Comparison of revision rates and epidemiological data of a single total knee arthroplasty system of different designs (cruciate retaining, posterior stabilized, mobile bearing, and fixed bearing): a meta-analysis and systematic review of clinical trials and national arthroplasty registries

Anton Wagner; Ulrike Wittig; Lukas Leitner; Ines Vielgut; Georg Hauer; Reinhold Ortmaier; Andreas Leithner; Patrick Sadoghi

doi:10.1007/s00402-024-05286-6

Comparison of revision rates and epidemiological data of a single total knee arthroplasty system of different designs (cruciate retaining, posterior stabilized, mobile bearing, and fixed bearing): a meta-analysis and systematic review of clinical trials and national arthroplasty registries

Arch Orthop Trauma Surg. 2024 Apr 3. doi: 10.1007/s00402-024-05286-6. Online ahead of print.

Authors

Anton Wagner¹, Ulrike Wittig¹, Lukas Leitner¹, Ines Vielgut¹, Georg Hauer¹, Reinhold Ortmaier², Andreas Leithner¹, Patrick Sadoghi³

Affiliations

¹ Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
² Ordensklinikum Linz, Barmherzige Schwestern, Seilerstätte 4, 4010, Linz, Austria.
³ Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. patricksadoghi@gmx.at.

PMID: 38570357
DOI: 10.1007/s00402-024-05286-6

Abstract

Background: This study aimed to meta-analyze epidemiological data, revision rates, and incidences of different designs of a single Total Knee Arthroplasty System and compare these factors across different countries.

Methods: A systematic review was conducted on clinical studies and arthroplasty registries of ATTUNE TKA from 1999 to 2020. The main endpoints analyzed were revision rates and epidemiological data.

Results: The average age of patients was 67.8 years, with a gender distribution of 60% female and 40% male. The pooled average BMI was 29.4 kg/m². Eight clinical studies showed a pooled revision rate per 100 observed CY of 0.5 (n = 1343 cases). Cumulative revision rates after 1, 3, and 5 years varied among registries, with the Swiss registry having the highest revision data (after 5 years: 6.3%) and the American registry having the lowest revision data (after 5 years: 1.7%). A comparison of the revision rates of mobile bearing and fixed bearing (41,200 cases) as well as cruciate retaining and posterior stabilized (n = 123,361 cases) showed no significant advantage in the first 5 years after implantation.

Conclusion: In conclusion, pooled data from 41,200 cases of TKA with a single Total Knee Arthroplasty System in two arthroplasty registries revealed that there was no significant difference in revision rates between the mobile bearing and fixed bearing design within the first 5 years after implantation. In addition, a comparison of the revision rates in n = 123,361 cases showed no significant advantage for cruciate retaining or posterior stabilized in the first 5 years after implantation.

Keywords: Attune knee system; Cruciate retaining; Fixed bearing; Mobile bearing; Posterior stabilized; Total knee arthroplasty.