Aims This multicentre retrospective observational study's aims were to investigate whether there are differences in the occurrence of radiolucent lines (RLLs) following total knee arthroplasty (TKA) between the conventional Attune baseplate and its successor, the novel Attune S+, independent from other potentially influencing factors; and whether tibial baseplate design and presence of RLLs are associated with differing risk of revision. Methods A total of 780 patients (39% male; median age 70.7 years (IQR 62.0 to 77.2)) underwent cemented TKA using the Attune Knee System) at five centres, and with the latest radiograph available for the evaluation of RLL at between six and 36 months from surgery. Univariate and multivariate logistic regression models were performed to assess associations between patient and implant-associated factors on the presence of tibial and femoral RLLs. Differences in revision risk depending on RLLs and tibial baseplate design were investigated with the log-rank test. Results The conventional and novel Attune baseplates were used in 349 (45%) and 431 (55%) patients, respectively. At a median follow-up of 14 months (IQR 11 to 25), RLLs were present in 29% (n = 228/777) and 15% (n = 116/776) of the tibial and femoral components, respectively, and were more common in the conventional compared to the novel baseplate. The novel baseplate was independently associated with a lower incidence of tibial and femoral RLLs (both regardless of age, sex, BMI, and time to radiograph). One- and three-year revision risk was 1% (95% CI 0.4% to 1.9%)and 6% (95% CI 2.6% to 13.2%), respectively. There was no difference between baseplate design and the presence of RLLs on the the risk of revision at short-term follow-up. Conclusion The overall incidence of RLLs, as well as the incidence of tibial and femoral RLLs, was lower with the novel compared to the conventional tibial Attune baseplate design, but higher than in the predecessor design and other commonly used TKA systems.

中文翻译：

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使用传统与 Attune S+ 胫骨底板的全膝关节置换术中的放射可透线和翻修风险。


目的 这项多中心回顾性观察研究的目的是调查传统 Attune 底板与其继任者新型 Attune S+ 之间全膝关节置换术 （TKA） 后放射可透线 （RLL） 的发生是否存在差异，独立于其他潜在影响因素;以及胫骨底板设计和 RLL 的存在是否与不同的翻修风险相关。方法 共有 780 名患者 （39% 为男性;中位年龄 70.7 岁 （IQR 62.0 至 77.2）） 在 5 个中心接受了使用 Attune 膝关节系统的骨水泥 TKA，并在手术后 6 至 36 个月时有最新的 X 线片可用于评估 RLL。进行单变量和多变量 logistic 回归模型，以评估患者和种植体相关因素与胫骨和股骨 RLL 存在的相关性。使用 log-rank 检验调查取决于 RLL 和胫骨底板设计的翻修风险差异。结果 常规和新型 Attune 底板分别用于 349 例 （45%） 和 431 例 （55%） 患者。在中位随访 14 个月 （IQR 11 至 25） 时，RLL 分别存在于 29% （n = 228/777） 和 15% （n = 116/776） 的胫骨和股骨成分中，与新型底板相比，在传统中更常见。新型底板与较低的胫骨和股骨 RLL 发生率独立相关 （无论年龄、性别、BMI 和 X 线检查时间如何）。1 年和 3 年翻修风险分别为 1% （95% CI [0.4%， 1.9%]）和 6% （95% CI [2.6%， 13.2%]）。底板设计和 RLL 的存在在短期随访中翻修风险方面没有差异。 结论与传统的胫骨 Attune 底板设计相比，新型 RLL 的总体发生率以及胫骨和股骨 RLL 的发生率较低，但高于前代设计和其他常用的 TKA 系统。