT failures at the time of most recent follow-up. Knee Society function score improved from 30 to 48. Almost all respondents reported either good or excellent satisfaction with their outcome. The average cost savings of using APT instead of MBT component can be substantial. We believe octogenarian patients represent the ideal population for an APT component, that functional outcomes and satisfaction levels will be acceptable to those patients, and that the component will outlast the remaining life of the patient while also potentially providing a substantial cost savings, compared with the cost of MBT components.