# Evaluating two implant designs in patients undergoing primary total knee arthroplasty using a novel measure of early optimal recovery: a retrospective observational study

## TL;DR

A new measure called early optimal recovery was used to compare two knee implant designs, showing better outcomes with one design.

## Contribution

A novel composite outcome measure, early optimal recovery (EOR), was introduced to evaluate TKA implant performance.

## Key findings

- Patients with the study implant had a higher probability of achieving EOR (65.8% vs. 38.9%).
- The study group had shorter hospital stays (≤48 hours) and better pain perception at 3 months.
- The study suggests improved quality of care with the ATTUNE® Knee System compared to LCS® COMPLETE.

## Abstract

Quality of care in total knee arthroplasty (TKA) between implants was assessed using a novel composite outcome measure, early optimal recovery (EOR), to indicate ideal clinical outcomes and minimal healthcare resource utilization.

Patients that underwent primary TKA in the study group (ATTUNE® Knee System) or control group (LCS® COMPLETE Knee System) were included in this retrospective, single-center study. EOR was defined as no complications, no readmissions, no extra outpatient visits, ≤ 48 h length of hospital stay (LOS), and restored range of motion and pain perception at 3-month follow-up. Multivariate logistic regression was used to compare EOR between the study and control groups. Results were adjusted for differences in baseline characteristics and are presented with 95% confidence intervals (CI). Data were collected from a specialized clinic for elective surgeries in the Netherlands, between January 2017 and December 2020.

A total of 566 patients (62.4% female, mean age 67 years) were included for analysis; 185 patients (32.7%) underwent TKA in the study group. Compared to the control group, patients in the study group had greater probability of achieving EOR (65.8% [95% CI: 55.1–75.2] vs. 38.9% [95% CI: 32.8–45.3]; p < 0.001), a LOS ≤ 48 h (77.2% [95% CI: 67.7–84.5] vs. 61.4% [95% CI: 54.7–67.7]; p < 0.05), and ideal pain perception at 3-month follow-up (93.3% [95% CI: 85.7–97.0] vs. 78.2% [95% CI: 71.0–83.9]; p < 0.05).

The study group was associated with a greater probability of achieving EOR versus the control group, suggesting improved quality of care.

The online version contains supplementary material available at 10.1007/s12306-024-00851-z.