Clinical Outcomes of a Modern Total Knee Arthroplasty Prosthesis Compared to Its Predecessor at 5-Year Follow-Up: Matched Pair Analysis

White, Peter B.; Turcan, Sava; Satalich, James; Ranawat, Amar S.; Ranawat, Chitranjan S.

doi:10.1016/j.arth.2020.06.024

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…Martin, et al [29] found a lower rate of crepitation in the ATTUNE group than in the PFC Sigma group at the 2-year follow-up (0.83% vs. 9.4%, respectively). Ranawat, et al [7] reported that ATTUNE patients had less incidence of anterior knee pain and crepitation than PFC Sigma patients; however, a longer-term follow-up study at 5-years postoperatively of the same population found no signi cant difference in the incidence of anterior knee pain between groups (11.7% vs. 22.1% for the ATTUNE and PFC Sigma groups, respectively; p = 0.09) [22]. The authors suggested explanation for this nding was that some patients in the earlier cohort were diseased and lost to follow-up.…”

Section: Discussionmentioning

confidence: 93%

“…However and in contrast, the results of our study revealed no signi cant differences between the ATTUNE and PFC Sigma knee systems relative to pain, modi ed knee score, or performance-based measures during a minimum followup of 5 years. White, et al [22] conducted a combined retrospective and prospective cohort matched-pair study that found signi cantly less residual pain (using yes or no questions) in the ATTUNE group than in the PFC Sigma group at the 5-year follow-up (19.5% vs. 36.3%, respectively; p = 0.02). However, when Knee Society Score (KSS) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were compared between the two knee systems, no signi cant difference between groups was observed for either measure.…”

Section: Discussionmentioning

confidence: 99%

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Midterm Functional Recovery of Total Knee Arthroplasty Patients Compared Between the ATTUNE Knee System and the Press Fit Condylar (PFC) SIGMA Knee System

Vanitcharoenkul

Unnanuntana

2021

Preprint

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Background The ATTUNE Knee System is a new prosthetic design that has theoretical advantages over the Press Fit Condylar (PFC) Sigma Knee System specific to improved knee kinematics and patellofemoral joint tracking. This study aimed to evaluate functional outcomes compared between the ATTUNE and PFC Sigma designs at a minimum follow-up of 5 years. Methods We retrospectively reviewed data from total knee arthroplasty patients who received either the ATTUNE or PFC Sigma system during November 2013 to February 2015 at Siriraj Hospital (Bangkok, Thailand). Functional outcomes were evaluated using timed up and go test, 2-minute walk test, modified knee score, numerical rating scale-pain, range of motion (ROM), and rate of anterior knee pain and crepitation at preoperation, 3-months, 1-year, and 5-years, postoperatively. Results Of 113 patients, 59 and 54 received the PFC Sigma and ATTUNE systems, respectively. At a minimum of 5-years follow-up, all functional outcomes improved significantly. Although the mean ROM at 5-years postoperatively was significantly higher in ATTUNE than in PFC Sigma, the difference was small (116° vs. 110°, respectively; p = 0.041). There were no significant differences in any of the other outcome measurements, including anterior knee pain, clunking, and crepitation, between groups at any study time point. Conclusions Our results revealed no major differences in functional outcomes between the PFC Sigma and ATTUNE TKA designs at an intermediate-term follow-up of at least 5 years. Longer-term follow-up study is needed to evaluate the benefits of the ATTUNE design relative to polyethylene wear and the rate of aseptic loosening.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Midterm Functional Recovery of Total Knee Arthroplasty Patients Compared Between the ATTUNE Knee System and the Press Fit Condylar (PFC) SIGMA Knee System

Vanitcharoenkul

Unnanuntana

2021

Preprint

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“…However, the results of our study revealed no significant differences between the ATTUNE and PFC Sigma knee systems relative to pain, modified knee score, or performance-based measures during a minimum follow-up of 5 years. White, et al [ 23 ] conducted a combined retrospective and prospective cohort matched-pair study that found significantly less residual pain (using yes or no questions) in the ATTUNE group than in the PFC Sigma group at the 5-year follow-up (19.5% vs. 36.3%, respectively; p = 0 . 02).…”

Section: Discussionmentioning

confidence: 99%

“…Although most previous studies found no major differences between the ATTUNE and PFC Sigma systems relative to functional outcomes during a short-term follow-up [ 27 – 30 ] (Table 4 ), some studies reported that the ATTUNE system had less patients who experienced crepitation and pain [ 7 , 23 , 31 , 32 ] due to improvement in some design features, including modifications to the trochlear groove and patellar shape to prevent patellofemoral maltracking, patellar tilt, and patellofemoral overstuffing [ 7 ]. Martin, et al [ 32 ] found a lower rate of crepitation in the ATTUNE group than in the PFC Sigma group at the 2-year follow-up (0.83% vs. 9.4%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Martin, et al [ 32 ] found a lower rate of crepitation in the ATTUNE group than in the PFC Sigma group at the 2-year follow-up (0.83% vs. 9.4%, respectively). Ranawat, et al [ 7 ] reported that ATTUNE patients had less incidence of anterior knee pain and crepitation than PFC Sigma patients; however, a longer-term follow-up study at 5-years postoperatively of the same population found no significant difference in the incidence of anterior knee pain between groups (11.7% vs. 22.1% for the ATTUNE and PFC Sigma groups, respectively; p = 0.09) [ 23 ]. The authors suggested explanation for this finding was that some patients in the earlier cohort were diseased and lost to follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Midterm functional recovery of Total knee arthroplasty patients compared between the ATTUNE knee system and the press fit condylar (PFC) SIGMA knee system

Vanitcharoenkul

Unnanuntana

2021

BMC Musculoskelet Disord

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Background The ATTUNE Knee System is a new prosthetic design that has theoretical advantages over the Press Fit Condylar (PFC) Sigma Knee System specific to improved knee kinematics and patellofemoral joint tracking. This study aimed to evaluate functional outcomes compared between the ATTUNE and PFC Sigma designs at a minimum follow-up of 5 years. Methods We retrospectively reviewed data from total knee arthroplasty (TKA) patients who received either the ATTUNE or PFC Sigma system during November 2013 to February 2015 at Siriraj Hospital (Bangkok, Thailand). Functional outcomes were evaluated using Timed Up and Go (TUG) test, 2-min walk test (2MWT), modified knee score, numerical rating scale-pain, range of motion (ROM), and rate of anterior knee pain and crepitation at preoperation, 3-months, 1-year, and 5-years postoperatively. Results Of 113 patients, 59 and 54 received the PFC Sigma and ATTUNE systems, respectively. At a minimum of 5-years follow-up, all functional outcomes improved significantly from the preoperative period although TUG test and 2MWT declined significantly from 1- to 5-years postoperatively only in the PFC Sigma group. The mean ROM at 5-years postoperatively was significantly higher in ATTUNE than in PFC Sigma; however, the difference was small (116° vs. 110°, respectively; p = 0.041). There were no significant differences in any of the other outcome measurements, including anterior knee pain, clunking, and crepitation, between groups at any study time point. Conclusions Our results revealed no major differences in functional outcomes between the PFC Sigma and ATTUNE TKA designs at an intermediate-term follow-up of at least 5 years. Longer-term follow-up study is needed to evaluate the benefits of the ATTUNE design relative to polyethylene wear and the rate of aseptic loosening.

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Does lucency equate to revision? A five‐year retrospective review of Attune and Triathlon total knee arthroplasty

O’Donovan

McAleese

Harty

2023

Knee surg. sports traumatol. arthrosc.

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Purpose The Attune® total knee arthroplasty system was introduced in 2013 to address lingering issues of patient dissatisfaction. However, recent literature reports concerns of early tibial tray debonding. The aim of this study was to compare the incidence of radiolucent lines, survivorship and patient reported outcome-measures between the Attune® system and the well-established Triathlon® system. Methods This retrospective database review was conducted at a single institution in Cork, Ireland. All primary Attune® (N = 445) and Triathlon® (N = 285) systems implanted between 2015 and 2016 were reviewed. Radiolucent lines were assessed for those with a minimum two-year radiological follow-up (Attune® = 338; Triathlon® = 231). X-rays were taken post op, at 6 months, 2 years and 5 years. Radiolucent lines were documented using the Modern Knee Society Radiographic System. Five-year survival was assessed using Kaplan–Meier analysis with the Log Rank method to determine statistical significance. The Oxford Knee Score and EQ-5D-5L, were collected pre-op, at 6 months, 2 years and 5 years post-operatively and compared using the Kruskal–Wallis Test. Results The Attune® had a higher proportion of radiolucent lines at the tibial tray [87.1% (54/62) vs 61.4% (27/44); p = 0.001] and at the implant–cement interface [62.9% (39/62) vs 43.2% (19/44); p = 0.02]. Conversely, the Triathlon® had a higher proportion AT the femur [38.6% (17/44) vs 12.9% (8/62); p = 0.001] and at the cement–bone interface [56.8% (25/44) vs 37.1% (23/62); p = 0.02]. The overall frequency of radiolucent lines was similar in both the Attune® and Triathlon® groups [17.8%, (60/338) vs 17.7%, (41/231); p = 0.49]. There was no difference in revision-free survival analysis at 5 years (Attune® 97.8% vs Triathlon® 95.8%; p = 0.129). The Attune® performed better at 5 years in the Oxford Knee Score [Attune® = 42.6 (SD 5.2) vs Triathlon® = 41 (SD 6.4); p = 0.001] and in the EQ-5D [Attune® = 0.773 (SD 0.187) vs Triathlon® = 0.729 (SD 0.218); p = 0.013]. There was no difference at 5 years in the EQ-VAS [Attune® = 80.4 (SD 13.7) vs Triathlon® = 78.5 (SD 15.3); p = 0.25]. Conclusion The Attune® system exhibited a higher incidence of radiolucent lines at the tibial tray. However, this did not lead to decreased survivorship at medium term follow-up compared to the Triathlon®. Furthermore, improvements in patient reported outcomes modestly favoured the Attune® system. Level of evidence III.

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Clinical Outcomes of a Modern Total Knee Arthroplasty Prosthesis Compared to Its Predecessor at 5-Year Follow-Up: Matched Pair Analysis

Cited by 10 publications

References 24 publications

Midterm Functional Recovery of Total Knee Arthroplasty Patients Compared Between the ATTUNE Knee System and the Press Fit Condylar (PFC) SIGMA Knee System

Midterm Functional Recovery of Total Knee Arthroplasty Patients Compared Between the ATTUNE Knee System and the Press Fit Condylar (PFC) SIGMA Knee System

Midterm functional recovery of Total knee arthroplasty patients compared between the ATTUNE knee system and the press fit condylar (PFC) SIGMA knee system

Does lucency equate to revision? A five‐year retrospective review of Attune and Triathlon total knee arthroplasty

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