Radiolucent lines and revision risk in total knee arthroplasty using the conventional versus the Attune S+ tibial baseplate.

IF 4.9 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2024-11-01 DOI:10.1302/0301-620X.106B11.BJJ-2024-0084.R3

Maria A Smolle, Maximilian Keintzel, Kevin Staats, Christoph Böhler, Reinhard Windhager, Amir Koutp, Andreas Leithner, Stefanie Donner, Tobias Reiner, Tobias Renkawitz, Manuel-Paul Sava, Michael T Hirschmann, Patrick Sadoghi

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引用次数: 0

Abstract

Aims: This multicentre retrospective observational study's aims were to investigate whether there are differences in the occurrence of radiolucent lines (RLLs) following total knee arthroplasty (TKA) between the conventional Attune baseplate and its successor, the novel Attune S+, independent from other potentially influencing factors; and whether tibial baseplate design and presence of RLLs are associated with differing risk of revision.

Methods: A total of 780 patients (39% male; median age 70.7 years (IQR 62.0 to 77.2)) underwent cemented TKA using the Attune Knee System) at five centres, and with the latest radiograph available for the evaluation of RLL at between six and 36 months from surgery. Univariate and multivariate logistic regression models were performed to assess associations between patient and implant-associated factors on the presence of tibial and femoral RLLs. Differences in revision risk depending on RLLs and tibial baseplate design were investigated with the log-rank test.

Results: The conventional and novel Attune baseplates were used in 349 (45%) and 431 (55%) patients, respectively. At a median follow-up of 14 months (IQR 11 to 25), RLLs were present in 29% (n = 228/777) and 15% (n = 116/776) of the tibial and femoral components, respectively, and were more common in the conventional compared to the novel baseplate. The novel baseplate was independently associated with a lower incidence of tibial and femoral RLLs (both regardless of age, sex, BMI, and time to radiograph). One- and three-year revision risk was 1% (95% CI 0.4% to 1.9%)and 6% (95% CI 2.6% to 13.2%), respectively. There was no difference between baseplate design and the presence of RLLs on the the risk of revision at short-term follow-up.

Conclusion: The overall incidence of RLLs, as well as the incidence of tibial and femoral RLLs, was lower with the novel compared to the conventional tibial Attune baseplate design, but higher than in the predecessor design and other commonly used TKA systems.

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使用传统胫骨底板和 Attune S+ 底板的全膝关节置换术中的放射线和翻修风险。

目的：这项多中心回顾性观察研究旨在探讨传统的Attune基底板和后继的新型Attune S+在全膝关节置换术（TKA）后出现放射状线（RLL）方面是否存在差异，是否与其他潜在的影响因素无关；以及胫骨基底板的设计和RLL的出现是否与不同的翻修风险有关：共有 780 名患者（39% 为男性；中位年龄为 70.7 岁（IQR 为 62.0 至 77.2））在五家中心接受了使用 Attune 膝关节系统的骨水泥 TKA 手术，并在术后 6 个月至 36 个月期间接受了最新的放射影像学检查以评估 RLL。我们采用单变量和多变量逻辑回归模型来评估患者和植入物相关因素与胫骨和股骨RLL之间的关系。通过对数秩检验研究了RLL和胫骨基底板设计对翻修风险的影响：349例（45%）和431例（55%）患者分别使用了传统和新型Attune基板。在中位随访14个月（IQR为11-25）时，胫骨和股骨组件中分别有29%（n=228/777）和15%（n=116/776）的患者出现RLL，传统基底板比新型基底板更常见。新型基底板与较低的胫骨和股骨RLL发生率独立相关（两者均与年龄、性别、体重指数和拍片时间无关）。一年和三年的翻修风险分别为1%（95% CI 0.4%至1.9%）和6%（95% CI 2.6%至13.2%）。基板设计和RLL的存在对短期随访的翻修风险没有影响：结论：与传统的胫骨Attune基底板设计相比，新型基底板的RLL总发生率以及胫骨和股骨RLL发生率较低，但高于前代设计和其他常用的TKA系统。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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