Does the clinical and radiologic outcomes following total knee arthroplasty using a new design cobalt‑chrome tibial plate or predecessor different?
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Background: This study aimed to compare clinical and radiographic outcomes for a new tibial component(Attune S+) and the previous design(Attune S) in total knee arthroplasty(TKA) patients using ATTUNE® posterior stabilized(PS) prosthesis and also assessed related factors for the development of tibial radiolucent line(RLL). Methods : This retrospective study included 362 knees(179 Attune S, 183 Attune S+) with an average 4 years(range, 2 to 8) follow-up. Clinical outcomes, radiologic parameters and the incidence of RLL around the tibial component were compared through the serial assessment. For the subgroup analysis, radiologic parameters were compared between patients with and without RLL. Results : There was no significant difference in terms of clinical outcomes and radiologic parameters between two designs. The incidence of RLL was not different through the serial follow-up(P>.05). In the subgroup analysis, the preoperative medial proximal tibial angle(83.7°vs 85.0°, P=0.01) was smaller and preoperative hip-knee-ankle angle(169.1° vs 171.8°, P=0.01) has more varus in the group with RLL than those without. Conclusions : The clinical and radiologic outcomes including the incidence of tibial RLL between new design and predecessor were not significantly different at average 4 years follow-up. The development of tibial RLL was associated with preoperative varus deformity of tibia and lower limb alignment.
Abstract
Background: This study aimed to compare clinical and radiographic outcomes for a new tibial component(Attune S+) and the previous design(Attune S) in total knee arthroplasty(TKA) patients using ATTUNE® posterior stabilized(PS) prosthesis and also assessed related factors for the development of tibial radiolucent line(RLL). Methods : This retrospective study included 362 knees(179 Attune S, 183 Attune S+) with an average 4 years(range, 2 to 8) follow-up. Clinical outcomes, radiologic parameters and the incidence of RLL around the tibial component were compared through the serial assessment. For the subgroup analysis, radiologic parameters were compared between patients with and without RLL. Results : There was no significant difference in terms of clinical outcomes and radiologic parameters between two designs. The incidence of RLL was not different through the serial follow-up(P>.05). In the subgroup analysis, the preoperative medial proximal tibial angle(83.7°vs 85.0°, P=0.01) was smaller and preoperative hip-knee-ankle angle(169.1° vs 171.8°, P=0.01) has more varus in the group with RLL than those without. Conclusions : The clinical and radiologic outcomes including the incidence of tibial RLL between new design and predecessor were not significantly different at average 4 years follow-up. The development of tibial RLL was associated with preoperative varus deformity of tibia and lower limb alignment.
참고문헌 (29)
- Saragaglia D, "Total knee arthroplasties from the origin to navigation : history, rationale, indications", Int Orthop, 43, pp.597~604 (2019)
- Bonutti PM, "Unusually high rate of early failure of tibial component in attune total knee arthroplasty system at implant-cement interface", J Knee Surg, 30, pp.435~439 (2017)
- Staats K, "Modern cemented total knee arthroplasty design shows a higher incidence of radiolucent lines compared to its predecessor", Knee Surg Sports Traumatol Arthrosc, 27, pp.1148~1155 (2019)
- Gallo J, "Osteolysis around total knee arthroplasty : a review of pathogenetic mechanisms", Acta Biomater, 9, pp.8046~8058 (2013)
- Song SJ, "Medial proximal tibial resorption after total knee arthroplasty according to the design of the cobalt chrome tibial baseplate", Arch Orthop Trauma Surg, 143, pp.3401~3407 (2023)
- DePuySynthes, "Attune S+ technology", ~ (2017)
- Maag C, "Influence of alignment-specific physiological loading following intraoperative lipid", marrow infiltration and intraoperative motions upon tibial implant fixation, 2020, ~
- Moro-oka TA, "Modified gap-balancing technique in total knee arthroplasty : evaluation of the post-operative coronal laxity", Knee Surg Sports Traumatol Arthrosc, 18, pp.375~380 (2010)
- Cawley DT, "Cementing techniques for the tibial component in primary total knee replacement", Bone Joint J (2013)[DOI]
- Giesinger JM, "WOMAC, EQ-5D and knee society score thresholds for treatment success after total knee arthroplasty", J Arthroplasty, 30, pp.2154~2158 (2015)
- Healy WL, "Complications of total knee arthroplasty : standardized list and definitions of the knee society", Clin Orthop Relat Res, 471, pp.215~220 (2013)
- Ewald FC, "The knee society total knee arthroplasty roentgenographic evaluation and scoring system", Clin Orthop Relat Res (1989)[DOI]
- Smith S, "The natural history of tibial radiolucent lines in a proximally cemented stemmed total knee arthroplasty", J Arthroplasty, 14, pp.3~8 (1999)
- Rizzo MG, "High-viscosity versus a lower-viscosity cement penetration at dough phase in vivo in primary total knee arthroplasty", J Arthroplasty, 36, pp.1995~1999 (2021)
- Aguinis H, "Best-practice recommendations for defining, identifying, and handling outliers", Organ Res Methods, 16, pp.270~301 (2013)
- Ecker ML, "Long-term results after total condylar knee arthroplasty. Significance of radiolucent lines", Clin Orthop Relat Res, 216, pp.151~158 (1987)
- Zhang Y, "Reliability of detecting prosthesis", cement interface radiolucencies in total hip arthroplasty, 2002, pp.20, 683~687
- Wong DW, "Tibial tray thickness does not significantly increase medial tibial bone resorption : Using tibial bone density as an objective measurement method", Knee, 27, pp.572~579 (2020)
- Bendich I, "The impact of component design and fixation on stress shielding after modern total knee arthroplasty", J Arthroplasty, 37, pp.S221~S225 (2022)
- Tsukada S, "Metal block augmentation for bone defects of the medial tibia during primary total knee arthroplasty", J Orthop Surg Res, 8, pp.36~ (2013)
- Yoon C, "Medial tibial periprosthetic bone resorption and its effect on clinical outcomes after total knee arthroplasty : cobalt-chromium vs titanium implants", J Arthroplasty, 33, pp.2835~2842 (2018)
- Jaeger S, "Does tibial design modification improve implant stability for total knee arthroplasty? an experimental cadaver study", Bone Joint Res, 11, pp.229~238 (2022)
- Ahn JH, "The effect of multiple drilling on a sclerotic proximal tibia during total knee arthroplasty", Int Orthop, 39, pp.1077~1083 (2015)
- Wautier D, "Radiolucent lines around knee arthroplasty components : a narrative review", Acta Orthop Belg, 86, pp.82~94 (2020)
- Li YR, "Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty", BMC Musculoskelet Disord, 20, pp.617~ (2019)
- Ritter MA, "Preoperative malalignment increases risk of failure after total knee arthroplasty", J Bone Joint Surg Am, 95, pp.126~131 (2013)
- Hampton CB, "Aseptic loosening at the tibia in total knee arthroplasty: a function of cement mantle quality?", J Arthroplasty, 35, pp.S190~S196 (2020)
- Ritter MA, "Radiolucency at the bone-cement interface in total knee replacement. The effects of bone-surface preparation and cement technique", J Bone Joint Surg Am, 76, pp.60~65 (1994)
- Refsum AM, "Cementing technique for primary knee arthroplasty : a scoping review", Acta Orthop, 90, pp.582~589 (2019)
