Clin Orthop Surg.
2022 Mar;14(1):96-104. 10.4055/cios20130.
Comparison of Patellofemoral Outcomes between Attune and PFC Sigma Designs: A Prospective Matched-Pair Analysis
- Affiliations
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- 1Department of Orthopaedics, Lilavati Hospital and Research Centre, Mumbai, India.
- 2Department of Orthopaedics, Breach Candy Hospital Trust, Mumbai, India.
- 3Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India.
- 4Department of Orthopaedics, Wrightington Hospital, Wrightington, UK.
- 5Department of Orthopaedics, AIIMS Hospital, New Delhi, India.
- 6Department of Orthopaedics, CK Birla Hospital, Haryana, India.
- KMID: 2526390
- DOI: http://doi.org/10.4055/cios20130
Abstract
- Background
Attune (DePuy Synthes) prosthesis was designed to overcome patellofemoral complications associated with PFC Sigma (DePuy Synthes) prosthesis. The aim of our study was to compare the incidence of anterior knee pain (AKP), patellofemoral crepitus (PCr), and functional outcome between them.
Methods
This prospective matched-pair study was conducted between January 2014 and June 2015, during which 75 consecutive Attune total knee arthroplasties (TKAs) were matched with 75 PFC Sigma TKAs based on age, sex, body mass index, pathology, and deformity. A single surgeon performed all the operations with aid of computer navigation, using a posterior-stabilized prosthesis with patellar resurfacing. Outcome was assessed by new Knee Society Score (NKSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. AKP and PCr were assessed by a patient-administered questionnaire till 2 years of follow-up. Three pairs were lost to follow-up and finally 72 pairs were analyzed.
Results
One patient in each group reported AKP and 1 patient from each group had PCr at 2 years postoperatively. None of these patients required additional surgery. The incidence of lateral retinacular release was higher with PFC Sigma (5/72) than Attune (2/72); however, this was statistically not significant (p = 0.4). The Attune group had a significantly greater range of motion (ROM) at 3 months postoperatively (p = 0.049). At final follow-up, ROM was comparable between two prosthesis designs. NKSS and WOMAC scores were also comparable between the groups.
Conclusions
We observed that both Attune and PFC Sigma had a low and comparable incidence of AKP and PCr up to 2 years of follow-up. The Attune group achieved a significantly greater ROM at 3 months postoperatively. At 2 years of follow-up, both prostheses had excellent and comparable clinical and functional results.
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