Background: Cementless fixation in total knee arthroplasty (TKA) has regained interest, supported by advances in porous implant design and robotic-assisted surgery. The Attune knee system with the Affixium tibial baseplate incorporates a 3D-printed porous surface designed to support cementless biological fixation, however, implant-specific patient-reported outcome data remain limited. This study reports early clinical and patient-reported outcomes following TKA using this construct.
Methods: We reviewed a prospectively maintained arthroplasty registry of consecutive patients undergoing primary TKA with the Attune knee system and Affixium tibial baseplate from a single surgeon. Patient-reported outcome measures (PROMs) included the Oxford Knee Score (OKS), KOOS-12 and EQ-5D, collected preoperatively and at 1 year postoperatively. Patient satisfaction, global perceived improvement, and willingness to undergo surgery again were also recorded. Outcomes were analysed using changes in scores, achievement of patient acceptable symptom state (PASS), and minimal important change (MIC) thresholds.
Results: A total of 142 patients had complete 1-year follow-up. Median OKS improved from 25 (IQR 10) preoperatively to 44 (IQR 7) at 1 year. Median KOOS-12 Summary improved from 42 (IQR 21) to 88 (IQR 23), with similar gains across Pain, Function, and Quality of Life domains. PASS was achieved by 97% for OKS and by 74% for KOOS-12 summary, and 70-76% for the Pain, Function, Quality of Life domains. Using established MIC thresholds, 83% achieved MIC for OKS and 86-90% across KOOS-12 domains. At 1 year, 95% of patients were satisfied or very satisfied, 97% reported their knee was better, and 90% would undergo the same surgery again. No revisions were required within the first postoperative year.
Conclusion: Primary TKA using the Attune knee system with the cementless Affixium tibial baseplate was associated with substantial improvement in PROMs, high satisfaction, and high rates of clinically meaningful improvement at 1 year. These findings support good early clinical performance of this cementless tibial construct in TKA.
