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Thicker Polyethylene Bearings Offer Equivalent Patient-reported Outcomes.

Weston Carpenter1, Sara Strecker, Leah Goldberg

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Thicker polyethylene bearings (PEB) in total knee arthroplasty (TKA) do not worsen patient outcomes. Thicker PEBs may offer slight benefits in pain and function for male patients, supporting their selective use.

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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.