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Comparison of Clinical Results and Risk of Patellar Injury between Attune and PFC Sigma Knee Systems

  • Song, Sang Jun (Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Kang, Se Gu (Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University) ;
  • Park, Cheol Hee (Department of Medicine, Graduate School, Kyung Hee University) ;
  • Bae, Dae Kyung (Department of Orthopaedic Surgery, Seoul Sacred Heart General Hospital)
  • Received : 2018.03.07
  • Accepted : 2018.05.27
  • Published : 2018.12.01

Abstract

Purpose: The purposes of this study were to compare clinical results after total knee arthroplasty (TKA) using the Attune and PFC Sigma knee designs and to investigate whether the use of the Attune prosthesis increased the risk of patellar injury in Asian patients. Materials and Methods: Three hundred knees that underwent TKA using Attune (group A) were compared to 300 knees that underwent TKA using PFC Sigma (group B). The Knee Society Knee Score (KS) and Function Score (FS), and range of motion (ROM) were compared. The residual patellar thickness was compared to evaluate the risk of patellar injury. Results: The postoperative KS and ROM of group A were better than those of group B (93.1 vs. 88.8, p<0.001 and $131.4^{\circ}$ vs. $129.0^{\circ}$, p=0.008, respectively). The postoperative FS did not differ significantly between the two groups (80.9 vs. 78.7, p=0.427). The residual patella was thinner in group A (14.8 mm vs. 15.7 mm, p=0.003), which made up a higher proportion of the high-risk group for patellar fractures with a residual thickness of <12 mm (7.5% vs. 2.1%, p=0.003). Conclusions: TKA using the Attune prosthesis provided more favorable clinical results than TKA using PFC Sigma. However, the risk of injury in the residual patella was increased with use of the Attune prosthesis in Asian patients.

Keywords

References

  1. Sheth NP, Pedowitz DI, Lonner JH. Periprosthetic patellar fractures. J Bone Joint Surg Am. 2007;89:2285-96. https://doi.org/10.2106/JBJS.G.00132
  2. Konan S, Sandiford N, Unno F, Masri BS, Garbuz DS, Duncan CP. Periprosthetic fractures associated with total knee arthroplasty: an update. Bone Joint J. 2016;98:1489-96.
  3. Yoo JD, Kim NK. Periprosthetic fractures following total knee arthroplasty. Knee Surg Relat Res. 2015;27:1-9. https://doi.org/10.5792/ksrr.2015.27.1.1
  4. Amirouche F, Choi KW, Goldstein WM, Gonzalez MH, Broviak S. Finite element analysis of resurfacing depth and obliquity on patella stress and stability in TKA. J Arthroplasty. 2013;28:978-84. https://doi.org/10.1016/j.arth.2013.02.002
  5. Oishi CS, Kaufman KR, Irby SE, Colwell CW Jr. Effects of patellar thickness on compression and shear forces in total knee arthroplasty. Clin Orthop Relat Res. 1996;(331):283-90.
  6. Reuben JD, McDonald CL, Woodard PL, Hennington LJ. Effect of patella thickness on patella strain following total knee arthroplasty. J Arthroplasty. 1991;6:251-8. https://doi.org/10.1016/S0883-5403(06)80172-5
  7. DePuy Synthes. $ATTUNE^{(R)}$ knee system [Internet]. Warsaw, IN: DePuy Synthes; 2018 [cited 2017 Sep 8]. Available from: https://www.depuysynthes.com/hcp/knee/products/qs/ATTUNE-Knee-System.
  8. Ranawat CS, White PB, West S, Ranawat AS. Clinical and radiographic results of attune and PFC sigma knee designs at 2-year follow-up: a prospective matched-pair analysis. J Arthroplasty. 2017;32:431-6. https://doi.org/10.1016/j.arth.2016.07.021
  9. Webb JE, Yang HY, Collins JE, Losina E, Thornhill TS, Katz JN. The evolution of implant design decreases the incidence of lateral release in primary total knee arthroplasty. J Arthroplasty. 2017;32:1505-9. https://doi.org/10.1016/j.arth.2016.11.050
  10. Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA. Femoral implant design modification decreases the incidence of patellar crepitus in total knee arthroplasty. J Arthroplasty. 2017;32:1310-3. https://doi.org/10.1016/j.arth.2016.11.025
  11. DePuy Synthes. $SIGMA^{(R)}$ total knee system [Internet]. Warsaw, IN: DePuy Synthes; 2018 [cited 2017 Sep 8]. Available from: https://www.depuysynthes.com/hcp/knee/products/qs/SIGMA-Total-Knee-System.
  12. Kim TK, Chung BJ, Kang YG, Chang CB, Seong SC. Clinical implications of anthropometric patellar dimensions for TKA in Asians. Clin Orthop Relat Res. 2009;467:1007-14. https://doi.org/10.1007/s11999-008-0557-0
  13. Pierce TP, Jauregui JJ, Cherian JJ, Elmallah RK, Harwin SF, Mont MA. Is there an ideal patellar thickness following total knee arthroplasty? Orthopedics. 2016;39:e187-92. https://doi.org/10.3928/01477447-20151222-03
  14. Bae DK, Baek JH, Yoon KT, Son HS, Song SJ. Comparison of patellofemoral outcomes after TKA using two prostheses with different patellofemoral design features. Knee Surg Sports Traumatol Arthrosc. 2017;25:3747-54. https://doi.org/10.1007/s00167-016-4264-1
  15. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;(248):13-4.
  16. Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. 1989;(248):9-12.
  17. Kawano T, Miura H, Nagamine R, Urabe K, Matsuda S, Mawatari T, Moro-Oka T, Iwamoto Y. Factors affecting patellar tracking after total knee arthroplasty. J Arthroplasty. 2002;17:942-7. https://doi.org/10.1054/arth.2002.34826
  18. Lie DT, Gloria N, Amis AA, Lee BP, Yeo SJ, Chou SM. Patellar resection during total knee arthroplasty: effect on bone strain and fracture risk. Knee Surg Sports Traumatol Arthrosc. 2005;13:203-8. https://doi.org/10.1007/s00167-004-0508-6
  19. Seo JG, Moon YW, Park SH, Lee JH, Kang HM, Kim SM. A case-control study of spontaneous patellar fractures following primary total knee replacement. J Bone Joint Surg Br. 2012;94:908-13.
  20. Stickley CD, Wages JJ, Hetzler RK, Andrews SN, Nakasone CK. Standard radiographs are not sufficient for assessing knee mechanical axis in patients with advanced osteoarthritis. J Arthroplasty. 2017;32:1013-7. https://doi.org/10.1016/j.arth.2016.09.024
  21. Ewald FC. The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. 1989;(248):9-12.
  22. Bae DK, Song SJ, Kim HJ, Seo JW. Change in limb length after high tibial osteotomy using computer-assisted surgery: a comparative study of closed- and open-wedge osteotomies. Knee Surg Sports Traumatol Arthrosc. 2013;21:120-6. https://doi.org/10.1007/s00167-012-1898-5
  23. Cabuk H, Imren Y, Tekin AC, Dedeoglu SS, Gurbuz H. High varus angle and lower posterior tibial slope associated with PCL injury in cruciate retaining total knee arthroplasty: an MRI study. J Knee Surg. 2018;31:277-83. https://doi.org/10.1055/s-0037-1603334
  24. Ritter MA, Pierce MJ, Zhou H, Meding JB, Faris PM, Keating EM. Patellar complications (total knee arthroplasty): effect of lateral release and thickness. Clin Orthop Relat Res. 1999;(367):149-57.
  25. Baldwin JL, House CK. Anatomic dimensions of the patella measured during total knee arthroplasty. J Arthroplasty. 2005;20:250-7. https://doi.org/10.1016/j.arth.2004.09.027
  26. Hsu HC, Luo ZP, Rand JA, An KN. Influence of patellar thickness on patellar tracking and patellofemoral contact characteristics after total knee arthroplasty. J Arthroplasty. 1996;11:69-80. https://doi.org/10.1016/S0883-5403(96)80163-X

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