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ATTUNE Revision System in the Revision Total Knee Arthroplasty Population

Not Applicable
Active, not recruiting
Conditions
Revision Total Knee Arthroplasty
Interventions
Device: ATTUNE Revision Knee System in Revision Total Knee Arthroplasty
Registration Number
NCT03153475
Lead Sponsor
DePuy Orthopaedics
Brief Summary

Five-year, Prospective, multi-center, non-randomized, non-controlled study of the ATTUNE® Revision total knee prostheses, utilizing the fixed bearing (FB) and rotating platform (RP) tibial component with the posterior stabilizing (PS) femoral component in revision total knee arthroplasty.

Detailed Description

The study is designed as a non-comparative, worldwide, multi-center study with up to 30 sites that will intend to implant a total of 400 Subjects (200 PS RP and 200 PS FB) with the study devices. The follow-up period of 5 years was selected to cover both the early post-operative period as well as the medium term period which is a good indicator of longer term survivorship.

The primary endpoint of survivorship at 5 years was selected to capture the time period during which the majority of revision failures occur while providing a good indication of long term survivorship. The secondary outcomes include commonly used measures of clinical performance that will allow for comparison with published literature. Additionally, patient reported outcomes, AORI bone defect classification , satisfaction and pain scores will be collected and analyzed.

Male and female Subjects, age 22-80 years, inclusive, with a failed primary knee arthroplasty, including unicompartmental or failed previous revision TKA, who are suitable candidates for revision TKA using the ATTUNE® Revision system are eligible for enrollment in this study. The use of the ATTUNE Revision system includes both partial and complete revision surgical procedures, including implantation of revision components as the second stage within a two-stage treatment for infection.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
400
Inclusion Criteria

Not provided

Exclusion Criteria
  1. The Subject is a woman who is pregnant or lactating.
  2. Contralateral knee has already been enrolled in this study.
  3. Subject had a contralateral amputation.
  4. Subject is currently diagnosed with radicular pain from the spine that radiates into the limb to receive RTKA.
  5. Subject has participated in a clinical investigation with an investigational product (drug or device) in the last three (3) months.
  6. Subject is currently involved in any personal injury litigation, medical-legal or worker's compensation claims.
  7. Subject, in the opinion of the Investigator, is a drug or alcohol abuser (in the last 5 years) or has a psychological disorder that could affect his/her ability to complete patient reported questionnaires or be compliant with follow-up requirements.
  8. Subject was diagnosed and is taking prescription medications to treat a muscular disorder that limits mobility due to severe stiffness and pain such as fibromyalgia or polymyalgia.
  9. Subject has a significant neurological or musculoskeletal disorder(s) or disease that may adversely affect gait or weight bearing activities (e.g., muscular dystrophy, multiple sclerosis, Charcot disease).
  10. Subject has a medical condition with less than five (5) years life expectancy as determined by the Investigator.
  11. Uncontrolled gout

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
ATTUNE Revision Knee SystemATTUNE Revision Knee System in Revision Total Knee ArthroplastyThe ATTUNE Revision system is complementary to the ATTUNE primary knee portfolio and includes both rotating platform (RP) and fixed bearing (FB) configurations. The system includes a full compliment of implants designed to address the challenges faced in revision knee surgeries. These implants include Stemmable tibial and femoral components, augments, sleeves and offsets
Primary Outcome Measures
NameTimeMethod
Survivorship5 Years

To evaluate the 5 year survivorship using Kaplan-Meier survival analysis, with revision for any reason as the endpoint, for the ATTUNE® Revision TKA PS FB and PS RP configurations.

Secondary Outcome Measures
NameTimeMethod
Tibial component alignment1, 2 and 5 years

Evaluate any changes in tibial component alignment at 1, 2 and 5 yrs compared to the first postoperative radiographs.

Patient's Knee Implant Performance (PKIP)Baseline, 2 and 5 yr timepoints

Evaluate change from preoperative baseline to 2 and 5 yr timepoints in functional outcomes, satisfaction and quality of life assessments, as measured using the PKIP patient reported outcome measure (overalll and subscores)

American Knee Society ScoreBaseline, 2 year, 5 year

Evaluate change from preoperative baseline to 2 and 5 yr timepoints in functional outcomes assessments, patient satisfaction and expectations and clinical evaluations as measured using the AKS measure

Survivorship1, 2, 3 and 4 years

Evaluate survivorship of the ATTUNE® Revision TKA system for the PS FB and PS RP configurations and the combined PS FB and PS RP configurations using Kaplan-Meier survival analysis at 1, 2, 3, and 4 years.

Frequency of radiolucent line occurrence1, 2 and 5 years

Evaluate ATTUNE® Revision TKA fixation through zonal radiographic analysis of the bone-implant interface at 1, 2 and 5 years after surgery compared to the first postoperative radiographs.

Restoration of joint lineFirst post-operative radiograph (1 day)

Radiographically evaluate the restoration of joint line using the first postoperative radiographs according to the methodology of Figgie.

Adverse EventsIntraoperative, 6 weeks, 1 yr, 2 yrs., 3 yrs., 4 yrs., 5 yrs.

Evaluate type and frequency of Adverse Events

Anatomic Tibiofemoral Alignment1, 2 and 5 years

Evaluate any changes in anatomic tibiofemoral alignment at 1, 2 and 5 yrs compared to the first postoperative radiographs.

EQ-5D-5LBaseline, 2 year and 5 year

Evaluate change from preoperative baseline to 2 and 5 yr timepoints in functional outcomes assessments, as measured using the EQ-5D-5L patient reported outcome measures

VAS Pain ScoreBaseline, 2 year and 5 year

Evaluate change from preoperative baseline to 2 and 5 yr timepoints in patient reported pain severity as measured using a modified VAS Pain Score (discrete numbers rather than a continual scale).

Knee Injury and Osteoarthritis Outcome Score Short form (KOOS-PS)Baseline, 2 year and 5 Year

Evaluate change from preoperative baseline to 2 and 5 yr timepoints in functional outcomes assessments, as measured using the KOOS-PS patient reported outcome measures

Patient SatisfactionBaseline, 2 year and 5 year

Evaluate change from preoperative baseline to 2 and 5 yr timepoints in patient reported satisfaction as measured using a Likert scale.

Readmissions6 weeks, 1 yr, 2 yrs., 3 yrs., 4 yrs., 5 yrs

Evaluate the timing, duration and reason for any readmissions stratified by adverse event type (operative site vs. systemic).

femoral component alignment1, 2 and 5 years

Evaluate any changes in femoral component alignment at 1, 2 and 5 yrs compared to the first postoperative radiographs.

Trial Locations

Locations (38)

Fondren Orthopedic Group

🇺🇸

Houston, Texas, United States

Scripps Clinic Torrey Pines

🇺🇸

San Diego, California, United States

Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology

🇨🇭

Basel, Switzerland

Krankenhaus der Barmherzigen Schwestern Linz Betriebsgesellschaft m.b.H.

🇦🇹

Linz, Austria

Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

University of Mississippi Medical Center

🇺🇸

Jackson, Mississippi, United States

Southern Joint Replacement Institute

🇺🇸

Nashville, Tennessee, United States

Colorado Joint Replacement

🇺🇸

Denver, Colorado, United States

Orthopaedic Center of the Rockies

🇺🇸

Fort Collins, Colorado, United States

Florida Orthopedic Associates

🇺🇸

DeLand, Florida, United States

Mery Hospital

🇺🇸

Ozark, Missouri, United States

Rothman Institute

🇺🇸

Egg Harbor Township, New Jersey, United States

UNC Orthopaedics

🇺🇸

Chapel Hill, North Carolina, United States

The Ohio State University Wexner Medical Center

🇺🇸

Columbus, Ohio, United States

Texas Institute for Hip & Knee Surgery

🇺🇸

Austin, Texas, United States

The Gold Coast Centre for Bone and Joint Surgery

🇦🇺

Gold Coast, Australia

St. John of God Murdoch Hospital

🇦🇺

Perth, Australia

MoRe Foundation

🇧🇪

Antwerp, Belgium

Concordia Joint Replacement

🇨🇦

Winnipeg, Canada

London Health Sciences Centre University Hospital

🇨🇦

London, Ontario, Canada

CHRU La Cavale Blanche

🇫🇷

Brest, France

Asklepios Orthopädische Klinik Lindenlohe

🇩🇪

Schwandorf, Germany

Centre Hospitalier Universitaire de Rennes

🇫🇷

Rennes, France

South Infirmary Public Hospital

🇮🇪

Cork, Ireland

University Hospital Maastricht

🇳🇱

Maastricht, Netherlands

CLINICHE GAVAZZENI SPA aka Humanitas Castelli

🇮🇹

Bergamo, Italy

Wellington Hospital

🇳🇿

Wellington, New Zealand

Hampshire Hospitals NHS Foundation Trust

🇬🇧

Basingstoke, United Kingdom

Chapel Allerton Orthopaedic Centre

🇬🇧

Leeds, United Kingdom

James Cook University Hospital

🇬🇧

North Yorkshire, United Kingdom

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

🇬🇧

Oswestry, United Kingdom

Nuffield Orthopaedic Centre

🇬🇧

Oxford, United Kingdom

Wrightington Hospital

🇬🇧

Wigan, United Kingdom

OrthoCarolina Hip and Knee Center

🇺🇸

Charlotte, North Carolina, United States

Orthopedic Partners

🇺🇸

Niantic, Connecticut, United States

Arthroplasty Foundation

🇺🇸

Louisville, Kentucky, United States

Klinik und Poliklinik für Orthopädie und Sportorthopädie am Klinikum rechts der Isar der Technischen Universität Münche

🇩🇪

Munich, Germany

Victoria Hospital NHS Fife

🇬🇧

Kirkcaldy, United Kingdom

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