{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:47:20Z","timestamp":1790858840824,"version":"4.1.0"},"reference-count":25,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Early migration of the uncemented cruciate-sacrificing rotating platform ATTUNE and Low Contact Stress (LCS) tibial components was classified as at-risk for aseptic loosening rates exceeding 6.5% at 15 years based on recent fixation-specific migration thresholds. In this secondary report of a randomized controlled trial (RCT) we aimed to evaluate whether the 5-year migration, inducible displacement, and the clinical outcome of the ATTUNE components were comparable to those of the LCS.Methods:\u00a0Patients from the initial 2-year radiostereometric analysis (RSA) RCT were recruited for a 5-year follow-up. At 5 years, participants underwent 2 supine and 1 loaded RSA examination, clinical assessments, and questionnaires. Migration was analyzed using maximum total point motion (MTPM), translations, and rotations, focusing on 5-year migration, continuous migration (&gt; 0.10 mm\/year), and inducible displacement. Revisions, along with clinical and functional outcomes, were also evaluated.Results:\u00a0At 5 years, 24 ATTUNE and 24 LCS implants were analyzed. The mean MTPM was similar for tibial components (ATTUNE 1.13mm [confidence interval (CI) 0.94\u20131.33]; LCS 1.24 mm [CI 1.05\u20131.46]) but significantly lower for the ATTUNE femoral component (1.14 mm [CI 0.92\u20131.39]) than LCS 1.87 mm [CI 1.57\u20132.21]). 2-to-5-year migration rates were comparable, but 11 ATTUNE and 7 LCS exceeded 0.10 mm MTPM\/year, indicating a higher risk of loosening. Inducible displacement was similar, although 1 patient with a tibial ATTUNE showed excessive displacement (3.34 mm MTPM) with focal osteolysis but no symptoms. 1 revision 10 days post-surgery was performed for an ATTUNE insert spinout, resolved with an isolated insert exchange. Clinical and functional outcomes were comparable.Conclusion:\u00a0At the 5-year follow-up, ATTUNE tibial components showed similar migration, while the femoral component migrated significantly less than the LCS, which mainly occurred during the first 2 years. 2-to-5-year migration rates, inducible displacement, and clinical and functional outcomes were comparable. These findings suggest a comparable long-term risk of aseptic loosening between the uncemented ATTUNE and LCS knee systems.<\/jats:p>","DOI":"10.2340\/17453674.2024.42744","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T13:38:58Z","timestamp":1736775538000},"source":"Crossref","is-referenced-by-count":8,"title":["5-year migration and inducible displacement of the uncemented LCS and ATTUNE rotating platform knee systems: a secondary report of a randomized controlled RSA trial"],"prefix":"10.2340","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0953-0070","authenticated-orcid":false,"given":"Raymond","family":"Puijk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-389X","authenticated-orcid":false,"given":"Lennard A","family":"Koster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5351-5057","authenticated-orcid":false,"given":"Bart G C W","family":"Pijls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwanjot","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein","family":"Schager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8772-9985","authenticated-orcid":false,"given":"Bart L","family":"Kaptein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Nolte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"94101","doi-asserted-by":"crossref","unstructured":"Anand R, Graves S E, de Steiger R N, Davidson D C, Ryan P, Miller L N, et al. 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