Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis

Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing

“…In the present study, the incidence of patellar crepitus at 1 year (10.6% and 28.9% in ATTUNE and P.F.C. Sigma groups, respectively) was similar to the incidences reported by Ranawat et al (17.7% and 30.9%, respectively) [11]. In addition, we found that the patellar creptius occurred at 3 months postoperatively.…”

“…Because this study did not resurface the patella and Vahur Metsna et al [18] found that the cartilage damage to the patella may be correlated with postoperative AKP, we also matched patellar cartilage grade between our two groups. The clinical outcomes measured according to KSS at the 1-year followup were consistent with the outcomes reported by Ranawat et al [11]. Carey et al [12] suggested better outcomes at the 6-month follow-up; however, we did not find differences at the 3-month and 1year follow-ups, which may have been due the different measured scores in the study by Carey et al Nevertheless, these results may indicate that this femoral implant design modification had no significant influence on clinical outcomes of TKA with or without patellar resurfacing at the short-term follow-up.…”

“…In addition, the incidence of AKP in the ATTUNE group was only approximately one-quarter of that in P.F.C. Sigma group (3.5% vs 13.5%), this ratio was lower than in the study by Ranawat et al (12.5% vs 25.8%) [11]. A previous study noted that severe AKP can lead to patient dissatisfaction following primary TKA, and revision was often required [24].…”

“…The new design aims-at least theoretically-to reduce the incidence of patellar crepitus and AKP. Most previous research investigating the advantages of the femoral implant design modification only recruited patients who underwent TKA with patellar resurfacing [10][11][12]. To our knowledge, the present investigation was the first prospective study to compare the incidence of AKP and patellar crepitus in patients who underwent TKA without patellar 7 resurfacing.…”

“…The main modifications of the new prostheses incorporate a new design of the femoral component that is more "friendly" to the patella, including a deeper and more extensive femoral trochlear groove and a smoother intercondylar box transition zone [9]. Recent clinical studies have shown that the femoral implant design modification in the ATTUNE Knee System (DePuy, Inc, Warsaw, IN, USA) decreased the incidence of AKP and patellar crepitus in posterior stabilized TKA [10,11]. Carey et al even suggested that a significant difference was demonstrated in clinical outcome at 6 months' postoperatively between the P.F.C.…”