OBJECTIVES: Many adjustments have been made to the design of Total Knee Arthroplasty (TKA) implants to improve outcomes. This study aims to investigate the impact of an innovative TKA implant design on a new composite outcome “early optimal recovery (EOR)”, an overall measure for value of care which combines early clinical outcomes and healthcare resource utilizations (HRU).

METHODS: In this retrospective observational study patients that underwent a primary TKA between January 2017 and December 2020 with the comparator (Attune® knee) or control device (LCS® knee) were included. EOR included no complications, no extra outpatient visits, length of hospital stay within 48 hours, ideal range of motion and ideal pain perception. A logistic regression model was used to compare the EOR between the comparator and control group. Results were adjusted for differences in baseline characteristics.

RESULTS: A total of 566 (62% female, mean age 67 years) patients were included for analysis of which 185 (33%) patients underwent TKA with the comparator device. A multivariate logistic regression analysis showed that 66% in the comparator group achieved EOR in comparison to 39% in the control group (p<0.05) (Odds ratio 3.03; 95% confidence interval: 1.66-5.71). 77% versus 61% (comparator versus control) of the patients were discharged within 48 hours and 93% versus 78% (comparator versus control) of the patients were pain-free after three months follow-up.

CONCLUSIONS: The comparator device was associated with improved early optimal recovery. These findings have potential implications for physicians, patients, providers and policy makers.