Is there a difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee replacement?

ISRCTN ISRCTN15117998
DOI https://doi.org/10.1186/ISRCTN15117998
Secondary identifying numbers 30-352 ex 17/18
Submission date
25/03/2022
Registration date
04/04/2022
Last edited
01/11/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Despite numerous scientific investigations, the tribological advantages of mobile bearing inserts have not been sustainably confirmed or refuted for modern knee prostheses in clinical studies. Simultaneously, total knee prostheses have substantially improved, especially in terms of the quality of polyethylene and fixation methods. Recent long term randomized controlled trials with large cohorts and literature reviews reported of no differences in durability, function, range of movement and migration. Modern total knee prostheses, such as the presented implant type (Attune®) provide a transition from stability and rotational freedom. This is the first study to analyze subjective and objective measurements between FB and MB inserts of this well-established TKA system.

Who can participate?
Every patient with end stage osteoarthritis that visited the outpatient department for Knee surgery at the Medical University of Graz between December 2015 and December 2016 was able to participate in this present study.

What does the study involve?
The study involves a surgical treatment (Total Knee Arthroplasty) and follow-up examinations over a 2-year follow-up period.

What are the possible benefits and risks of participating?
There were no specific or clinically relevant risks of participating as only as two well established Total Knee Arthroplasty systems were used in this present study.

Where is the study run from?
Medical University of Graz (Austria)

When is the study starting and how long is it expected to run for?
March 2018 to February 2020

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Prof. Dr. med. Patrick Sadoghi, patrick.sadoghi@medunigraz.at

Contact information

Dr Paul Ruckenstuhl
Public

Auenbruggerplatz 5
Graz
8036
Austria

Phone +43 31638513358
Email paul.ruckenstuhl@medunigraz.at
Prof Patrick Sadoghi
Scientific

Department of Orthopaedics and Trauma
Medical University of Graz
Auenbruggerplatz 5
Graz
A-8036
Austria

ORCiD logoORCID ID 0000-0003-1767-555X
Phone +43 316 385 81580
Email patrick.sadoghi@medunigraz.at

Study information

Study designProspective single center cohort study of 2 non-randomized stratified groups
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet.
Scientific titleNo difference in clinical outcome, pain, and range of motion between fixed and mobile bearing Attune total knee arthroplasty. A prospective single-center trial.
Study objectivesThe purpose of this study was to compare fixed and mobile bearing inserts in order to draw conclusions regarding clinical benefits.
Ethics approval(s)Approved 22/03/2018, Ethics committee of the Medical University of Graz (Auenbruggerplatz 2, 8036 Graz, Austria; +43 316 385 13928; ethikkommission@medunigraz.at), ref: 30-352 ex 17/18
Health condition(s) or problem(s) studiedComparison between fixed and mobile bearing inserts for Total Knee Arthroplasty in order to draw conclusions regarding clinical benefits
InterventionAll patients either received a fixed or mobile bearing insert during Total Knee Arthroplasty. The decision whether a patient received a mobile or fixed insert was made prior to the surgery based in a non-randomized setting. During the operation, the selection of insert type was not changed in any case.
Participants were followed up for a minimum of 2 years.

Between January 2015 and December 2016, a total of 544 primary total knee arthroplasties were implanted at one single orthopedic center. During this period another prospective level II study was conducted selecting patients of this time interval (n=200). The remaining 344 patients were eligible for the presented study. All patients either received a fixed or mobile bearing insert. The decision whether a patient received a MB of FB insert was made prior to the surgery based in a non-randomized setting. During the operation the selection of insert type was not changed in any case. Patients with a secondary arthritis, previous knee surgeries except arthroscopies, and varus/valgus-deformities of more than 20° were excluded. Moreover, we only included patients treated with one well-proved and worldwide used type of implant (Attune®, DePuy-Synthes, Warsaw, Indiana). All implants were tibial and femoral fixed with cement.
Intervention typeDevice
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Cemented total knee arthroplasty (Attune®) treated with a mobile or a fixed insert.
Primary outcome measureMeasured at for a minimum of 2 years follow-up.
1. Subjective assessment of success using the WOMAC score
2. Subjective assessment of success using Visual Analogue Scale
3. Range of Motion using the Knee-Society-Score
Secondary outcome measuresThere are no secondary outcome measures
Overall study start date22/03/2018
Completion date04/02/2020

Eligibility

Participant type(s)All
Age groupAdult
SexBoth
Target number of participants100
Total final enrolment85
Key inclusion criteria1. End staged-osteoarthritis of the Knee Joint
2. Patients between 50-80 years of age
3. Signed consent to participate in the present study
Key exclusion criteria1. Secondary Arthritis
2. Varus/Valgus deformities of more than 20°
3. Previous knee surgery except arthroscopy
Date of first enrolment01/01/2015
Date of final enrolment31/12/2016

Locations

Countries of recruitment

  • Austria

Study participating centre

Medical University Graz
Auenbruggerplatz 5
Graz
8036
Austria

Sponsor information

Medical University of Graz
University/education

Auenbruggerpl. 5
Graz
8036
Austria

Phone +43 316 38513358
Email ortho.trauma@uniklinikum.kages.at
Website http://www.medunigraz.at/en/
ROR logo "ROR" https://ror.org/02n0bts35

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/03/2022
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal.
IPD sharing planAvailable on request
patrick.sadoghi@medunigraz.at

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol file 04/04/2022 No No
Results article 02/05/2022 22/09/2022 Yes No

Additional files

41422 protocol.pdf

Editorial Notes

22/09/2022: Publication reference added.
04/04/2022: Trial's existence confirmed by Medical University of Graz.