Results of ATTUNE Total Knee Replacement Implantation – Data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man

Introduction

The ATTUNE knee replacement system is the successor to the successful SIGMA implant, which has a very strong position in the history of arthroplasty. Innovative features of the ATTUNE system include a unique type of femoral component curvature radius increasing implant stability, a new type of patellar replacement reducing the risk of anterior knee pain syndrome, and the possibility of variable polyethylene insert sizes for the tibial component thanks to a unique locking mechanism.

The results of available mid-term studies indicate that the new system achieves excellent clinical results with a minimal number of re-implantations, as also evidenced by the British registry. The registry was established in 2002 as the National Joint Registry for England and Wales, with Northern Ireland joining in 2013. Currently, it is one of the highest quality national joint registries, comprising more than 1 million cases of knee replacement implantations.

Results from the British Registry

In May 2019, the registry recorded 24,963 cases of ATTUNE total knee replacement implantation in 22,479 patients. Implants have been monitored since 2009, with broader clinical practice use noted from 2013. The patient sample did not differ in parameters of age, BMI value, ASA score, and indication criteria from the overall population in the registry.

An independent analysis demonstrated a 5-year implant durability rate of 97.4%, with a cumulative revision rate of 2.6% (95% confidence interval [CI] 2.1–3.2), which is consistent with the cumulative revision rate for all knee replacements (2.2%). From the total number of implantations, only 262 revision surgeries were performed during the monitored period. Compared to other types of knee replacements, the proportion of revision procedures was significantly lower than the expected number of revisions in the parameters of aseptic loosening of the femoral component, unexplained pain, poor component positioning, and femoral osteolysis.

The advantage of the ATTUNE replacement is also confirmed by patient-reported outcomes using various scoring systems (Oxford Knee Score, EQ-5D index, EQ-VAS). In terms of procedure success and patient satisfaction with the replacement, the ATTUNE replacement was rated better by patients compared to other types of knee replacements (p < 0.05).

Conclusion

Data from the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man confirm the high durability of the ATTUNE implant in the mid-term and overall high patient satisfaction compared to other types of knee replacements.

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CZ-2020-02-80

Source: Implant Summary Report for DePuy ATTUNE CR and ATTUNE PS. NJR Database extract. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 2019 May 7.