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Medial tibial bone resorption following total knee arthroplasty comparing a traditional with a kinematic design

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

New total knee prostheses are being designed to improve clinical outcome, survivorship and patient satisfaction following total knee arthroplasty (TKA). A new knee system was developed with improvements in patellofemoral joint, trochlear geometry, polyethylene formulation and tibial baseplate. Aim of this study was to compare the newer kinematic knee system with its existing predecessor knee system in terms of clinical outcome, revision rates, radiographic outcomes specifically medial tibial bone resorption.

Methods

The prospective matched-pair study included 88 TKA surgeries using newer kinematic design knee prostheses, performed between January 2015 and December 2016, out of which 82 patients were available for final follow-up. The control cohort of 82 traditional TKA prosthesis was matched in terms of age, gender and body mass index. All surgeries were performed by the single surgeon using medial parapatellar arthrotomy and posterior stabilized implants were used. Clinical outcomes were assessed using knee society score, range of motion (ROM), anterior knee pain and crepitation. Radiological examinations included recording of radiolucent lines and medial tibial bone resorption.

Results

At the 5-year follow-up, no significant differences were noted in terms of mean knee society score (93.3 ± 6.6 vs 94.2 ± 8.1), knee function score (88.5 ± 10.5 vs 89.1 ± 11.2) and ROM. The incidences of anterior knee pain and crepitation were lower in the newer group (8.5% vs 21.9% and 14.6% vs 32.9%, respectively) compared to the traditional prosthesis group. No cases of aseptic loosening were observed in either cohort. No significant difference was seen in terms of radiolucent lines (29.3% vs 26.8%) and medial tibial resorption (2.43% in each group) incidences.

Conclusions

At the 5 years follow-up no significant differences were noted between the two groups in terms of clinical and radiological outcomes, except the former proved to be better for anterior knee pain and crepitation.

Level of evidence

II.

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Availability of data and material

The authors declare no conflict regarding the data transparency.

References

  1. Baker PN, van der Meulen JH, Lewsey J, Gregg PJ, National Joint Registry for England and Wales (2007) The role of pain and function in determining patient satisfaction after total knee replacement Data from the National Joint Registry for England and Wales. J Bone Jt Surg Br 89(7):893–900. https://doi.org/10.1302/0301-620X.89B7.19091

    Article  CAS  Google Scholar 

  2. Scott CE, Howie CR, MacDonald D, Biant LC (2010) Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Jt Surg Br 92(9):1253–1258. https://doi.org/10.1302/0301-620X.92B9.24394

    Article  CAS  Google Scholar 

  3. Nam D, Nunley RM, Barrack RL (2014) Patient dissatisfaction following total knee replacement: a growing concern? Bone Jt J 96-B(11 Supple A):96–100. https://doi.org/10.1302/0301-620X.96B11.34152

    Article  CAS  Google Scholar 

  4. Maniar RN, Bhatnagar N, Bidwai R, Dhiman A, Chanda D, Sanghavi N (2022) Comparison of patellofemoral outcomes between Attune and PFC Sigma designs: a prospective matched-pair analysis. Clin Orthop Surg 14(1):96–104. https://doi.org/10.4055/cios20130

    Article  PubMed  Google Scholar 

  5. Ranawat CS, White PB, West S, Ranawat AS (2017) Clinical and radiographic results of Attune and PFC Sigma knee designs at 2-year follow-up: a prospective matched-pair analysis. J Arthroplast 32(2):431–436. https://doi.org/10.1016/j.arth.2016.07.021

    Article  Google Scholar 

  6. Song SJ, Kang SG, Park CH, Bae DK (2018) Comparison of clinical results and risk of patellar injury between Attune and PFC Sigma knee systems. Knee Surg Relat Res 30(4):334–340. https://doi.org/10.5792/ksrr.18.020

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cerquiglini A, Henckel J, Hothi H et al (2019) Analysis of the Attune tibial tray backside: a comparative retrieval study. Bone Jt Res 8(3):136–145. https://doi.org/10.1302/2046-3758.83.BJJ-2018-0102.R2

    Article  CAS  Google Scholar 

  8. Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA (2017) Femoral implant design modification decreases the incidence of patellar crepitus in total knee arthroplasty. J Arthroplast 32(4):1310–1313. https://doi.org/10.1016/j.arth.2016.11.025

    Article  Google Scholar 

  9. Panchani SK, Divecha HM, Lafferty R et al (2021) Early functional outcomes after evolutionary total knee arthroplasty: a randomized controlled trial. Is new always better? JB JS Open Access 6(3):e21.00016. https://doi.org/10.2106/JBJS.OA.21.00016

    Article  PubMed  PubMed Central  Google Scholar 

  10. Carey BW, Harty J (2018) A comparison of clinical- and patient-reported outcomes of the cemented ATTUNE and PFC sigma fixed bearing cruciate sacrificing knee systems in patients who underwent total knee replacement with both prostheses in opposite knees. J Orthop Surg Res 13(1):54. https://doi.org/10.1186/s13018-018-0757-6

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bonutti PM, Khlopas A, Chughtai M et al (2017) Unusually high rate of early failure of tibial component in ATTUNE total knee arthroplasty system at implant-cement interface. J Knee Surg 30(5):435–439. https://doi.org/10.1055/s-0037-1603756

    Article  PubMed  Google Scholar 

  12. Murphy JD, Braunlich PR, Judson Iv WR, Harker JN, Baumann PA (2021) Early aseptic failure of the tibial component-cement interface in ATTUNE® total knee arthroplasty: a report of three cases. Cureus 13(12):e20582. https://doi.org/10.7759/cureus.20582

    Article  PubMed  PubMed Central  Google Scholar 

  13. Martin JR, Watts CD, Levy DL, Kim RH (2017) Medial tibial stress shielding: a limitation of cobalt chromium tibial baseplates. J Arthroplast 32(2):558–562. https://doi.org/10.1016/j.arth.2016.07.027

    Article  Google Scholar 

  14. Yoon C, Chang MJ, Chang CB, Song MK, Shin JH, Kang SB (2018) Medial tibial periprosthetic bone resorption and its effect on clinical outcomes after total knee arthroplasty: cobalt-chromium vs titanium implants. J Arthroplast 33(9):2835–2842. https://doi.org/10.1016/j.arth.2018.04.025

    Article  Google Scholar 

  15. Martin JR, Watts CD, Levy DL, Miner TM, Springer BD, Kim RH (2017) Tibial tray thickness significantly increases medial tibial bone resorption in cobalt-chromium total knee arthroplasty implants. J Arthroplast 32(1):79–82. https://doi.org/10.1016/j.arth.2016.06.007

    Article  Google Scholar 

  16. Deen JT, Clay TB, Iams DA, Horodyski M, Parvataneni HK (2017) Proximal tibial resorption in a modern total knee prosthesis. Arthroplast Today 4(2):244–248. https://doi.org/10.1016/j.artd.2017.10.005

    Article  PubMed  PubMed Central  Google Scholar 

  17. Willy RW, Hoglund LT, Barton CJ et al (2019) Patellofemoral pain. J Orthop Sports Phys Ther 49(9):CPG1–CPG95. https://doi.org/10.2519/jospt.2019.0302

    Article  PubMed  Google Scholar 

  18. Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    Article  Google Scholar 

  19. Nakahara H, Okazaki K, Mizu-Uchi H et al (2015) Correlations between patient satisfaction and ability to perform daily activities after total knee arthroplasty: why aren’t patients satisfied? J Orthop Sci 20(1):87–92. https://doi.org/10.1007/s00776-014-0671-7

    Article  PubMed  Google Scholar 

  20. Robinson T, King SW, Pilling RWD et al (2021) Attune total knee arthroplasty: is there evidence of early tibial component de-bonding? A prospective cohort study with a minimum two year follow-up. J Arthrosc Jt Surg. https://doi.org/10.1016/j.jajs.2021.03.007

    Article  Google Scholar 

  21. Sires J, Lennon S, Inglis M, Nguyen A, Wilson C (2020) Early results of the Attune knee system: a minimum 2 year follow up observational study. Open Access J Biomed Sci 2(4):494–498. https://doi.org/10.38125/OAJBS.000201

    Article  Google Scholar 

  22. Bateman DK, Preston JS, Mennona S, Gui E, Kayiaros S (2020) Comparison between the Attune and PFC Sigma in total knee arthroplasty: no difference in patellar clunk and crepitus or anterior knee pain. Orthopedics 43(6):e508–e514. https://doi.org/10.3928/01477447-20200812-05

    Article  PubMed  Google Scholar 

  23. Wong DW, Lee QJ, Lo CK, Wong YC, Law KW, Li AH (2020) Tibial tray thickness does not significantly increase medial tibial bone resorption: using tibial bone density as an objective measurement method. Knee 27(2):572–579. https://doi.org/10.1016/j.knee.2019.12.011

    Article  PubMed  Google Scholar 

  24. Shichman I, Oakley CT, Thomas J, Fernandez-Madrid I, Meftah M, Schwarzkopf R (2023) Comparison of traditional PS versus kinematically designs in primary total knee arthroplasty [published online ahead of print, 2023 Jan 10]. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-023-04763-8

  25. Choudhury AK, Gupta K, Ansari S, Raja BS, Paul S, Kalia RB (2023) Modern implants in total knee arthroplasty are more patellofemoral joint friendly compared to their traditional design: a systematic review and meta-analysis [published online ahead of print, 2023 Mar 24]. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-023-04832-y

  26. Vanitcharoenkul E, Unnanuntana A (2021) Midterm functional recovery of total knee arthroplasty patients compared between the ATTUNE knee system and the press fit condylar (PFC) SIGMA knee system. BMC Musculoskelet Disord 22(1):620. https://doi.org/10.1186/s12891-021-04464-6

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

No funding was received for conducting this study.

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Author notes

  1. Challa Dinesh Reddy, Pera Jayavardhan Reddy and Mahendra Singh contributed equally.

Authors and Affiliations

  1. Department of Orthopaedics, Dr SN Medical College Jodhpur, Jodhpur, India

    Mukesh Kumar Saini, Mahendra Singh & Mahesh Bhati

  2. Department of Orthopaedics, Star Hospitals, B Block, Banjara Hills, Hyderabad, India

    Challa Dinesh Reddy, Neelam Ramana Reddy & Pera Jayavardhan Reddy

Authors
  1. Mukesh Kumar Saini
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  3. Neelam Ramana Reddy
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Contributions

MKS conceptualized and designed the study; CDR, NRR, MKS and MS participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; PJR and MB revised the article critically for important intellectual content.

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Correspondence to Mukesh Kumar Saini.

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Ethical approval was obtained from Institutional review board for this study.

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Saini, M.K., Reddy, C.D., Reddy, N.R. et al. Medial tibial bone resorption following total knee arthroplasty comparing a traditional with a kinematic design. Arch Orthop Trauma Surg 143, 7139–7146 (2023). https://doi.org/10.1007/s00402-023-05000-y

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