Tibial Baseplate-Cement Interface Debonding in the ATTUNE Total Knee Arthroplasty System

Torino, Daniel; Damsgaard, Christopher; Kolessar, David J.; Hayes, Daniel S.; Foster, B.; Constantino, Jesse; Graham, Jove

doi:10.1016/j.artd.2022.06.012

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…Meta-analysis of six studies showed an overall rate of loosening of 1.2% (95% CI 0.2% to 6.3%) (heterogeneity: tau 2 = 6.092, I 2 = 93.273, Q = 29.731; p < 0.001). 21,23,25,27,29,30 Meta-analysis of three studies reporting on rates of loosening of TKAs with fixed-bearing components showed an overall rate of 2.4% (95% CI 0.2% to 25.5%) (heterogeneity: tau 2 = 4.605, I 2 = 91.283, Q = 22.942; p < 0.001). 21,25,27 Analysis of three studies reporting rates of loosening of TKAs with PS components showed a rate of 1.5% (95% CI 0.1% to 22.6%) (heterogeneity: tau 2 = 3.936, I 2 = 93.702, Q = 79.394; p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 4,910 studies were identified by title, 12 of which met the inclusion criteria. [20][21][22][23][24][25][26][27][28][29][30][31] Figure 1 shows the Preferred reporting items for systematic reviews and meta-analyses flow diagram. 32 table i summarizes the characteristics of the studies, which were included, with a total of 3,861 tKas (2,600 attUne, 1,261 other systems).…”

Section: Resultsmentioning

confidence: 99%

“…meta-analysis of six studies reporting on revision due to loosening showed an overall rate of revision of 0.9% (95% ci 0.2% to 5.1%) (heterogeneity: tau 2 = 3.587, I 2 = 93.131, Q = 72.789; p < 0.001). 21,25,[28][29][30][31] Seven national joint registries (UK, Australia, New Zealand, sweden, Germany, netherlands, switzerland) reporting on the †Excluding the three studies reporting on RLL ≥ 2 mm. 20,23,31 ‡Medial tibia (AP): included one study which defined as radiolucency any medial tibial bone resorption, but only radiolucencies reported for zones of medial tibial baseplate included.…”

Section: Resultsmentioning

confidence: 99%

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High rate of radiolucent lines following the cemented original design of the ATTUNE total knee arthroplasty

et al. 2023

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AimsLoosening of components after total knee arthroplasty (TKA) can be associated with the development of radiolucent lines (RLLs). The aim of this study was to assess the rate of formation of RLLs in the cemented original design of the ATTUNE TKA and their relationship to loosening.MethodsA systematic search was undertaken using the Cochrane methodology in three online databases: MEDLINE, Embase, and CINAHL. Studies were screened against predetermined criteria, and data were extracted. Available National Joint Registries in the Network of Orthopaedic Registries of Europe were also screened. A random effects model meta-analysis was undertaken.ResultsOf 263 studies, 12 were included with a total of 3,861 TKAs. Meta-analysis of ten studies showed high rates of overall tibial or femoral RLLs for the cemented original design of the ATTUNE TKA. The overall rate was 21.4% (95% confidence interval (CI) 12.7% to 33.7%) for all types of design but was higher for certain subgroups: 27.4% (95% CI 13.4% to 47.9%) for the cruciate-retaining type, and 29.9% (95% CI 15.6% to 49.6%) for the fixed-bearing type. Meta-analysis of five studies comparing the ATTUNE TKA with other implants showed a significantly higher risk of overall tibial or femoral RLLs (odds ratio (OR) 2.841 (95% CI 1.219 to 6.623); p = 0.016) for the ATTUNE. The rates of loosening or revision for loosening were lower, at 1.2% and 0.9% respectively, but the rates varied from 0% to 16.3%. The registry data did not report specifically on the original ATTUNE TKA or on revision due to loosening, but ‘all-cause’ five-year revision rates for the cemented ATTUNE varied from 2.6% to 5.9%.ConclusionThe original cemented ATTUNE TKA has high rates of RLLs, but their clinical significance is uncertain given the overall low associated rates of loosening and revision. However, in view of the high rates of RLLs and the variation in the rates of loosening and revision between studies and registries, close surveillance of patients who have undergone TKA with the original ATTUNE system is recommended.Cite this article: Bone Joint J 2023;105-B(6):610–621.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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High rate of radiolucent lines following the cemented original design of the ATTUNE total knee arthroplasty

et al. 2023

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“…Two Pubmed studies (1) Torino et al [ 21 ] (n = 742) and (2) Giaretta et al [ 24 ] (n = 228) had revisions in Attune-TKA. The mean follow-up period for the studies was 3.2 years (Range 2–5y).…”

Section: Resultsmentioning

confidence: 99%

“…Another study by Pabinger et al with 168 included studies without differentiation with regard to a knee system showed a median revision rate in the studies of 0.7 revisions/100 CY. A limitation of our study and a possible reason for the lower results is certainly that only two studies [ 21 , 24 ] that published data on Attune Knee TKA had revisions and that in most cases the studies were conducted by one department.…”

Section: Discussionmentioning

confidence: 99%

Comparison of revision rates and epidemiological data of a single total knee arthroplasty system of different designs (cruciate retaining, posterior stabilized, mobile bearing, and fixed bearing): a meta-analysis and systematic review of clinical trials and national arthroplasty registries

Wagner,

Wittig,

Leitner

et al. 2024

Arch Orthop Trauma Surg

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Background This study aimed to meta-analyze epidemiological data, revision rates, and incidences of different designs of a single Total Knee Arthroplasty System and compare these factors across different countries. Methods A systematic review was conducted on clinical studies and arthroplasty registries of ATTUNE TKA from 1999 to 2020. The main endpoints analyzed were revision rates and epidemiological data. Results The average age of patients was 67.8 years, with a gender distribution of 60% female and 40% male. The pooled average BMI was 29.4 kg/m2. Eight clinical studies showed a pooled revision rate per 100 observed CY of 0.5 (n = 1343 cases). Cumulative revision rates after 1, 3, and 5 years varied among registries, with the Swiss registry having the highest revision data (after 5 years: 6.3%) and the American registry having the lowest revision data (after 5 years: 1.7%). A comparison of the revision rates of mobile bearing and fixed bearing (41,200 cases) as well as cruciate retaining and posterior stabilized (n = 123,361 cases) showed no significant advantage in the first 5 years after implantation. Conclusion In conclusion, pooled data from 41,200 cases of TKA with a single Total Knee Arthroplasty System in two arthroplasty registries revealed that there was no significant difference in revision rates between the mobile bearing and fixed bearing design within the first 5 years after implantation. In addition, a comparison of the revision rates in n = 123,361 cases showed no significant advantage for cruciate retaining or posterior stabilized in the first 5 years after implantation.

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Aseptische Prothesenlockerung am Kniegelenk

Halder,

Schrednitzki

2023

Orthopädie Und Unfallchirurgie

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Tibial Baseplate-Cement Interface Debonding in the ATTUNE Total Knee Arthroplasty System

Cited by 10 publications

References 27 publications

High rate of radiolucent lines following the cemented original design of the ATTUNE total knee arthroplasty

High rate of radiolucent lines following the cemented original design of the ATTUNE total knee arthroplasty

Comparison of revision rates and epidemiological data of a single total knee arthroplasty system of different designs (cruciate retaining, posterior stabilized, mobile bearing, and fixed bearing): a meta-analysis and systematic review of clinical trials and national arthroplasty registries

Aseptische Prothesenlockerung am Kniegelenk

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