Analysis of the Attune tibial tray backside: A comparative retrieval study.

Implant-cement interface Retrieval analysis Total knee arthroplasty

Journal

Bone & joint research
ISSN: 2046-3758
Titre abrégé: Bone Joint Res
Pays: England
ID NLM: 101586057

Informations de publication

Date de publication:
Mar 2019
Historique:
entrez: 19 4 2019
pubmed: 19 4 2019
medline: 19 4 2019
Statut: epublish

Résumé

The Attune total knee arthroplasty (TKA) has been used in over 600 000 patients worldwide. Registry data show good clinical outcome; however, concerns over the cement-tibial interface have been reported. We used retrieval analysis to give further insight into this controversial topic. We examined 12 titanium (Ti) PFC Sigma implants, eight cobalt-chromium (CoCr) PFC Sigma implants, eight cobalt-chromium PFC Sigma rotating platform (RP) implants, and 11 Attune implants. We used a peer-reviewed digital imaging method to quantify the amount of cement attached to the backside of each tibial tray. We then measured: 1) the size of tibial tray thickness, tray projections, peripheral lips, and undercuts; and 2) surface roughness (Ra) on the backside and keel of the trays. Statistical analyses were performed to investigate differences between the two designs. There was no evidence of cement attachment on any of the 11 Attune trays examined. There were significant differences between Ti and CoCr PFC Sigma implants and Attune designs (p < 0.05); however, there was no significant difference between CoCr PFC Sigma RP and Attune designs (p > 0.05). There were significant differences in the design features between the investigated designs (p < 0.05). The majority of the earliest PFC Sigma designs showed evidence of cement, while all of the retrieved Attune trays and the majority of the RP PFC trays in this study had no cement attached. This may be attributable to the design differences of these implants, in particular in relation to the cement pockets. Our results may help explain a controversial aspect related to cement attachment in a recently introduced TKA design.

Identifiants

pubmed: 30997039
doi: 10.1302/2046-3758.83.BJJ-2018-0102.R2
pii: 10.1302_2046-3758.83.BJJ-2018-0102.R2
pmc: PMC6446526
doi:

Types de publication

Journal Article

Langues

eng

Pagination

136-145

Déclaration de conflit d'intérêts

ICMJE COI statement: P. Allen reports money received from DePuy Synthes not related to this study. A. Eskelinen reports money in the form of a grant from Zimmer Biomet and DePuy Synthes not related to this study. M. T. Hirschmann reports money received from DePuy Synthes and Smith & Nephew not related to this study.

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Auteurs

A Cerquiglini (A)

Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.

J Henckel (J)

Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.

H Hothi (H)

Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.

P Allen (P)

Princess Alexandra NHS Trust, Harlow, UK.

J Lewis (J)

BMI Goring Hall Hospital, Goring-by-Sea, West Sussex, UK.

A Eskelinen (A)

The Coxa Hospital for Joint Replacement, Tampere, Finland.

J Skinner (J)

Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.

M T Hirschmann (MT)

Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Bruderholz, Switzerland; University of Basel, Basel, Switzerland.

A J Hart (AJ)

Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.

Classifications MeSH