Does the ideal total knee arthroplasty for younger patients exist?

Abstract

A total knee arthroplasty (TKA) is still not able to reinstate the physiological kinematics of the knee. This results in a considerable number of unsatisfied patients, especially if they are younger and active. Recently developed TKA systems claim to consider these biomechanical properties. The current study investigates the outcome (range of motion, stability) of the new ATTUNE™ TKA system (DePuy, Warsaw, IN, USA) in in young patients. This was a prospective study design (55 patients, 55 knees, age < 70 years, 01/2012-07/2012). Patients received an ATTUNE™ TKA and were examined preoperatively and at 6 months postoperatively for range of motion and stability (Knee Society score). Age: 63 ± 8 years; range of motion increased from 112.33 ± 13.6° to 123.60 ± 11,1° (p < 0.001). Coronal stability improved significantly (preoperatively vs. postoperatively, p < 0.001). Sagittal stability was not significantly different (preoperatively vs. postoperatively, p > 0.05). The data of this study show improved early functional results in younger patients in comparison to the current literature. However, until now no existing TKA system can be identified as ideal. But taking recent biomechanical knowledge into consideration, modern TKA designs have the potential to improve the functional outcome. Especially for younger patients with superior muscle-status and coordinative abilities this seems beneficial.