Background

The ATTUNE total knee replacement is a relatively new total knee replacement system. Currently, there is only 5-year survival data available for this implant in the national registries. The aim of this project is to evaluate the survival of this implant and the indications for revision with a minimum of two years follow up.

Methods

All patients who underwent surgery with this implant at a single, large volume institution were included and recorded on a prospective dataset. Case notes and radiographs were reviewed to confirm indications for revision and complications experienced.

Results

A total of 1,352 Attune total knee replacements were implanted in 1,214 patients. The mean age was 68.9 (SD 10.3), with 824 (60.9%) female and 631 (47.6%) left sided. Mean BMI was 31.9.0 (SD 6.03) and procedures were performed by ten consultants.
The median follow-up was 4.1 [I.Q.R. 3.2-5.4] years. 40 patients died during the follow up window, with no patients dying within 90 days of the primary procedure.
Kaplan-Meier Implant survival was 99.3% (95% CI 98.9-99.8%) at two years, 98.5% (97.8-99.2%) at four years and 98.0% (97.0-99.0%) at seven years. 20 implants were revised: three for stiffness, eight for infection (4 DAIR and 4 revisions), four for patellofemoral pain requiring secondary patella resurfacing, four with aseptic loosening and one with periprosthetic fracture.

Conclusion/Findings
The results from this large series of knee replacements demonstrates a low revision rates at medium term follow up of this prosthesis. We have not identified an unduly high rate of tibial or femoral loosening with revision rates consistent with those demonstrated in the national joint registry.
This study is limited as a single centre, retrospective review of outcomes, albeit with a diverse range of surgeons performing these procedures. Despite these limitations we conclude that the Attune knee is an implant with a low revision rate