Thicker Polyethylene Bearings Offer Equivalent Patient-reported Outcomes

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science

Background:

• Polyethylene bearing (PEB) thickness is crucial for stability and balance in total knee arthroplasty (TKA).
• The impact of thicker PEBs (≥13 mm) on patient-reported outcomes (PROs) compared to thinner PEBs (<13 mm) is not well understood.

Purpose of the Study:

• To compare patient-reported and surgical outcomes between thicker (≥13 mm) and thinner (<13 mm) PEBs in primary TKA.

Main Methods:

• Retrospective analysis of 2,751 primary TKA patients (osteoarthritis) from 2020-2023.
• Patients grouped by PEB thickness (≥13 mm vs. <13 mm).
• Outcomes assessed: PROs (KOOS, FJS), inpatient pain/mobility, surgical data, 90-day complications; analyzed using multivariate statistics.

Main Results:

• No clinically significant differences in PROs between thicker and thinner PEB groups.
• Slightly better KOOS and pain scores at 6-12 months in the ≥13 mm group, primarily in male patients, but not clinically meaningful.
• Equivalent Forgotten Joint Scores and early complication rates between groups.

Conclusions:

• Thicker PEBs (≥13 mm) in TKA do not negatively impact PROs or early surgical outcomes.
• Thicker PEBs may offer slight midterm improvements in pain and function for male patients.
• Findings support selective use of thicker bearings for intraoperative balance without compromising patient satisfaction.