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. 2016 Aug 21;2(4):193-198.
doi: 10.1016/j.artd.2016.05.002. eCollection 2016 Dec.

Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design

Pier Francesco Indelli  1 , Gennaro Pipino  2 , Paul Johnson  3 , Angelo Graceffa  4 , Massimiliano Marcucci  5
Affiliations

Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design

Pier Francesco Indelli et al. Arthroplast Today. .

Abstract

Background: Total knee arthroplasty (TKA) designs continue to be modified to optimize patient's outcome. This study was designed to compare clinical and radiological results of classic worldwide used TKA posterior-stabilized (PS) design to those of its recent evolution.

Methods: A consecutive group of 100 patients undergoing TKA using a classic cemented fixed-bearing PS TKA system was matched by age, gender, body max index to 100 patients having the newer cemented fixed-bearing PS design, both by the same manufacturer. Patients were assessed preoperatively, at 12 months and at 24 months minimum follow-up (range, 24-46) in a standard prospective fashion. The outcome assessments used were the Oxford Knee Score, the Knee Society Score, range of motion, and a satisfaction survey. A 2-sample t test comparing the 2 groups was performed.

Results: No patients were lost at follow-up. At 2-year follow-up, differences in clinical and radiological Knee Society Score (P = .09), Oxford Score (P = .08), and overall satisfaction rate did not reach statistical significance. Implant group 2 showed a statistically significant decrease in postoperative anterior knee pain (P = .006). At final follow-up, 16% of group 1 knees achieved > 130° flexion compared with 37% in group 2 (P = .0009). There were 2 revisions for any reason in group 1 and none in group 2.

Conclusions: Design modifications applied to the newer TKA system allowed greater flexion and lower patellofemoral complications but did not appear to achieve better overall clinical scores.

Keywords: Attune; Knee; Outcomes; Posterior-stabilized; TKA; Total knee arthroplasty.

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Figures

Figure 1
Figure 1
DePuy Synthes PFC Sigma PS (a) and Attune (b) TKA systems. The posterior femoral condyles gradual change of curvature between the 2 femoral designs can be noted in the highlighted rectangular spaces.
Figure 2
Figure 2
Left knee. De Puy Synthes Attune TKA system: sizing and rotational alignment guide for the femoral component. In this case the external rotation of the femoral component was set at 3° of external rotation.
Figure 3
Figure 3
A 76-year-old female patient. Anteroposterior and lateral weight-bearing views at 27 months follow-up. Left TKA (Attune, DePuy Synthes, Warsaw, IN).
See this image and copyright information in PMC

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