Trial reportActa orthopaedica2025
5-year migration and inducible displacement of the uncemented LCS and ATTUNE rotating platform knee systems: a secondary report of a randomized controlled RSA trial.
Trial report in Acta orthopaedica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Inducible displacement measured with radiostereometric analysis in primary knee arthroplasty: a systematic review of clinical studies.Acta orthopaedica · 2026Pooled it
- Meta-analysis of prognostic factors in patients with knee arthroplasty.Frontiers in surgery · 2025Pooled it
- Long-term migration of monoblock vs modular design in uncemented total knee arthroplasty: a secondary report of a randomized trial using radiostereometric analysis.Acta orthopaedica · 2025Trial
- Tibial migration of a novel cementless total knee arthroplasty : a multicentre radiostereometric analysis study.Bone & joint open · 2026Article
- Editorial: Why the randomized controlled trial is still at the apex and the gold standard for evaluating new medical and surgical interventions.Acta orthopaedica · 2025Article
- Total hip arthroplasty for acute acetabular fractures through the replace-in-situ philosophy : radiological assessment of component stability.Bone & joint open · 2025Article
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7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeEarly migration of the uncemented cruciate-sacrificing rotating platform ATTUNE and Low Contact Stress (LCS) tibial components was classified as at-risk for aseptic loosening rates exceeding 6.5% at 15 years based on recent fixation-specific migration thresholds. In this secondary report of a randomized controlled trial (RCT) we aimed to evaluate whether the 5-year migration, inducible displacement, and the clinical outcome of the ATTUNE components were comparable to those of the LCS.
methodsPatients from the initial 2-year radiostereometric analysis (RSA) RCT were recruited for a 5-year follow-up. At 5 years, participants underwent 2 supine and 1 loaded RSA examination, clinical assessments, and questionnaires. Migration was analyzed using maximum total point motion (MTPM), translations, and rotations, focusing on 5-year migration, continuous migration (> 0.10 mm/year), and inducible displacement. Revisions, along with clinical and functional outcomes, were also evaluated.
resultsAt 5 years, 24 ATTUNE and 24 LCS implants were analyzed. The mean MTPM was similar for tibial components (ATTUNE 1.13mm [confidence interval (CI) 0.94-1.33]; LCS 1.24 mm [CI 1.05-1.46]) but significantly lower for the ATTUNE femoral component (1.14 mm [CI 0.92-1.39]) than LCS 1.87 mm [CI 1.57-2.21]). 2-to-5-year migration rates were comparable, but 11 ATTUNE and 7 LCS exceeded 0.10 mm MTPM/year, indicating a higher risk of loosening. Inducible displacement was similar, although 1 patient with a tibial ATTUNE showed excessive displacement (3.34 mm MTPM) with focal osteolysis but no symptoms. 1 revision 10 days post-surgery was performed for an ATTUNE insert spinout, resolved with an isolated insert exchange. Clinical and functional outcomes were comparable.
conclusionAt the 5-year follow-up, ATTUNE tibial components showed similar migration, while the femoral component migrated significantly less than the LCS, which mainly occurred during the first 2 years. 2-to-5-year migration rates, inducible displacement, and clinical and functional outcomes were comparable. These findings suggest a comparable long-term risk of aseptic loosening between the uncemented ATTUNE and LCS knee systems.
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