Knee Surg Relat Res  
Comparison of Clinical Results and Risk of Patellar Injury between Attune and PFC Sigma Knee Systems
Sang Jun Song, MD, PhD1, Se Gu Kang, MD1, Cheol Hee Park, MD2, and Dae Kyung Bae, MD, PhD3
1Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul; 2Department of Medicine, Graduate School, Kyung Hee University, Seoul; 3Department of Orthopaedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea
Correspondence to: Cheol Hee Park, MD
Department of Medicine, Graduate School, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
Tel: +82-2-958-9489, Fax: +82-2-964-3865
Received: March 7, 2018; Revised: April 24, 2018; Accepted: May 27, 2018; Published online: August 31, 2018.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: The purposes of this study were to compare clinical results after total knee arthroplasty (TKA) using the Attune and PFC Sigma knee designs and to investigate whether the use of the Attune prosthesis increased the risk of patellar injury in Asian patients.
Materials and Methods: Three hundred knees that underwent TKA using Attune (group A) were compared to 300 knees that underwent TKA using PFC Sigma (group B). The Knee Society knee score (KS) and function score (FS), and range of motion (ROM) were compared. The residual patellar thickness was compared to evaluate the risk of patellar injury.
Results: The postoperative KS and ROM of group A were better than those of group B (93.1 vs. 88.8, p<0.001 and 131.4° vs. 129.0°, p=0.008, respectively). The postoperative FS did not differ significantly between the two groups (80.9 vs. 78.7, p=0.427). The residual patella was thinner in group A (14.8 mm vs. 15.7 mm, p=0.003), which made up a higher proportion of the high-risk group for patellar fractures with a residual thickness of <12 mm (7.5% vs. 2.1%, p=0.003).
Conclusions: TKA using the Attune prosthesis provided more favorable clinical results than TKA using PFC Sigma. However, the risk of injury in the residual patella was increased with use of the Attune prosthesis in Asian patients.
Keywords: Knee, Arthroplasty, Patella, Injury, Risk


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