1. Knee Replacement Options (The Attune Knee)
By: Brian Myette
BME 281
Section 2

2. The Problem/Background
Complete Knee replacement surgery is the most common joint replacement procedure.
Osteoarthritis- As one ages, inflammation forms in the join, OA is the end result of extreme inflammation in the knee.
Rheumatoid Arthritis- A disease that effects both of the knees. Can happen at any ages. It destroys the cartilage in the knee.
Post-traumatic Arthritis- Very common in athletes. Happens due to injury in the knee ligaments, femoral fracture, or Meniscus tear.
A prosthetic Artificial hand is designed for duplicating the exact motions of the human hand.
It uses nerve endings to replicate the sensory-motor abilities in the hand. 2

3. Cont…
Studies have shown higher incidence of anterior knee pain in unresurfaced patellae due to replacement surgery.
The Goal of engineers is to produce a knee system with a “patella friendly” Femoral component.
The Study
Evaluate the mechanics of the unresurfaced patella. This was compared with natural and resurfaced motion conditions of the patellofemoral joint.
It tested the kinematics of the implant, and it strain on the patella.
The Prosthetic devises that are commercially made for the public have really evolved over the years. because just ten years ago, scientists said that commercial prosthetic hands were not close to giving the recipient the ability to grasp items. Such devices looked like the one in the picture here.
The joints are motivated by a single motor drive acting concurrently on the metacarpo-phalangeal (MP) joints. These joints can be found in the thumb, the index, and the middle finger. The other joints can only bend submissively. 3

4. History
1891 German surgeon Theophilus Gluck performed knee replacement using Ivory to replace the joint. The ivory joint was connectedand stabilized using plaster.
In 1974,researchers at Mass Gen developed "total condylar knee," a plastic component that resembled the traditional knee structure and allowed for total joint replacement with limited motion.
In the 1980’s the concept of “moble-knee Replacement” was coined. The component was not completely fixed, which offered for more motion and higher angle of knee flexion.
In the Early 90’s The LCS and Sigma knees were designed. These models focused on eliminating the strain on the patella after surgery, without taking away from the knee flexion ability.
2011- The First Attune knee was used in surgery, and was extremely sucessful. The patient had full control and 90 degrees on flexion in the knee within 2 weeks.

5. The Attune Knee
The Attune knee is ideal for patients with Painful and disabled knee joint resulting from osteoarthritis, rheumatoid arthritis, traumatic arthritis where one or more separations in the joint are involved.
The implant also can be used to correct varus, valgus, or posttraumatic deformity
The implant has more anatomic geometry, with a deep patellar groove and a wider lateral ridge
1. Natural grasping capability
2. Natural appearance (cosmetic appearance)
3. Secure grasping and sensory feedback
4. ”Natural” command interface. 5

6. ATTUNE Advancements
Match the anatomy of virtually any knee found in a person, because it is designed and tested based on size and shape of the knee, and the gender and ethnicity of the patient.
It is made of a unique polyethylene plastic insert which should create the longest lasting and strongest insert ever created.
This insert and the larger perfect area for the patella provides for greater range of motion and significantly quicker recovery.

7. Future New Materials- metals and plastic components.
Computer systems used in surgery to “improve” the quality of surgery, and decrease the percent of patients that need corrective surgery.
What happens is that the nerve are too severed to work correctly, and connecting a harsh material would just make it a lot worse, so scientist introduced a nano plastic that would act like a tube, and slide over the nerve ending to protect it from being damaged more, and at the same time sending the electronic signals from the nerves to the prosthetic hand.
With this blast in tecnology, I see that the field will be widening, and the capabilites of the prosthetic hand will be growing
As explained in the video, the future may include prosthetic hands with feeling. The same signals that transfer for the movement of the hand, can also be transferred in a different mannor for feeling in the hand. 7

8. Works Cited
Advocate Lutheran General Hospital. "World’s First Attune Knee Replacement Completed at Advocate Lutheran General Hospital." Triblocal.com. N.p., 3 Jan Web. 27 Oct < ridge/community/stories/2012/01/world%E2%80%99s-first-attune-knee-replacement-completed-at-advocate- lutheran-general-hospital/>.
Cluett, Jonathan. "Considering Knee Replacement Surgery?" About.com Orthopedics. N.p., 8 Apr Web. 27 Oct <
"Arthritis of the Knee - OrthoInfo - AAOS." Arthritis of the Knee - OrthoInfo - AAOS. N.p., n.d. Web. 27 Oct <
Fitzpatrick, Clare K., and Paul J. Rullkoetter. "Influence of Patellofemoral Articular Geometry and Material on Mechanics of the Unresurfaced Patella." Journal of Biomechanics45.11 (2012):   July- Aug Web. 27 Oct
"Depuy Attune Total Knee System by Johnson & Johnson." Depuy Attune Total Knee System by Johnson & Johnson. N.p., n.d. Web. 27 Oct <
Beach, Emily. "History of Knee Replacement." EHow. Demand Media, 21 July Web. 27 Oct <