There are few modern reports that document the results of all-polyethylene (all-poly) tibial components in younger, active patients. The potential benefits of this design are the elimination of backside wear and lower implant cost than modular, metal-backed components. Nonetheless, since the mid 1980s, modular, metal-backed tibial trays have dominated the total knee arthroplasty market based on finite-element analysis studies that demonstrated superior force distribution compared with conventional all-poly components. As a result, backside wear has become an emerging problem and refocused design efforts on unitized components. Our clinical experience indicates that an all-poly tibial component fixed with cement can provide excellent performance and survivorship even in younger, active patients at intermediate follow-up.
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