Short term patient outcomes after total knee arthroplasty

Does the implant matter?

Ilda B. Molloy, Benjamin J. Keeney, Michael B. Sparks, Nicholas G. Paddock, Karl Koenig, Wayne E. Moschetti, David S. Jevsevar

Research output: Contribution to journalArticle

Abstract

Background: Newer implants for total knee arthroplasty (TKA) often gain market share at higher cost with little patient-reported and long-term clinical data. We compared outcomes after TKA using two different implants: DePuy PFC Sigma and Attune. Methods: Using a prospective data repository from an academic tertiary medical center, we analyzed 2116 TKAs (1603 Sigma and 513 Attune) from April 2011 through July 2016. Outcomes included length of surgery, length of stay, facility discharge, 90-day reoperation, range of motion (ROM) change, and patient-reported physical function (PCS). Results: There was no difference in length of surgery (Attune − 2.87 min, P = 0.143). Implant type was not associated with extended LOS (> 3 days) (OR 0.80, P = 0.439). There was no difference in facility discharge (OR 0.65, P = 0.103). Unadjusted 90-day reoperations were 0.3% for Sigma and 1.0% for Attune cohorts (P = 0.158). Sigma implants were associated with more ROM improvement in unadjusted analyses (+ 2.1 degree improvement P = 0.031). Fifty nine percent of the Sigma cohort and 49% of the Attune cohort achieved the minimal clinically important (MCID) change for PCS improvement, although there was no adjusted difference in achieving MCID (Attune OR 0.84, P = 0.435). There was no adjusted difference in absolute PCS improvement (Attune + 0.12 score, P = 0.864). Conclusions: Our data show no difference in physical function and most outcomes between Sigma and Attune. Attune implants had shorter absolute LOS, but there were no differences in extended LOS.

Original languageEnglish (US)
Pages (from-to)687-699
Number of pages13
JournalKnee
Volume26
Issue number3
DOIs
StatePublished - Jun 1 2019

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Knee Replacement Arthroplasties
Articular Range of Motion
Reoperation
Length of Stay
Costs and Cost Analysis

Keywords

  • Attune
  • Implant
  • Patient-reported outcome measures
  • Physical function
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Molloy, I. B., Keeney, B. J., Sparks, M. B., Paddock, N. G., Koenig, K., Moschetti, W. E., & Jevsevar, D. S. (2019). Short term patient outcomes after total knee arthroplasty: Does the implant matter? Knee, 26(3), 687-699. https://doi.org/10.1016/j.knee.2019.01.018

Short term patient outcomes after total knee arthroplasty : Does the implant matter? / Molloy, Ilda B.; Keeney, Benjamin J.; Sparks, Michael B.; Paddock, Nicholas G.; Koenig, Karl; Moschetti, Wayne E.; Jevsevar, David S.

In: Knee, Vol. 26, No. 3, 01.06.2019, p. 687-699.

Research output: Contribution to journalArticle

Molloy, IB, Keeney, BJ, Sparks, MB, Paddock, NG, Koenig, K, Moschetti, WE & Jevsevar, DS 2019, 'Short term patient outcomes after total knee arthroplasty: Does the implant matter?', Knee, vol. 26, no. 3, pp. 687-699. https://doi.org/10.1016/j.knee.2019.01.018
Molloy IB, Keeney BJ, Sparks MB, Paddock NG, Koenig K, Moschetti WE et al. Short term patient outcomes after total knee arthroplasty: Does the implant matter? Knee. 2019 Jun 1;26(3):687-699. https://doi.org/10.1016/j.knee.2019.01.018
Molloy, Ilda B. ; Keeney, Benjamin J. ; Sparks, Michael B. ; Paddock, Nicholas G. ; Koenig, Karl ; Moschetti, Wayne E. ; Jevsevar, David S. / Short term patient outcomes after total knee arthroplasty : Does the implant matter?. In: Knee. 2019 ; Vol. 26, No. 3. pp. 687-699.
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abstract = "Background: Newer implants for total knee arthroplasty (TKA) often gain market share at higher cost with little patient-reported and long-term clinical data. We compared outcomes after TKA using two different implants: DePuy PFC Sigma and Attune. Methods: Using a prospective data repository from an academic tertiary medical center, we analyzed 2116 TKAs (1603 Sigma and 513 Attune) from April 2011 through July 2016. Outcomes included length of surgery, length of stay, facility discharge, 90-day reoperation, range of motion (ROM) change, and patient-reported physical function (PCS). Results: There was no difference in length of surgery (Attune − 2.87 min, P = 0.143). Implant type was not associated with extended LOS (> 3 days) (OR 0.80, P = 0.439). There was no difference in facility discharge (OR 0.65, P = 0.103). Unadjusted 90-day reoperations were 0.3{\%} for Sigma and 1.0{\%} for Attune cohorts (P = 0.158). Sigma implants were associated with more ROM improvement in unadjusted analyses (+ 2.1 degree improvement P = 0.031). Fifty nine percent of the Sigma cohort and 49{\%} of the Attune cohort achieved the minimal clinically important (MCID) change for PCS improvement, although there was no adjusted difference in achieving MCID (Attune OR 0.84, P = 0.435). There was no adjusted difference in absolute PCS improvement (Attune + 0.12 score, P = 0.864). Conclusions: Our data show no difference in physical function and most outcomes between Sigma and Attune. Attune implants had shorter absolute LOS, but there were no differences in extended LOS.",
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T2 - Does the implant matter?

AU - Molloy, Ilda B.

AU - Keeney, Benjamin J.

AU - Sparks, Michael B.

AU - Paddock, Nicholas G.

AU - Koenig, Karl

AU - Moschetti, Wayne E.

AU - Jevsevar, David S.

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N2 - Background: Newer implants for total knee arthroplasty (TKA) often gain market share at higher cost with little patient-reported and long-term clinical data. We compared outcomes after TKA using two different implants: DePuy PFC Sigma and Attune. Methods: Using a prospective data repository from an academic tertiary medical center, we analyzed 2116 TKAs (1603 Sigma and 513 Attune) from April 2011 through July 2016. Outcomes included length of surgery, length of stay, facility discharge, 90-day reoperation, range of motion (ROM) change, and patient-reported physical function (PCS). Results: There was no difference in length of surgery (Attune − 2.87 min, P = 0.143). Implant type was not associated with extended LOS (> 3 days) (OR 0.80, P = 0.439). There was no difference in facility discharge (OR 0.65, P = 0.103). Unadjusted 90-day reoperations were 0.3% for Sigma and 1.0% for Attune cohorts (P = 0.158). Sigma implants were associated with more ROM improvement in unadjusted analyses (+ 2.1 degree improvement P = 0.031). Fifty nine percent of the Sigma cohort and 49% of the Attune cohort achieved the minimal clinically important (MCID) change for PCS improvement, although there was no adjusted difference in achieving MCID (Attune OR 0.84, P = 0.435). There was no adjusted difference in absolute PCS improvement (Attune + 0.12 score, P = 0.864). Conclusions: Our data show no difference in physical function and most outcomes between Sigma and Attune. Attune implants had shorter absolute LOS, but there were no differences in extended LOS.

AB - Background: Newer implants for total knee arthroplasty (TKA) often gain market share at higher cost with little patient-reported and long-term clinical data. We compared outcomes after TKA using two different implants: DePuy PFC Sigma and Attune. Methods: Using a prospective data repository from an academic tertiary medical center, we analyzed 2116 TKAs (1603 Sigma and 513 Attune) from April 2011 through July 2016. Outcomes included length of surgery, length of stay, facility discharge, 90-day reoperation, range of motion (ROM) change, and patient-reported physical function (PCS). Results: There was no difference in length of surgery (Attune − 2.87 min, P = 0.143). Implant type was not associated with extended LOS (> 3 days) (OR 0.80, P = 0.439). There was no difference in facility discharge (OR 0.65, P = 0.103). Unadjusted 90-day reoperations were 0.3% for Sigma and 1.0% for Attune cohorts (P = 0.158). Sigma implants were associated with more ROM improvement in unadjusted analyses (+ 2.1 degree improvement P = 0.031). Fifty nine percent of the Sigma cohort and 49% of the Attune cohort achieved the minimal clinically important (MCID) change for PCS improvement, although there was no adjusted difference in achieving MCID (Attune OR 0.84, P = 0.435). There was no adjusted difference in absolute PCS improvement (Attune + 0.12 score, P = 0.864). Conclusions: Our data show no difference in physical function and most outcomes between Sigma and Attune. Attune implants had shorter absolute LOS, but there were no differences in extended LOS.

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KW - Patient-reported outcome measures

KW - Physical function

KW - Total knee arthroplasty

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