Polyethylene spinout in the Attune® Cruciate-Retaining Rotating-Platform (CR RP) total knee arthroplasty performed with a cruciate-sacrificing and measured-resection technique

• Published in: Knee Surgery and Related Research, 32(0) 2020, 32(0), , pp.36-36
• Main Authors: Keogh, Cillian J., Mulcahy, David, Reidy, Declan, Beverland, David E., Harty, James A.
• Format: Article
• Language: English
• Subjects: Arthritis; Balancing; Cruciate; Design; Gap; Joint replacement surgery; Joint surgery; Knee; Ligaments; Orthopedics; Osteoarthritis; Patients; Platform; Polyethylene; Prostheses; Retaining; Rotating; Surgeons; Surgical techniques; X-rays; 정형외과학
• ISSN: 2234-2451; 2234-0726; 1225-1623; 2234-2451
• DOI: 10.1186/s43019-020-00057-0

Introduction Polyethylene (PE) spinout is a known but uncommon complication when using a mobile-bearing (MB) total knee arthroplasty (TKA) design. Sacrificing the posterior cruciate ligament (PCL) is within the manufacturer’s recommendations for the Attune® Cruciate-Retaining Rotating-Platform (CR RP) knee design. Aim To discuss the potential aetiology and prevention of spinout in the Attune® CR RP knee. Methods We used a retrospective radiological review from two centres reporting a higher rate of spinout in the Attune® CR RP knee using a cruciate-sacrificing and measured-resection technique when compared to a gap-balancing technique. Three hundred and thirty-two patients were evaluated over a 3-year period. Results There were 8 out of 279 (2.86%) cases of spinout in our first cohort of patients using a measured-resection technique. There were 0 out of 53 cases of spinout in our second cohort of patients where a gap-balancing technique was used. One spinout was reduced closed, the other seven were initially revised to a thicker RP insert of the same design. Of these seven, three underwent a further revision TKA and one patient required a knee fusion/arthrodesis. Conclusions This study reports a higher incidence of PE spinout in the Attune® CR RP TKA when a measured-resection technique in combination with PCL resection is performed. We recommend a gap-balancing technique with conservative soft-tissue release if the surgeon is planning to sacrifice the PCL in the Attune® CR RP.