Early clinical outcomes and survivorship of the Attune total knee arthroplasty system

Abstract

Introduction: Total knee arthroplasty (TKA) is an effective treatment for end-stage osteoarthritis. Modern day implant designs have boasted long survivorships of more than 90% at twelve years. The ATTUNE Total Knee Replacement system was developed in 2013 with hopes to improve patella tracking and knee kinematics. This study is to evaluate the early survivorship and clinical outcomes of this modern implant design. Methodology: Retrospective review of all ATTUNE TKAs with a minimum two-year follow up performed since 2014 in Queen Mary Hospital and Duchess of Kent’s Children Hospital. Implant survivorship, complications and causes for revision were analysed. Clinical outcomes including pre-operative and post-operative range of motion, flexion deformity, Knee Society Knee Score (KSKS), Knee Society Function Score (KSFA) and hip-knee-ankle mechanical alignment were assessed. Results and Analysis: There were 422 ATTUNE TKAs performed in 377 patients with 65.9% (278/377) female predominance. The average age was 66 years old (range: 42-87). Average pre-operative flexion deformity improved from 6.9 degrees (range: 0-40, SD: 6.3) to 1 degree (range: 0-30, SD: 2.5) after operation (p<0.01). Flexion range also significantly improved from 102 degrees (range: 30-130, SD: 14.5) to 108.5 degrees (range: 70-130, SD: 11.3) post-operatively (p<0.01). Clinical outcome measurements at two years showed improvement of the KSKS from 43.9 to 91.7 (p<0.01) and KSFA from 48.4 to 68.9 (p<0.01). We report a survivorship of 99% at two years with only three cases requiring revision surgery. These included one case each of peri-prosthetic infection, aseptic loosening and insert dislocation requiring exchange. Discussion and Conclusion: Early results show good clinical outcomes and survivorship at two years.