When DePuy Synthes launched the ATTUNE Knee System, six years ago, the stated goal was improving patient satisfaction. In that stretch of time, the number of patients whose treatment has involved the ATTUNE has grown to over 500,000, across 43 countries. The clinical data suggest DePuy Synthes has achieved their objective of improved outcomes.
The question, then, is where do they go from here?
“We are not resting on our laurels,” says Rajit Kamal, global franchise leader at DePuy Synthes.
Specifically, DePuy Synthes recently expanded the ATTUNE line to address one of the top long-term complications for patients who’ve undergone total knee replacement surgery. While the main problem in the first two years following surgery remains infection, recent research suggests that following two years the primary challenge is aseptic loosening.
Digging into the established studies and bringing their own research to bear on the problem, the team at DePuy Synthes made an interesting discovery.
“When you look at all the variables that are associated with aseptic tibial loosening, the number one factor that affects it is lipid infiltration,” explains Liam Rowley, knee development director at DePuy Synthes. “So if you get the lipids or the marrow between the cement and the implant itself, it causes something like a lubrication film. And it doesn’t allow the cement to bond.”
After DePuy Synthes identified lipid infiltration as the most significant cause of aseptic loosening, the company set out to find a solution. They ultimately developed a pair of key revisions, introduced as ATTUNE S+ technology.
The ATTUNE S+ technology includes a Microblast surface, which is slightly rougher, allowing for greater penetration of bone cement while also reducing the infiltration of lipids.
DePuy Sythes also added a technology dubbed Macrolock.
“These are undercut pockets underneath the tibial plateau of the implant,” Rowley says. “What that provides is something like a dovetail lock that allows cement to lock in, so it’s not as affected by the lipid infiltration.”
The main innovation is the combination of Macrolock and Microblast features
Released in September, the ATTUNE S+ technology experienced quick adoption in many quarters, in part because the workflow for surgeons hasn’t changed. By now, over 2,500 patients have ATTUNE S+ technology implants in place.
Thus far, DePuy Synthes has gotten strong feedback from surgeons in the field, and the research suggests the ATTUNE S+ technology will make a big impact on the endurance of total knee replacements, already a procedure known for strong outcomes.
“As an industry, we should always be striving to make procedural success rates as close to ideal as possible, through improvements in design, materials, technology,” says Kamal. “I think it’s incumbent on us to always be striving to get there.”