OBJECTIVES:

Total Knee Arthroplasty (TKA) is a successful, widely-used procedure that provides pain relief and improved function for osteoarthritic patients. Given the increased demand for TKAs, there is a need for meaningful innovation that improves clinical outcomes and optimises resource utilisation. The DePuy Synthes (DS) ATTUNE® Knee System has been designed to improve patient function and satisfaction. The objective of this study was to compare the length of stay (LOS) for TKA patients who received ATTUNE versus the DS SIGMA® Knee System.

METHODS:

A single center, retrospective analysis was conducted between 2013 and 2015 at a private Italian hospital. 200 consecutive patients from a single surgeon underwent TKA, representing the last 100 SIGMA cases and first 100 ATTUNE cases (post 20 learning curve cases). The primary endpoint was LOS. Electronic medical records were used to collect patient characteristics: age, gender, marital status, ASA grade, prior TKA, and pre-operative Oxford Knee Scores (OKS). Bivariate analyses to compare patient characteristics by implant were generated and a linear regression model was constructed to evaluate LOS as a function of demographic and clinical variables.

RESULTS:

Patients implanted with ATTUNE demonstrated a 4-day reduction in mean LOS (95% CI 3.5 – 4.5 p<0.0001): ATTUNE: 9.7 (SD: 1.2); SIGMA: 13.7(SD: 1.9). There were no significant differences in reported characteristics between the two groups. The proportion of females (71%) was similar; there were no significant age differences with most patients between 61 and 70. Most patients were married (ATTUNE: 92%, SIGMA: 85%). All patients (100%) had severe preoperative OKS (ATTUNE: mean=9.5 (SD: 3.7), SIGMA: mean=9.4 (SD4.1)), and 22.5% patients had previous contralateral TKA (ATTUNE: 23%, SIGMA: 22%).

CONCLUSIONS:

Statistically significant differences were noted in the LOS between the two groups. This Real World study demonstrates how the adoption of ATTUNE could potentially benefit providers, payors and patients by reducing LOS.