{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:11:34Z","timestamp":1780330294498,"version":"3.54.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee Surg &amp; Relat Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This study aimed to compare clinical and radiographic outcomes for a new tibial component (Attune S\u2009+) and the previous design (Attune S) in total knee arthroplasty (TKA) patients using ATTUNE\u00ae posterior stabilized (PS) prosthesis and also assessed related factors for the development of tibial radiolucent line(RLL).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective study included 362 knees (179 Attune S, 183 Attune S\u2009+) with an average 4\u00a0years (range, 2\u20138) follow-up. Clinical outcomes, radiologic parameters and the incidence of RLL around the tibial component were compared through the serial assessment. For the subgroup analysis, radiologic parameters were compared between patients with and without RLL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There was no significant difference in terms of clinical outcomes and radiologic parameters between two designs. The incidence of RLL was not different through the serial follow-up (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). In the subgroup analysis, the preoperative medial proximal tibial angle (83.7\u00b0 versus 85.0\u00b0, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) was smaller and preoperative hip-knee-ankle angle (169.1\u00b0 versus 171.8\u00b0, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) has more varus in the group with RLL than those without.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The clinical and radiologic outcomes including the incidence of tibial RLL between new design and predecessor were not significantly different at average 4\u00a0years follow-up. The development of tibial RLL was associated with preoperative varus deformity of tibia and lower limb alignment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43019-024-00239-0","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T08:43:58Z","timestamp":1731401038000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Does the clinical and radiologic outcomes following total knee arthroplasty using a new design cobalt-chrome tibial plate or predecessor different?"],"prefix":"10.1186","volume":"36","author":[{"given":"Kang-Il","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Ho","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3984-1213","authenticated-orcid":false,"given":"Kyeonguk","family":"Min","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"239_CR1","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1007\/s00264-018-3913-z","volume":"43","author":"D Saragaglia","year":"2019","unstructured":"Saragaglia D, Rubens-Duval B, Gaillot J, Lateur G, Pailhe R (2019) Total knee arthroplasties from the origin to navigation: history, rationale, indications. Int Orthop 43:597\u2013604","journal-title":"Int Orthop"},{"key":"239_CR2","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1055\/s-0037-1603756","volume":"30","author":"PM Bonutti","year":"2017","unstructured":"Bonutti PM, Khlopas A, Chughtai M, Cole C, Gwam CU, Harwin SF, Whited B, Omiyi DE, Drumm JE (2017) Unusually high rate of early failure of tibial component in attune total knee arthroplasty system at implant-cement interface. J Knee Surg 30:435\u2013439","journal-title":"J Knee Surg"},{"key":"239_CR3","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1007\/s00167-018-5130-0","volume":"27","author":"K Staats","year":"2019","unstructured":"Staats K, Wannmacher T, Weihs V, Koller U, Kubista B, Windhager R (2019) Modern cemented total knee arthroplasty design shows a higher incidence of radiolucent lines compared to its predecessor. Knee Surg Sports Traumatol Arthrosc 27:1148\u20131155","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"239_CR4","doi-asserted-by":"publisher","first-page":"8046","DOI":"10.1016\/j.actbio.2013.05.005","volume":"9","author":"J Gallo","year":"2013","unstructured":"Gallo J, Goodman SB, Konttinen YT, Wimmer MA, Holinka M (2013) Osteolysis around total knee arthroplasty: a review of pathogenetic mechanisms. Acta Biomater 9:8046\u20138058","journal-title":"Acta Biomater"},{"key":"239_CR5","doi-asserted-by":"publisher","first-page":"3401","DOI":"10.1007\/s00402-022-04642-8","volume":"143","author":"SJ Song","year":"2023","unstructured":"Song SJ, Lee HW, Park CH (2023) Medial proximal tibial resorption after total knee arthroplasty according to the design of the cobalt chrome tibial baseplate. Arch Orthop Trauma Surg 143:3401\u20133407","journal-title":"Arch Orthop Trauma Surg"},{"key":"239_CR6","unstructured":"DePuySynthes. Attune S+ technology: JRC; 2017."},{"key":"239_CR7","unstructured":"Maag C, Peckenpaugh E, Metcalfe A, Langhorn J, Heldreth M. 2020. Influence of alignment-specific physiological loading following intraoperative lipid\/marrow infiltration and intraoperative motions upon tibial implant fixation. Orthopaedic Proceedings."},{"key":"239_CR8","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s00167-009-0977-8","volume":"18","author":"TA Moro-oka","year":"2010","unstructured":"Moro-oka TA, Shiraishi H, Iwamoto Y, Banks SA (2010) Modified gap-balancing technique in total knee arthroplasty: evaluation of the post-operative coronal laxity. Knee Surg Sports Traumatol Arthrosc 18:375\u2013380","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"239_CR9","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B3.29586","author":"DT Cawley","year":"2013","unstructured":"Cawley DT, Kelly N, McGarry JP, Shannon FJ (2013) Cementing techniques for the tibial component in primary total knee replacement. Bone Joint J. https:\/\/doi.org\/10.1302\/0301-620X.95B3.29586","journal-title":"Bone Joint J"},{"key":"239_CR10","doi-asserted-by":"publisher","first-page":"2154","DOI":"10.1016\/j.arth.2015.06.012","volume":"30","author":"JM Giesinger","year":"2015","unstructured":"Giesinger JM, Hamilton DF, Jost B, Behrend H, Giesinger K (2015) WOMAC, EQ-5D and knee society score thresholds for treatment success after total knee arthroplasty. J Arthroplasty 30:2154\u20132158","journal-title":"J Arthroplasty"},{"key":"239_CR11","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s11999-012-2489-y","volume":"471","author":"WL Healy","year":"2013","unstructured":"Healy WL, Della Valle CJ, Iorio R, Berend KR, Cushner FD, Dalury DF, Lonner JH (2013) Complications of total knee arthroplasty: standardized list and definitions of the knee society. Clin Orthop Relat Res 471:215\u2013220","journal-title":"Clin Orthop Relat Res"},{"key":"239_CR12","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198911000-00003","author":"FC Ewald","year":"1989","unstructured":"Ewald FC (1989) The knee society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res. https:\/\/doi.org\/10.1097\/00003086-198911000-00003","journal-title":"Clin Orthop Relat Res"},{"key":"239_CR13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/S0883-5403(99)99999-0","volume":"14","author":"S Smith","year":"1999","unstructured":"Smith S, Naima VS, Freeman MA (1999) The natural history of tibial radiolucent lines in a proximally cemented stemmed total knee arthroplasty. J Arthroplasty 14:3\u20138","journal-title":"J Arthroplasty"},{"key":"239_CR14","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1016\/j.arth.2021.02.010","volume":"36","author":"MG Rizzo","year":"2021","unstructured":"Rizzo MG, Hall AT, Downing JT, Robinson RP (2021) High-viscosity versus a lower-viscosity cement penetration at dough phase in vivo in primary total knee arthroplasty. J Arthroplasty 36:1995\u20131999","journal-title":"J Arthroplasty"},{"key":"239_CR15","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1177\/1094428112470848","volume":"16","author":"H Aguinis","year":"2013","unstructured":"Aguinis H, Gottfredson RK, Joo H (2013) Best-practice recommendations for defining, identifying, and handling outliers. Organ Res Methods 16:270\u2013301","journal-title":"Organ Res Methods"},{"key":"239_CR16","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/00003086-198703000-00023","volume":"216","author":"ML Ecker","year":"1987","unstructured":"Ecker ML, Lotke PA, Windsor RE, Cella JP (1987) Long-term results after total condylar knee arthroplasty. Significance of radiolucent lines. Clin Orthop Relat Res 216:151\u20138","journal-title":"Clin Orthop Relat Res"},{"key":"239_CR17","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1016\/S0736-0266(02)00005-0","volume":"20","author":"Y Zhang","year":"2002","unstructured":"Zhang Y, Putnam AW, Heiner AD, Callaghan JJ, Brown TD (2002) Reliability of detecting prosthesis\/cement interface radiolucencies in total hip arthroplasty. J Orthop Res 20:683\u2013687","journal-title":"J Orthop Res"},{"key":"239_CR18","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.knee.2019.12.011","volume":"27","author":"DW Wong","year":"2020","unstructured":"Wong DW, Lee QJ, Lo CK, Wong YC, Law KW, Li AH (2020) Tibial tray thickness does not significantly increase medial tibial bone resorption: Using tibial bone density as an objective measurement method. Knee 27:572\u2013579","journal-title":"Knee"},{"key":"239_CR19","doi-asserted-by":"publisher","first-page":"S221","DOI":"10.1016\/j.arth.2022.01.074","volume":"37","author":"I Bendich","year":"2022","unstructured":"Bendich I, Lawrie CM, Riegler V, Barrack RL, Nunley RM (2022) The impact of component design and fixation on stress shielding after modern total knee arthroplasty. J Arthroplasty 37:S221\u2013S225","journal-title":"J Arthroplasty"},{"key":"239_CR20","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/1749-799X-8-36","volume":"8","author":"S Tsukada","year":"2013","unstructured":"Tsukada S, Wakui M, Matsueda M (2013) Metal block augmentation for bone defects of the medial tibia during primary total knee arthroplasty. J Orthop Surg Res 8:36","journal-title":"J Orthop Surg Res"},{"key":"239_CR21","doi-asserted-by":"publisher","first-page":"2835","DOI":"10.1016\/j.arth.2018.04.025","volume":"33","author":"C Yoon","year":"2018","unstructured":"Yoon C, Chang MJ, Chang CB, Song MK, Shin JH, Kang SB (2018) Medial tibial periprosthetic bone resorption and its effect on clinical outcomes after total knee arthroplasty: cobalt-chromium vs titanium implants. J Arthroplasty 33:2835\u20132842","journal-title":"J Arthroplasty"},{"key":"239_CR22","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1302\/2046-3758.114.BJR-2021-0169.R1","volume":"11","author":"S Jaeger","year":"2022","unstructured":"Jaeger S, Eissler M, Schwarze M, Schonhoff M, Kretzer JP, Bitsch RG (2022) Does tibial design modification improve implant stability for total knee arthroplasty? an experimental cadaver study. Bone Joint Res 11:229\u2013238","journal-title":"Bone Joint Res"},{"key":"239_CR23","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1007\/s00264-014-2551-3","volume":"39","author":"JH Ahn","year":"2015","unstructured":"Ahn JH, Jeong SH, Lee SH (2015) The effect of multiple drilling on a sclerotic proximal tibia during total knee arthroplasty. Int Orthop 39:1077\u20131083","journal-title":"Int Orthop"},{"key":"239_CR24","first-page":"82","volume":"86","author":"D Wautier","year":"2020","unstructured":"Wautier D, Ftaita S, Thienpont E (2020) Radiolucent lines around knee arthroplasty components\u202f: a narrative review. Acta Orthop Belg 86:82\u201394","journal-title":"Acta Orthop Belg"},{"key":"239_CR25","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1186\/s12891-019-3008-z","volume":"20","author":"YR Li","year":"2019","unstructured":"Li YR, Gao YH, Yang C, Ding L, Zhang X, Chen H, Liu J, Qi X (2019) Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty. BMC Musculoskelet Disord 20:617","journal-title":"BMC Musculoskelet Disord"},{"key":"239_CR26","doi-asserted-by":"publisher","first-page":"126","DOI":"10.2106\/JBJS.K.00607","volume":"95","author":"MA Ritter","year":"2013","unstructured":"Ritter MA, Davis KE, Davis P, Farris A, Malinzak RA, Berend ME, Meding JB (2013) Preoperative malalignment increases risk of failure after total knee arthroplasty. J Bone Joint Surg Am 95:126\u2013131","journal-title":"J Bone Joint Surg Am"},{"key":"239_CR27","doi-asserted-by":"publisher","first-page":"S190","DOI":"10.1016\/j.arth.2020.02.028","volume":"35","author":"CB Hampton","year":"2020","unstructured":"Hampton CB, Berliner ZP, Nguyen JT, Mendez L, Smith SS, Joseph AD, Padgett DE, Rodriguez JA (2020) Aseptic loosening at the tibia in total knee arthroplasty: a function of cement mantle quality? J Arthroplasty 35:S190\u2013S196","journal-title":"J Arthroplasty"},{"key":"239_CR28","doi-asserted-by":"publisher","first-page":"60","DOI":"10.2106\/00004623-199401000-00008","volume":"76","author":"MA Ritter","year":"1994","unstructured":"Ritter MA, Herbst SA, Keating EM, Faris PM (1994) Radiolucency at the bone-cement interface in total knee replacement. The effects of bone-surface preparation and cement technique. J Bone Joint Surg Am 76:60\u20135","journal-title":"J Bone Joint Surg Am"},{"key":"239_CR29","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1080\/17453674.2019.1657333","volume":"90","author":"AM Refsum","year":"2019","unstructured":"Refsum AM, Nguyen UV, Gjertsen JE, Espehaug B, Fenstad AM, Lein RK, Ellison P, Hol PJ, Furnes O (2019) Cementing technique for primary knee arthroplasty: a scoping review. Acta Orthop 90:582\u2013589","journal-title":"Acta Orthop"}],"container-title":["Knee Surgery &amp; Related Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43019-024-00239-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43019-024-00239-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43019-024-00239-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T21:19:16Z","timestamp":1731446356000},"score":1,"resource":{"primary":{"URL":"https:\/\/kneesurgrelatres.biomedcentral.com\/articles\/10.1186\/s43019-024-00239-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,12]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["239"],"URL":"https:\/\/doi.org\/10.1186\/s43019-024-00239-0","relation":{},"ISSN":["2234-2451"],"issn-type":[{"value":"2234-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,12]]},"assertion":[{"value":"8 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study had been approved from IRB (KHNMC 2023\u201310-012).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Agreed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34"}}