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Knee Systems: Trends and ATTUNE’s new technology

Posted in Research to Reality | Jun 2013 | Comments (0)

Tags: Editor's Choiceknee

The global market for knee replacement reached an estimated $7 billion in 2012, according to ORTHOWORLD®’s ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. Growth was supported by an increase in total knee replacement procedures and the introduction of new products to meet patients’ needs.

ORTHOPRENEUR® spoke to Hannah McEwen, Worldwide Director, Knee Development at Johnson & Johnson about the company’s recently-launched ATTUNE™ Knee System and trends in knee replacement.

ORTHOPRENEUR: What is unique about the ATTUNE™ Knee System?   

Hannah McEwen: The new ATTUNE™ Knee represents the largest research and development project in the history of DePuy Synthes Joint Reconstruction.

The ATTUNE Knee is designed to help improve stability and motion. It combines the latest in design, kinematics, engineering and materials to deliver a high level of stability and motion to help patients achieve their optimum range of motion, giving them freedom to move while remaining very stable. The ATTUNE Knee does this through several key proprietary technologies, exclusive to DePuy Synthes Joint Reconstruction:

  • ATTUNE GRADIUS™ Curve: A patented gradually reducing radius that provides optimum conformity throughout the range of motion and is designed to achieve anterior/posterior stability.
  • SOFCAM™ Contact: A patented S-curve design that provides a smooth engagement for stability through flexion, while reducing stresses placed on the implant.
  • LOGICLOCK™ Tibial Base: A patented locking design that provides the architecture to optimize kinematics while reducing wear to the lowest reported levels in the industry.1 As a result, surgeons do not have to compromise on component size, picking the optimum size and fit for each patient.
  • GLIDERIGHT™ Articulation: A proprietary design to accommodate patient variation and soft tissue interaction, while optimizing patella tracking.

The ATTUNE Knee uses DePuy Synthes Joint Reconstruction’s AOX™ Polyethylene material, which was designed to optimize performance of the material while providing wear resistance, oxidative stability and mechanical integrity. attune knee system 1

In addition to addressing unmet patient needs, the ATTUNE Knee is designed to meet surgeon and provider needs to deliver care more efficiently through the use of INTUITION™ Instruments, which are lightweight, fewer in number and compatible with the ATTUNE Knee.

ORTHOPRENEUR: What should surgeons know about working with ATTUNE?

McEwen: Through extensive customer research, DePuy Synthes Joint Reconstruction developed a deep understanding of how instruments are utilized and how they affect the surgeon, patient and each member of the hospital team. As a result, the INTUITION Instruments are designed to deliver care more efficiently and feature:

  • Single-layer instrument cases that are lightweight with fewer instruments, reducing weight by 51% as compared to previously available instruments. The instruments also minimize the number of instrument cases in the operating room (OR), which can potentially lower sterilization and hospital costs.
  • Novel use of composite materials in orthopaedic instruments, while maintaining instrument durability.
  • Design clarity through the use of color coding and clear markings, potentially reducing OR surgical errors.
  • Intuitive designs that are easy to learn and reduce surgical steps, contributing to a more efficient procedure. An intuitive user interface provides ease-of-use, a reduced learning curve and improved OR team experience. The total number of instruments required to carry out all of the common surgical steps has also been reduced.

DePuy Synthes Joint Reconstruction took an extensive approach to the research and development process of the ATTUNE Knee, working with global thought-leaders and experts in their fields of study over the past six years, as well as testing with academic institutions and renowned surgeons. In addition, the ATTUNE Knee has been extensively tested in vitro and will be studied in several in vivo studies in more than 12 countries.

ORTHOPRENEUR: What did the collaborative research between DePuy Synthes Joint Reconstruction and the University of Denver and the University of Kansas find? How was the research used in developing the ATTUNE Knee?

McEwen: We first did extensive research to understand how traditional knee designs perform in total knee patients. This research began with the analysis of fluoroscopic studies. In these studies, abrupt changes in the motion and stability of the knee were reported. This is thought to be a factor leading to the lack of confidence reported by some patients following total knee replacement.2,3 

Through collaboration with the University of Kansas and the University of Denver, we replicated this motion in experimental and computational models where the motions of existing designs were studied during various activities such as walking, descending stairs and bending. This research led to the discovery of an interaction between implant geometry and the motion experienced by patients.4 Cadaver and computer models were then used to test new design iterations and ultimately helped develop the patented geometry of the ATTUNE Knee.

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