PHYSIOLOGICAL MATCHING◊ for function, motion, and durability
Members of the JOURNEY◊ II Active Knee Solutions Family include:
Partial Knee Replacements
- JOURNEY◊ UNI
- JOURNEY◊ PFJ
Total Knee Replacements
- JOURNEY◊ II BCS
- JOURNEY◊ II CR
Watch the JOURNEY II Active Knee Solutions Animation on YouTube
JOURNEY II BCS:
The JOURNEY II Bi-Cruciate Stabilised Knee System has been specifically designed through proprietary simulation software (LifeModeler) to address the rapidly changing demands of the modern orthopaedic marketplace. With the lack of satisfaction behind the performance of conventional total knee replacements and the growing number of active, informed patients, JOURNEY II BCS seeks to bridge the gap of improving patient satisfaction and implant longevity through unmatched function, motion, and durability.
As the mix of patients shifts to the active, informed segment, the orthopaedic market has seen a demand for higher levels of function from knee replacements in an effort to regain their pre-arthritic lifestyles. This can be achieved by retaining the anatomic levels of stability and strength which should lead to higher levels of patient satisfaction.
Stability – The patented, proprietary anterior cam supplements the function of the anterior cruciate ligament (ACL) which helps to eliminate mid-flexion instability, a leading cause of early revisions in replaced knees.
Strength – The patented, proprietary anatomic shapes of the femur and tibia promote anatomic positioning and motion post-replacement which has shown to allow less muscle exertion while performing activities of daily living.
Satisfaction – The chief goal of this system is to provide further improvement to those already achieved with the original JOURNEY BCS design by providing patients the normal patterns of kinematic motion yet to be seen in other systems.
In any knee replacement, restoring the knee motion is a critical element in providing the return to activities that patients are demanding. Motion is not simply the flexion ranges a knee can achieve, but also the movements between the femur and tibia and tibia bones inside the joint, called kinematics.
Flexion - The JOURNEY II BCS system seeks to provide the highest levels of motion (up to 155° possible) to allow patients the opportunity to perform the activities they love.
Kinematics – The patented anatomic shapes of the JOURNEY II BCS allow the bones in the knee joint to move in their normal anatomic pattern after the replacement is done while conventional knee replacements force these same bones to move in a non-anatomic, simple fashion, like a door hinge which might cause issues as patients attempt to regain their active lifestyles post-replacement.
With the patient population shifting not only to more activity, but also opting for intervention at an earlier age, the implants’ durability in regards to wear (long-term performance) and managing complications are more important than ever.
Wear - Smith & Nephew created VERILAST◊ Technology to help reduce wear -- one of the leading causes of implant failure. VERILAST Technology is combination of our proprietary OXINIUM◊ alloy and a highly cross-linked polyethylene (XLPE).
Metal Sensitivity – Understanding that no measurable nickel content is of immeasurable benefit to nickel-sensitive patients and that minimising the possibility for post-op metal sensitivity complications simplifies the worries of a surgeon, Smith & Nephew provides its proprietary, award-winning material of OXINIUM◊ to uniquely manage these concerns.
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1. US Department of Health and Human Services Agency (HHSA) for Healthcare Research and Quality (AHRQ) Knee Replacements Up Dramatically Among Adults 45 to 64 Years Old. AHRQ News and Numbers, November 3, 2011. Agency for Healthcare Research and Quality, Rockville, MD.
2. Phil Noble et al; Does total knee replacement restore normal knee function? 2005; CORR. (431): 157-65.
3. Huch K, Müller KA, Stürmer T, Brenner H, Puhl W, Günther KP. Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study. Ann Rheum Dis. 2005 Dec; 64 (12):1715-20.
4. Comparing patient outcomes after THA and TKA: is there a difference? Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Clin Orthop Relat Res. 2010 Feb; 468(2):542-6. Epub 2009 Sep 4.
5. Functional comparison of posterior cruciate-retained versus cruciate-sacrificed total knee arthroplasty. Dorr LD, Ochsner JL, Gronley J, Perry J. Clin Orthop Relat Res. 1988 Nov; (236):36-43.
6. Victor J, Mueller JK, Komistek RD, Sharma A, Nadaud MC, Bellemans J. In vivo kinematics after a cruciate-substituting TKA. Clin Orthop Relat Res. 2010 Mar; 468(3):807-14.
7. Zingde SM, Sharma A, Komistek RD, Dennis, DA, Mahfouz, MR. In vivo comparison of kinematics for 1891 non-implanted and implanted knees. AAOS. 2009; Scientific Exhibit No. 22.
8. Zingde SM, Mueller J, Komistek RD, MacNaughton JM, Anderle MR, Mauhfouz MR. In vivo comparison of tka kinematics for subjects having a PS, PCR, or Bi-Cruciate Stabilizing design. Orthopedic Research Society. 2009; Paper No. 2067.
9. Bicruciate-stabilised total knee replacements produce more normal sagittal plane kinematics than posterior-stabilised designs.Ward TR, Burns AW, Gillespie MJ, Scarvell JM, Smith PN J Bone Joint Surg Br. 2011 Jul;93(7):907-13.
10. Catani F, Ensini A, Belvedere C, Feliciangeli A, Benedetti MG, Leardini A, Giannini S. In vivo kinematics and kinetics of a bi-cruciate substituting total knee arthroplasty: a combined fluoroscopic and gait analysis study. J Orthop Res. 2009 Dec;27(12):1569-75.
11. Morra EA, Rosca M, Greenwald JFI, Greenwald AS. The influence of contemporary knee design on high flexion: a kinematic comparison with the normal knee. JBJS Am. 2008; 90: 195-201.
12. The Mark Coventry Award: Articular contact estimation in TKA using in vivo kinematics and finite element analysis. Catani F, Innocenti B, Belvedere C, Labey L, Ensini A, Leardini A. Clin Orthop Relat Res. 2010 Jan; 468(1):19-28. doi: 10.1007/s11999-009-0941-4. Epub 2009 Jun 23.
13. Van Duren BH, Pandit H, Price M, Tilley S, Gill HS, Murray DW, Thomas NP. Bicruciate substituting total knee replacement: how effective are the added kinematic constraints in vivo? Knee Surg Sports Traumatol Arthrosc. 2012 Oct; 20 (10):2002-10. Epub 2011 Nov 29.
14. Arbuthnot JE, Brink RB. Assessment of the antero-posterior and rotational stability of the anterior cruciate ligament analogue in a guided motion bi-cruciate stabilized total knee arthroplasty. J Med Eng Technol. 2009;33(8):610-5.
15. Lester DK and Shantharam R. Objective Sagittal Instability of CR-TKA by Functional EMG During Normal Walking. AAOS. 2012; Presentation No. 810.
16. Pritchett JW. Patient preferences in knee prostheses. J Bone Joint Surg Br. 2004 Sep; 86(7):979-82.
17. Pritchett JW. Anterior cruciate-retaining total knee arthroplasty. J Arthroplasty. 1996 Feb; 11(2):194-7.
18. Rajgopal A; Dahiya V; Kochhar H. Bi-Cruciate Substituting Total Knee Arthroplasty Early Experience. International Society for Technology in Arthroplasty: 22 Congress. 2009; Poster No. 107.
19. Haas S. Kinematics of the Knee & JOURNEY BCS. Insall Club Annual Meeting. June 2010
20. Banks SA; Fregly BJ; Boniforti F; Reinschmidt C; Romagnoli S. Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements. Knee Surg Sports Traumatol Arthrosc. 2005 Oct; 13(7):551-6. Epub 2005 Jan 20.
21. Mahfouz MR, Komistek RD, Dennis DA, Hoff WA. In vivo assessment of the kinematics in normal and anterior cruciate ligament-deficient knees. J Bone Joint Surg Am. 2004;86-A Suppl 2:56-61.
22. Carpenter RD, et al, Magnetic resonance imaging of in vivo patellofemoral kinematics after total knee arthroplasty, The Knee (2009), doi:10.1016/j.knee.2008.12.016
23. Brilhault J, Ries MD. Measuring patellar height using the lateral active flexion radiograph: Effect of total knee implant design. Knee. 2010 Mar;17(2):148-51. doi: 10.1016/j.knee.2009.07.008. Epub 2009 Aug 31.
24. Leopold SS, Silverton CD, Barden RM, Rosenberg AG. Isolated revision of the patellar component in total knee arthroplasty. J Bone Joint Surg Am 2003; 85-A:41–7.
25. Breugem SJ, van Ooij B, Haverkamp D, Sierevelt IN, van Dijk CN. No difference in anterior knee pain between a fixed and a mobile posterior stabilized total knee arthroplasty after 7.9 years. Knee Surg Sports Traumatol Arthrosc. 2012 Nov 3. [Epub ahead of print]
26. Lee GC, Garino JP, Kim RH, Lenz N. Contributions of Femoral, Tibial and Patellar Malposition to Patellar Maltracking in Total Knee Arthroplasty. AAOS. 2013; Poster No. 114
27. Nha KW, Papannagari R, Gill TJ, Van de Velde SK, Freiberg AA, Rubash HE, Li G. In vivo patellar tracking: clinical motions and patellofemoral indices. J Orthop Res. 2008 Aug;26(8):1067-74.
28. Victor J, Ries M, Bellemans J, Robb WM, Van Hellemondt G. High-flexion, motion-guided total knee arthroplasty: who benefits the most? Orthopedics. 2007 Aug; 30 (8 Suppl): 77–9.
29. Kuroyanagi Y, Mu S, Hamai S, Robb WJ, Banks SA. In vivo knee kinematics during stair and deep flexion activities in patients with bicruciate substituting total knee arthroplasty. J Arthroplasty. 2012 Jan; 27(1):122-8. doi: 10.1016/j.arth.2011.03.005. Epub 2011 Apr 19.
30. H. M. J. McEwen, P. I. Barnett, C. J. Bell, R. Farrar, D. D. Auger, M. H. Stone and J. Fisher, The influence of design, materials and kinematics on the in vitro wear of total knee replacements, J Biomech, 2005;38(2):357-365.
31. A. Parikh, M. Morrison and S. Jani, Wear testing of crosslinked and conventional UHMWPE against smooth and roughened femoral components, Orthop Res Soc, San Diego, CA, Feb 11-14, 2007, 0021.
32. AA. Essner, L. Herrera, S. S. Yau, A. Wang, J. H. Dumbleton and M. T. Manley, Sequentially crosslinked and annealed UHMWPE knee wear debris, Orthop Res Soc, Washington D.C., 2005, 71.
33. L. Herrera, J. Sweetgall, A. Essner and A. Wang, “Evaluation of sequentially crosslinked and annealed wear debris, World Biomater Cong, Amsterdam, May 28-Jun 1, 2008, 583.
34. C. Schaerer, K. Mimnaugh, O. Popoola and J. Seebeck, “Wear of UHMWPE tibial inserts under simulated obese patient conditions,” Orthop Res Soc, New Orleans, LA, Feb 6-10, 2010, 2329.
35. Biomet publication, FDA Cleared Claims for E1 Antioxidant Infused Technology”
36. Ref: DePuy Attune 510 K Document K101433 Dec 10, 2010
37. Ref: Smith & Nephew OR-12-129: 5 million cycles according to ISO 14243-1  (on file with Smith & Nephew).
38. Hunter, G., and Long, M. Abrasive Wear of Oxidized Zr-2.5Nb, CoCrMo, and Ti-6Al-4V Against Bone Cement. 6th World Biomaterials Cong. Trans., Society for Biomaterials, Minneapolis, MN, 2000, p. 835.
39. Long, M., Riester, L., and Hunter, G. no-hardness Measurements of Oxidized Zr-2.5Nb and Various Orthopaedic Materials. Trans. Soc. Biomaterials, 21, 1998, p. 528.
40. Poggie RA, Wert J, Mishra A, et al (1992). Friction and wear characterization of UHMWPE in reciprocating sliding contact with Co-Cr, Ti-6Al-4V, and zirconia implant bearing surfaces. Wear and Friction of Elastomers, Denton R and Keshavan MK, Eds., West Conshohocken, PA: ASTM International.
41. Nasser, S.: Biology of Foreign Bodies: Tolerance, Osteolysis and Allergy in Total Knee Arthroplasty, Edited by J. Bellemans, M.D. Ries and J. Victor; Springer -Verlag, Heidelberg, 2005
42. Cartier P, Khefacha A, Sanouiller JL, Frederick K. Unicondylar knee arthroplasty in middle-aged patients: a minimum 5-year follow-up. Orthopedics. 2007 Aug; 30 (8 Suppl):62-5.
43. Marcella E. Elpers, Thomas J. Heyse, Danyal H. Nawabi, Timothy M. Wright, Steven B. Haas; Oxidized Zirconium vs Cobalt-Chromium TKA: Surface Roughness of Retrieved Femoral Components; Transactions of Orthopaedic Research Society 2013