We read with interest the article titled, "All-Polyethylene tibial implant in young, active patients" (2012;27(l):10-14). The authors have brought out a very important issue about the use of all-poly tibial component in young patients, as earlier reports have been reporting their use in elderly patients older than 60 years [1]. However, the authors have failed to mention about the primary diagnosis of their patient population. This may have relevance in the choice of implant because we feel that patients with inflammatory arthritis with associated osteoporosis may not be suitable candidates for all-poly tibial implants. Moreover, the presence of bone defects in their cases has not been documented. The presence of a significant bone defect may restrict its use, especially if an associated bone grafting procedure or the use of stem is required. The cost saving is probably one of the driving forces for its use, especially in developing countries, but at present, the use of all-poly tibial implants still needs to be restricted in selecting patients (with good bone stock, without any significant bone loss, etc) until sufficient data from multicentric, randomized controlled trials are available.
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