Michael Barbella, Managing Editor03.16.22
DePuy Synthes,** the Orthopaedics Company of Johnson & Johnson, has added two new innovations to its kinematically advanced and proveni,ii,iii,iv,v,vi ATTUNE Knee portfolio: the ATTUNE Cementless Fixed Bearing Knee with AFFIXIUM 3DP Technology and the ATTUNE Medial Stabilized Knee System.
"The ATTUNE AFFIXIUM Knee is a game changer for patients," said Dr. Ryan Nunley,*** orthopedic surgeon in St. Louis, Mo. "The porous nature more naturally represents bone structure, which I believe helps with initial implant stability. Cementless fixation is growing quickly, and this is a phenomenal opportunity for advancing patient care."
Approximately 20 percent of total knee arthroplasty (TKA) patients are dissatisfied with their results.vii The biggest challenges reported are functional activities beyond walking, such as kneeling or getting in-out of a car.vii,viii The ATTUNE Knee is already addressing the 20 percent gap by delivering significantly better patient satisfaction than other knees in the same classix and has demonstrated implant survivorship within class.x,xi,xii,xiii,xiv
The new innovations build on the kinematic features and proprietary technologies of the original ATTUNE Knee, including the ATTUNE GRADIUS Curve and GLIDERIGHT Articulation, which are designed to revolutionize knee patient care.
Introduced in late 2021, the ATTUNE Cementless Fixed Bearing Knee with AFFIXIUM 3DP Technology (ATTUNE AFFIXIUM Knee) is a next-generation, 3D printed cementless knee designed for a growing population of more active patients for whom biological fixation helps to better meet the demands of their active lifestyle today and into the future. The ATTUNE AFFIXIUM Knee is the first in the ATTUNE Knee portfolio to utilize this advanced 3D printing technology, which creates a three-dimensional lattice structure, generating a similar porosity to natural bone for advanced biological fixationxv and helps enhance initial implant stability.xvi
The ATTUNE AFFIXIUM Knee follows the 2019 launch of the ATTUNE Rotating Platform Cementless Knee which utilizes POROCOAT Porous Coating for cementless application.
Designed to meet patients' needs for improved feel and function, DePuy Synthes has also introduced the ATTUNE Medial Stabilized Knee System, which incorporates asymmetric anatomic inserts with a raised medial lip, to provide medial stabilityxvii and a TruARC Lateral Path for natural knee function.xvii,xviii,xix The versatility of the system addresses a range of posterior cruciate ligament (PCL) management and surgical philosophies.xx More than just an insert, the ATTUNE Medial Stabilized Knee System brings together the ATTUNE GRADIUS Curve and the LOGICLOCK Tibial base, to restore natural knee kinematics.xvii,xviii,xix
"We are truly entering the next phase in knee replacement surgery - knee restoration," said Dr. Jonathan Vigdorchik,**** orthopedic surgeon in New York, N.Y. "The ATTUNE Medial Stabilized Knee System is the perfect complement to the ATTUNE Knee platform and provides my patients with the medial conformity and lateral rollback that I want so that their knee feels more natural."
Both the ATTUNE AFFIXIUM Knee and the ATTUNE Medial Stabilized Knee System work seamlessly with the innovative VELYS Robotic-Assisted Solution, which helps surgeons provide a tailored experience intraoperatively based on each patient's anatomy. The precision and reliability of robotic-assisted bone cuts means the surgeon can accommodate patient-specific surgical techniques and control the implant position and fit for each patient.
"Through our DePuy Synthes Knee Solutions, we're revolutionizing the traditional approach to total knee arthroplasty by offering patients a tailored surgical experience based on the combination of our kinematically advanced implants, our differentiated digital technology, and patient-specific techniques," said Juston Gates,***** worldwide vice president of Knee Reconstruction for DePuy Synthes. "We believe that this combination can lead to knee restoration and with it, we envision a future of better outcomes and improved patient satisfaction."
DePuy Synthes, the Orthopaedics Company of Johnson & Johnson, provides one of the most comprehensive orthopaedics portfolios in the world that helps heal and restore movement for the millions of patients. DePuy Synthes solutions, in specialties including joint reconstruction, trauma, extremities, craniomaxillofacial, spinal surgery and sports medicine, in addition to the VELYS Digital Surgery portfolio, are designed to advance patient care while delivering clinical and economic value to health care systems worldwide.
* Comprising the surgery, orthopaedics, vision and interventional solutions businesses within Johnson & Johnson's MedTech segment.
** DePuy Synthes represents the products and services of DePuy Synthes Sales, Inc. and its affiliates.
*** Dr. Ryan Nunley is a design surgeon and paid consultant of an affiliate of DePuy Synthes.
**** Dr. Jonathan Vigdorchik is a design surgeon and a paid consultant of an affiliate of DePuy Synthes.
*****Juston Gates is an employee of Medical Device Business Services, Inc.
References
i Ranawat CS, White PB, West S, Ranawat AS. Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis. J Arthroplasty 2017;32(2):431-436.
ii Indelli PF, Pipino G, Johnson P, Graceffa A, Marcucci M. Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design. Arthroplasty Today 2016;2(4):193-198.
iii Toomey SD, Daccach JA, Shah JC, Himden SE, Lesko JP, Hamilton WG. Comparative Incidence of Patellofemoral Complications Between 2 Total Knee Arthroplasty Systems in a Multicenter, Prospective Clinical Study. J Arthroplasty 2017;32(9S):S187-S192.
iv Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA. Femoral Implant Design Modification Decreases the Incidence of Patellar Crepitus in Total Knee Arthroplasty. J Arthroplasty 2017;32(4):1310-1313.
v Hamilton W, Brenkel I, Barnett S, et al. Comparison of P.F.C. SIGMA to ATTUNE: A Prospective, Multicenter Study. Podium Presentation at the Closed Meeting of the Knee Society, Sept 2018, St Louis, MO, USA. 2018.
vi Etter K, Lerner J, Kalsekar I, de Moor C, Yoo A, Swank M. Comparative Analysis of Hospital Length of Stay and Discharge Status of Two Contemporary Primary Total Knee Systems. J Knee Surg. 2017. 1(212): 1-10. DOI https://doi.org/10.1055/s-0037-1604442. Premier Perspective™ Database analysis including 38 US hospitals, representing 1,178 primary, unilateral TKAs with the ATTUNE Knee and 5,707 primary, unilateral TKAs with Triathlon™.
vii Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA: is there a difference? Clin Orthop Relat Res. 2010;468(2):542-546.
viii Tippett SR, Mang J, Dwyer KA, Lesko J, O'Dell T. Collecting data with palm technology: comparing preoperative expectations and postoperative satisfaction in patients undergoing total knee arthroplasty. J Bone Joint Surg Am. 2010;92:259-67.
ix National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. Implant Summary Report for DePuy Synthes ATTUNE CR and ATTUNE PS. NJR Database extract May 6, 2021, page 14 – data derived from general health questions at 6-month post-op follow-up. Licensed for use until May 18, 2022, Available at www.ATTUNEevidence.com (US) and www.provingthepromise.com (EMEA).
x Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Automated Industry Report System (AIRS), ID No.4155 for DePuy Synthes, ATTUNE CR/ATTUNE Total Knee, (Procedures from 1 September 1999 – 4 May 2021), Accessed 6 May 2021, AOA, Adelaide: 1-17.
xi Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Automated Industry Report System (AIRS), ID No.4156 for DePuy Synthes, ATTUNE PS/ATTUNE Total Knee, (Procedures from 1 September 1999 – 4 May 2021), Accessed 6 May 2021, AOA, Adelaide: 1-17.
xii National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 17th Annual Report, 2020. Table 3.K7 (a), page 148. Available from: www.njrreports.org.uk.
xiii Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Automated Industry Report System (AIRS), ID No. 5698 for DePuy Synthes, ATTUNE Total Knee, (Procedures from 1 September 1999 – 7 December 2021), Accessed 9 December 2021.
xiv Ranawat CS, White PB, West S, Ranawat AS. Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis. J Arthroplasty 2017;32(2):431-436.
xv W. Tong, B. Smith, et al 2020 ORS paper No 337.
xvi DePuy Synthes TR-000002196 report, Adaptiv, 2018.
xvii DePuy Synthes. Design Verification Study, Forward Dynamics Analysis, DKB Simulation of the Attune MS and Attune CR Designs ,SEA103664945. Adaptive. 2021.
xviii Johal P, Williams A, Wragg P, Hunt D, Gedroyc W. Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using 'interventional' MRI. J Biomech. 2005;38(2):269-276.
xix DePuy Synthes. Forward dynamics modeling analysis: multi-patient verification report, SEA103845908. Adaptive. 2021.
xx DePuy Synthes ATTUNE Fix Bearing Knee, IFU 0902-00-902 Rev B.
"The ATTUNE AFFIXIUM Knee is a game changer for patients," said Dr. Ryan Nunley,*** orthopedic surgeon in St. Louis, Mo. "The porous nature more naturally represents bone structure, which I believe helps with initial implant stability. Cementless fixation is growing quickly, and this is a phenomenal opportunity for advancing patient care."
Approximately 20 percent of total knee arthroplasty (TKA) patients are dissatisfied with their results.vii The biggest challenges reported are functional activities beyond walking, such as kneeling or getting in-out of a car.vii,viii The ATTUNE Knee is already addressing the 20 percent gap by delivering significantly better patient satisfaction than other knees in the same classix and has demonstrated implant survivorship within class.x,xi,xii,xiii,xiv
The new innovations build on the kinematic features and proprietary technologies of the original ATTUNE Knee, including the ATTUNE GRADIUS Curve and GLIDERIGHT Articulation, which are designed to revolutionize knee patient care.
Introduced in late 2021, the ATTUNE Cementless Fixed Bearing Knee with AFFIXIUM 3DP Technology (ATTUNE AFFIXIUM Knee) is a next-generation, 3D printed cementless knee designed for a growing population of more active patients for whom biological fixation helps to better meet the demands of their active lifestyle today and into the future. The ATTUNE AFFIXIUM Knee is the first in the ATTUNE Knee portfolio to utilize this advanced 3D printing technology, which creates a three-dimensional lattice structure, generating a similar porosity to natural bone for advanced biological fixationxv and helps enhance initial implant stability.xvi
The ATTUNE AFFIXIUM Knee follows the 2019 launch of the ATTUNE Rotating Platform Cementless Knee which utilizes POROCOAT Porous Coating for cementless application.
Designed to meet patients' needs for improved feel and function, DePuy Synthes has also introduced the ATTUNE Medial Stabilized Knee System, which incorporates asymmetric anatomic inserts with a raised medial lip, to provide medial stabilityxvii and a TruARC Lateral Path for natural knee function.xvii,xviii,xix The versatility of the system addresses a range of posterior cruciate ligament (PCL) management and surgical philosophies.xx More than just an insert, the ATTUNE Medial Stabilized Knee System brings together the ATTUNE GRADIUS Curve and the LOGICLOCK Tibial base, to restore natural knee kinematics.xvii,xviii,xix
"We are truly entering the next phase in knee replacement surgery - knee restoration," said Dr. Jonathan Vigdorchik,**** orthopedic surgeon in New York, N.Y. "The ATTUNE Medial Stabilized Knee System is the perfect complement to the ATTUNE Knee platform and provides my patients with the medial conformity and lateral rollback that I want so that their knee feels more natural."
Both the ATTUNE AFFIXIUM Knee and the ATTUNE Medial Stabilized Knee System work seamlessly with the innovative VELYS Robotic-Assisted Solution, which helps surgeons provide a tailored experience intraoperatively based on each patient's anatomy. The precision and reliability of robotic-assisted bone cuts means the surgeon can accommodate patient-specific surgical techniques and control the implant position and fit for each patient.
"Through our DePuy Synthes Knee Solutions, we're revolutionizing the traditional approach to total knee arthroplasty by offering patients a tailored surgical experience based on the combination of our kinematically advanced implants, our differentiated digital technology, and patient-specific techniques," said Juston Gates,***** worldwide vice president of Knee Reconstruction for DePuy Synthes. "We believe that this combination can lead to knee restoration and with it, we envision a future of better outcomes and improved patient satisfaction."
DePuy Synthes, the Orthopaedics Company of Johnson & Johnson, provides one of the most comprehensive orthopaedics portfolios in the world that helps heal and restore movement for the millions of patients. DePuy Synthes solutions, in specialties including joint reconstruction, trauma, extremities, craniomaxillofacial, spinal surgery and sports medicine, in addition to the VELYS Digital Surgery portfolio, are designed to advance patient care while delivering clinical and economic value to health care systems worldwide.
* Comprising the surgery, orthopaedics, vision and interventional solutions businesses within Johnson & Johnson's MedTech segment.
** DePuy Synthes represents the products and services of DePuy Synthes Sales, Inc. and its affiliates.
*** Dr. Ryan Nunley is a design surgeon and paid consultant of an affiliate of DePuy Synthes.
**** Dr. Jonathan Vigdorchik is a design surgeon and a paid consultant of an affiliate of DePuy Synthes.
*****Juston Gates is an employee of Medical Device Business Services, Inc.
References
i Ranawat CS, White PB, West S, Ranawat AS. Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis. J Arthroplasty 2017;32(2):431-436.
ii Indelli PF, Pipino G, Johnson P, Graceffa A, Marcucci M. Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design. Arthroplasty Today 2016;2(4):193-198.
iii Toomey SD, Daccach JA, Shah JC, Himden SE, Lesko JP, Hamilton WG. Comparative Incidence of Patellofemoral Complications Between 2 Total Knee Arthroplasty Systems in a Multicenter, Prospective Clinical Study. J Arthroplasty 2017;32(9S):S187-S192.
iv Martin JR, Jennings JM, Watters TS, Levy DL, McNabb DC, Dennis DA. Femoral Implant Design Modification Decreases the Incidence of Patellar Crepitus in Total Knee Arthroplasty. J Arthroplasty 2017;32(4):1310-1313.
v Hamilton W, Brenkel I, Barnett S, et al. Comparison of P.F.C. SIGMA to ATTUNE: A Prospective, Multicenter Study. Podium Presentation at the Closed Meeting of the Knee Society, Sept 2018, St Louis, MO, USA. 2018.
vi Etter K, Lerner J, Kalsekar I, de Moor C, Yoo A, Swank M. Comparative Analysis of Hospital Length of Stay and Discharge Status of Two Contemporary Primary Total Knee Systems. J Knee Surg. 2017. 1(212): 1-10. DOI https://doi.org/10.1055/s-0037-1604442. Premier Perspective™ Database analysis including 38 US hospitals, representing 1,178 primary, unilateral TKAs with the ATTUNE Knee and 5,707 primary, unilateral TKAs with Triathlon™.
vii Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA: is there a difference? Clin Orthop Relat Res. 2010;468(2):542-546.
viii Tippett SR, Mang J, Dwyer KA, Lesko J, O'Dell T. Collecting data with palm technology: comparing preoperative expectations and postoperative satisfaction in patients undergoing total knee arthroplasty. J Bone Joint Surg Am. 2010;92:259-67.
ix National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. Implant Summary Report for DePuy Synthes ATTUNE CR and ATTUNE PS. NJR Database extract May 6, 2021, page 14 – data derived from general health questions at 6-month post-op follow-up. Licensed for use until May 18, 2022, Available at www.ATTUNEevidence.com (US) and www.provingthepromise.com (EMEA).
x Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Automated Industry Report System (AIRS), ID No.4155 for DePuy Synthes, ATTUNE CR/ATTUNE Total Knee, (Procedures from 1 September 1999 – 4 May 2021), Accessed 6 May 2021, AOA, Adelaide: 1-17.
xi Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Automated Industry Report System (AIRS), ID No.4156 for DePuy Synthes, ATTUNE PS/ATTUNE Total Knee, (Procedures from 1 September 1999 – 4 May 2021), Accessed 6 May 2021, AOA, Adelaide: 1-17.
xii National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 17th Annual Report, 2020. Table 3.K7 (a), page 148. Available from: www.njrreports.org.uk.
xiii Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Automated Industry Report System (AIRS), ID No. 5698 for DePuy Synthes, ATTUNE Total Knee, (Procedures from 1 September 1999 – 7 December 2021), Accessed 9 December 2021.
xiv Ranawat CS, White PB, West S, Ranawat AS. Clinical and Radiographic Results of Attune and PFC Sigma Knee Designs at 2-Year Follow-Up: A Prospective Matched-Pair Analysis. J Arthroplasty 2017;32(2):431-436.
xv W. Tong, B. Smith, et al 2020 ORS paper No 337.
xvi DePuy Synthes TR-000002196 report, Adaptiv, 2018.
xvii DePuy Synthes. Design Verification Study, Forward Dynamics Analysis, DKB Simulation of the Attune MS and Attune CR Designs ,SEA103664945. Adaptive. 2021.
xviii Johal P, Williams A, Wragg P, Hunt D, Gedroyc W. Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using 'interventional' MRI. J Biomech. 2005;38(2):269-276.
xix DePuy Synthes. Forward dynamics modeling analysis: multi-patient verification report, SEA103845908. Adaptive. 2021.
xx DePuy Synthes ATTUNE Fix Bearing Knee, IFU 0902-00-902 Rev B.