Early experience with the ATTUNE Total Knee Replacement System

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Stefano Giaretta
Mattia Berti
Gian Mario Micheloni
Alberto Ceccato
Francesco Marangoni
Alberto Momoli

Keywords

TKA, ATTUNE Total Knee Replacement, Radiolucency

Abstract

Background: Modern TKA implants promise to improve functional outcomes, stability, patient satisfaction and operating room efficiency. The purpose of this retrospective study is to evaluate our short-term clinical and radiological results and survival using the ATTUNE Total Knee Replacement System. Methods: The authors reviewed 228 primary cemented TKAs using ATTUNE Total Knee Replacement System which were implanted between 2014 and 2018 concerning short-term clinical and radiographical outcomes and survival. Clinical evaluation was performed using the Knee injury Osteoarthritis Outcome Score (KOOS), the Oxford Score and a Numeric Rating Scale (NRS) for pain. Radiographic analysis was performed using the Modern Knee Society Score Evaluation System. Results: The means of the clinical results as measured with KOOS score were Pain 82,7, Symptoms 79, ADL 78,3, Sport and recreation 51,8 and QOL 78,6. The mean Oxford score was 35 and NRS 2. The mean ROM was 113,4 (SD 9,4 range 90-130). Radiographically mean mechanical axis was 1,97° of Varus and radiolucent lines were detected in 43 knees (22,4%). The survival rate is 98.4% at 2 years and 97.4% at 5 years. Conclusion: At short-term follow-up the ATTUNE Knee Replacement System provide excellent clinical and radiographical outcomes and good results regarding revision rate. Due to high incidence of radiolucent lines, those patients should be closely monitored even though they show no clinical evidence for loosening.

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References

Clin Orthop Relat Res [Internet]. 1997 Dec [cited 2019 Oct 4];(345):79–86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9418624
2. Abdel MP, Morrey ME, Jensen MR, Morrey BF. Increased long-term survival of posterior cruciate-retaining versus posterior cruciate-stabilizing total knee replacements. J Bone Jt Surg - Ser A. 2011 Nov 16;93(22):2072–8.
3. Arthur CHC, Wood AM, Keenan ACM, Clayton RAE, Walmsley P, Brenkel I. Ten-year results of the Press Fit Condylar Sigma total knee replacement. Bone Joint J [Internet]. 2013 Feb [cited 2019 Oct 4];95-B(2):177–80. Available from: http://online.boneandjoint.org.uk/doi/10.1302/0301-620X.95B2.29695
4. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res [Internet]. 2010 Jan [cited 2019 Aug 28];468(1):57–63. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19844772
5. Scott CEH, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br [Internet]. 2010 Sep [cited 2019 Oct 7];92(9):1253–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20798443
6. Causero A, Di Benedetto P, Beltrame A, Gisonni R, Cainero V, Pagano M. Design evolution in total knee replacement: which is the future? Acta Biomed [Internet]. 2014 Sep 24 [cited 2019 Oct 8];85 Suppl 2:5–19. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25409713
7. Song SJ, Kang SG, Park CH, Bae DK. Comparison of Clinical Results and Risk of Patellar Injury between Attune and PFC Sigma Knee Systems. Knee Surg Relat Res. 2018 Dec 1;30(4):334–40.
8. Song SJ, Park CH, Liang H, Kang SG, Park JJ, Bae DK. Comparison of Clinical Results and Injury Risk of Posterior Tibial Cortex Between Attune and Press Fit Condylar Sigma Knee Systems. J Arthroplasty. 2018;33(2):391–7.
9. Bonutti PM, Khlopas A, Chughtai M, Cole C, Gwam CU, Harwin SF, et al. Unusually High Rate of Early Failure of Tibial Component in ATTUNE Total Knee Arthroplasty System at Implant-Cement Interface. J Knee Surg. 2017 Jun 1;30(5):435–9.
10. Monticone M, Ferrante S, Salvaderi S, Rocca B, Totti V, Foti C, et al. Development of the Italian version of the knee injury and osteoarthritis outcome score for patients with knee injuries: cross-cultural adaptation, dimensionality, reliability, and validity. Osteoarthr Cartil [Internet]. 2012 Apr [cited 2019 Oct 7];20(4):330–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22285738
11. Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br [Internet]. 1998 Jan [cited 2019 Oct 7];80(1):63–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9460955
12. Meneghini RM, Mont MA, Backstein DB, Bourne RB, Dennis DA, Scuderi GR. Development of a Modern Knee Society Radiographic Evaluation System and Methodology for Total Knee Arthroplasty. Vol. 30, Journal of Arthroplasty. Churchill Livingstone Inc.; 2015. p. 2311–4.
13. Ryan JA, Meyers KN, DiBenedetto P, Wright TM, Haas SB. Failure of the Patellar Tendon with the Patella Everted versus Noneverted in a Matched-Pair Cadaver Model. HSS J. 2010;6(2):134–7.
14. Piedade SR, Pinaroli A, Servien E, Neyret P. Revision after early aseptic failures in primary total knee arthroplasty. Knee Surgery, Sport Traumatol Arthrosc. 2009 Mar;17(3):248–53.
15. Hazelwood KJ, O’Rourke M, Stamos VP, McMillan RD, Beigler D, Robb WJ. Case series report: Early cement-implant interface fixation failure in total knee replacement. Knee. 2015 Oct 1;22(5):424–8.
16. Rao AR, Engh GA, Collier MB, Lounici S. Tibial interface wear in retrieved total knee components and correlations with modular insert motion. J Bone Jt Surg - Ser A. 2002 Oct 1;84(10):1849–55.
17. Zhang QH, Cossey A, Tong J. Stress shielding in periprosthetic bone following a total knee replacement: Effects of implant material, design and alignment. Med Eng Phys. 2016 Dec 1;38(12):1481–8.
18. Kopinski JE, Aggarwal A, Nunley RM, Barrack RL, Nam D. Failure at the Tibial Cement-Implant Interface With the Use of High-Viscosity Cement in Total Knee Arthroplasty. J Arthroplasty [Internet]. 2016 [cited 2019 Oct 15];31(11):2579–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27155996
19. No. Hip, Knee & Shoulder Arthroplasty National Joint Replacement Registry. Australian Orthopaedic Assiocation. Annual Report. 2017.
20. No. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. 2017;14th Annua.
21. Staats K, Wannmacher T, Weihs V, Koller U, Kubista B, Windhager R. Modern cemented total knee arthroplasty design shows a higher incidence of radiolucent lines compared to its predecessor. Knee Surgery, Sport Traumatol Arthrosc. 2019 Apr 5;27(4):1148–55.
22. Ranawat CS, White PB, West S, Ranawat AS. Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis. J Arthroplasty [Internet]. 2017 [cited 2019 Oct 14];32(2):431–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27600300
23. Molloy IB, Keeney BJ, Sparks MB, Paddock NG, Koenig KM, Moschetti WE, et al. Short term patient outcomes after total knee arthroplasty: Does the implant matter? Knee [Internet]. 2019 Jun [cited 2019 Oct 14];26(3):687–99. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30910627
24. Turgeon TR, Gascoyne TC, Laende EK, Dunbar MJ, Bohm ER, Richardson CG. The assessment of the stability of the tibial component of a novel knee arthroplasty system using radiostereometric analysis. Bone Jt J. 2018 Dec 1;100B(12):1579–84.
25. Lum ZC, Shieh AK, Dorr LD. Why total knees fail-A modern perspective review. Vol. 9, World Journal of Orthopaedics. Baishideng Publishing Group Co; 2018. p. 60–4.
26. Sharkey PF, Lichstein PM, Shen C, Tokarski AT, Parvizi J. Why are total knee arthroplasties failing today--has anything changed after 10 years? J Arthroplasty [Internet]. 2014 Sep [cited 2019 Oct 14];29(9):1774–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25007726
27. Cerquiglini A, Henckel J, Hothi H, Allen P, Lewis J, Eskelinen A, et al. Analysis of the attune tibial tray backside: A comparat ive retrieval study. Bone Jt Res. 2019 Mar 1;8(3):136–45.
28. Takagi H, Asai S, Sato A, Maekawa M, Kawashima H, Kanzaki K. Case series report of navigation-based in vivo knee kinematics in total knee arthroplasty with a gradually reducing femoral radius design. Ann Med Surg. 2017 May 1;17:33–7.

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