Abstract：
Previous studies have demonstrated equivalent survivorship of modular metal-backed tibial (MBT) and all-polyethylene tibial (APT) components. The purpose of this study is to compare the utilization and outcomes of APT and MBT components in a large US database.
The American Joint Replacement Registry was queried to identify all patients undergoing primary total knee arthroplasty (TKA) during the study period from 2012 to 2019. These patients were divided into cohorts based on tibial component (APT or MBT). Cohort demographics including gender, hospital size, hospital teaching status, region, age, and Charlson Comorbidity Index were reported with descriptive statistics. Overall reoperation rates and revisions for infection, aseptic loosening, periprosthetic fracture, manipulation under anesthesia, and revision for other reasons were identified using International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes and compared across APT and MBT cohorts. Kaplan-Meir survival analysis was performed based on reason for reoperation for APT and MBT.
During the study period, 703,007 TKAs were reported with 97.8% utilizing MBT and 2.2% utilizing APT components. Despite the introduction of alternative payment models during the study period, the utilization of APT decreased from 5.8% in 2012 to 1.7% in 2019. The survival of APT and MBT TKAs were similar across the study period: 98.1% vs 98.6% at 8 years. The rate of reoperation for all-causes was higher for APT compared to MBT (1.36% vs 1.00%; odds ratio 1.52).
Despite their paucity of use and lower cost APT remained within a 0.4% margin of survivorship when compared to MBT implants for up to 8 years.
Level III, retrospective.
The American Joint Replacement Registry was queried to identify all patients undergoing primary total knee arthroplasty (TKA) during the study period from 2012 to 2019. These patients were divided into cohorts based on tibial component (APT or MBT). Cohort demographics including gender, hospital size, hospital teaching status, region, age, and Charlson Comorbidity Index were reported with descriptive statistics. Overall reoperation rates and revisions for infection, aseptic loosening, periprosthetic fracture, manipulation under anesthesia, and revision for other reasons were identified using International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes and compared across APT and MBT cohorts. Kaplan-Meir survival analysis was performed based on reason for reoperation for APT and MBT.
During the study period, 703,007 TKAs were reported with 97.8% utilizing MBT and 2.2% utilizing APT components. Despite the introduction of alternative payment models during the study period, the utilization of APT decreased from 5.8% in 2012 to 1.7% in 2019. The survival of APT and MBT TKAs were similar across the study period: 98.1% vs 98.6% at 8 years. The rate of reoperation for all-causes was higher for APT compared to MBT (1.36% vs 1.00%; odds ratio 1.52).
Despite their paucity of use and lower cost APT remained within a 0.4% margin of survivorship when compared to MBT implants for up to 8 years.
Level III, retrospective.
摘要：
先前的研究表明，模块化金属背衬胫骨（MBT）和全聚乙烯胫骨（APT）组件的存活率相同。这项研究的目的是比较美国大型数据库中APT和MBT组件的利用率和结果。
查询了美国关节置换登记处，以确定2012年至2019年研究期间所有接受初次全膝关节置换术（TKA）的患者。根据胫骨组件（APT或MBT）将这些患者分为队列。队列人口统计数据，包括性别，医院规模,医院教学现状,区域,年龄,和Charlson合并症指数用描述性统计方法报告。总的再手术率和感染的修订，无菌性松动,假体周围骨折,在麻醉下操作，并使用国际疾病分类确定了其他原因的修订，第九次修订和当前程序术语代码，并比较了APT和MBT队列。根据APT和MBT再次手术的原因进行Kaplan-Meir生存分析。
在研究期间，报告了703,007个TKAs，其中97.8%使用MBT，2.2%使用APT组件。尽管在研究期间引入了替代支付模式，APT的利用率从2012年的5.8%下降到2019年的1.7%。在整个研究期间，APT和MBTTKAs的生存率相似：在8年时分别为98.1%和98.6%。与MBT相比，APT的全因再手术率较高（1.36％vs1.00％；比值比1.52）。
与MBT植入物相比，尽管它们的使用很少且成本较低，但APT在长达8年的时间内仍保持在0.4％的生存率之内。
III级,回顾性。
查询了美国关节置换登记处，以确定2012年至2019年研究期间所有接受初次全膝关节置换术（TKA）的患者。根据胫骨组件（APT或MBT）将这些患者分为队列。队列人口统计数据，包括性别，医院规模,医院教学现状,区域,年龄,和Charlson合并症指数用描述性统计方法报告。总的再手术率和感染的修订，无菌性松动,假体周围骨折,在麻醉下操作，并使用国际疾病分类确定了其他原因的修订，第九次修订和当前程序术语代码，并比较了APT和MBT队列。根据APT和MBT再次手术的原因进行Kaplan-Meir生存分析。
在研究期间，报告了703,007个TKAs，其中97.8%使用MBT，2.2%使用APT组件。尽管在研究期间引入了替代支付模式，APT的利用率从2012年的5.8%下降到2019年的1.7%。在整个研究期间，APT和MBTTKAs的生存率相似：在8年时分别为98.1%和98.6%。与MBT相比，APT的全因再手术率较高（1.36％vs1.00％；比值比1.52）。
与MBT植入物相比，尽管它们的使用很少且成本较低，但APT在长达8年的时间内仍保持在0.4％的生存率之内。
III级,回顾性。
