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Analysis of the Attune tibial tray backside: A comparative retrieval study
A Cerquiglini1, J Henckel1, H Hothi1
1Institute of Orthopaedics and Musculoskeletal Science, University College London and the Royal National Orthopaedic Hospital, Stanmore, UK.
Bone & Joint Research
|April 19, 2019
Summary
Retrieval analysis of total knee arthroplasty (TKA) implants revealed no cement on Attune tibial trays, unlike some PFC Sigma designs. Design differences, particularly cement pockets, may explain this observation in TKA cement fixation.
Area of Science:
- Orthopedic surgery
- Biomaterials engineering
- Medical device analysis
Background:
- The Attune total knee arthroplasty (TKA) is widely used, but concerns exist regarding its cement-tibial interface.
- Registry data indicate good clinical outcomes, yet the cement fixation warrants further investigation.
Purpose of the Study:
- To investigate the cement attachment on the backside of retrieved Attune tibial trays.
- To compare the Attune design with PFC Sigma implants regarding cement fixation and design features.
Main Methods:
- Retrieval analysis of 11 Attune tibial trays and various PFC Sigma implants (titanium and cobalt-chromium).
- Digital imaging to quantify cement attachment.
- Measurement of tibial tray design features (thickness, projections, lips, undercuts) and surface roughness (Ra).
Main Results:
- No cement was found attached to any of the 11 retrieved Attune tibial trays.
- Significant differences in cement attachment and design features were observed between Attune and some PFC Sigma implants.
- No significant difference in cement attachment was found between Attune and the cobalt-chromium PFC Sigma rotating platform (RP) designs.
Conclusions:
- The absence of cement on Attune trays, contrasted with some PFC Sigma designs, may be due to differences in implant geometry, specifically cement pockets.
- These findings offer insight into the controversial cement-tibial interface of the Attune TKA design.
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