The assessment of the stability of the tibial component of a novel knee arthroplasty system using radiostereometric analysis

Bone Joint J. 2018 Dec;100-B(12):1579-1584. doi: 10.1302/0301-620X.100B12.BJJ-2018-0566.R1.


Aims: The introduction of a novel design of total knee arthroplasty (TKA) must achieve outcomes at least as good as existing designs. A novel design of TKA with a reducing radius of the femoral component and a modified cam-post articulation has been released and requires assessment of the fixation to bone. Radiostereometric analysis (RSA) of the components within the first two postoperative years has been shown to be predictive of medium- to long-term fixation. The aim of this study was to assess the stability of the tibial component of this system during this period of time using RSA.

Patients and methods: A cohort of 30 patients underwent primary, cemented TKA using the novel posterior stabilized fixed-bearing (ATTUNE) design. There was an even distribution of men and women (15:15). The mean age of the patients was 64 years (sd 8) at the time of surgery; their mean body mass index (BMI) was 35.4 kg/m 2 (sd 7.9). RSA was used to assess the stability of the tibial component at 6, 12, and 24 months compared with a six-week baseline examination. Patient-reported outcome measures were also assessed.

Results: The mean maximum total point motion (MTPM) of the tibial component between 12 and 24 months postoperatively was 0.08 mm (sd 0.08), which is well below the published threshold of 0.2 mm (p < 0.001). Patient-reported outcome measures consistently improved.

Conclusion: The tibial component of this novel design of TKA showed stability between assessment 12 and 24 months postoperatively, suggesting an acceptably low risk of medium- to long-term failure due to aseptic loosening.

Keywords: Radiostereometric analysis; Stability; Tibial fixation; Total knee arthroplasty.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / methods*
  • Bone Cements*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery*
  • Knee Prosthesis*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery
  • Postoperative Period
  • Prosthesis Design
  • Radiostereometric Analysis / methods*
  • Time Factors
  • Treatment Outcome
  • Young Adult


  • Bone Cements