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JOURNEY II AKS

Active Knee Solutions

Algemeen

For orthopaedic surgeons seeking treatment solutions beyond traditional knee replacements, JOURNEY II Active Knee Solutions has been engineered to empower patients with a renewed right to an active lifestyle by breaking through traditional knee replacement barriers and delivering  Function, Motion, and Durability through PHYSIOLOGICAL MATCHING.


Function

Stability
Anatomic, articular surfaces are designed to help restore native anatomy and yield a normal anatomic A/P position throughout the range of motion. 

Strength

More normal muscle firing patterns are expected due to proper A/P positioning, thereby helping to prevent muscle fatigue during activities of daily living.

Satisfaction

Improving patients’ ease of activities of daily living can be expected due to the anticipated improvements of strength and stability. 

Motion

Flexion
The normal kinematic patterns of movement provide the correct environment to allow an anatomic, deep flexion performance. 

Kinematics
Tibiofemoral
• Extension
• Mid-Flexion
• Deep Flexion

Patellofemoral
• Provides improved contact which may improve wear performance 1
• Provides improved patella tracking which may minimize anterior pain 1, 2
• Provides more freedom of baseplate positioning without maltracking concerns 3 

Durability

VERILAST Technology, the combination of OXINIUM Oxidized Zirconium and highly cross-linked polyethylene (XLPE).  Using this technology, JOURNEY II TKA is designed to match the same high standards for wear performance.   

Wear

  • OXINIUM Oxidized Zirconium is an advanced bearing material that combines the strength of metal with the wear resistance of ceramics.
  • OXINIUM Technology is 4,900 times more resistant to abrasion than CoCr. 4
  • OXINIUM Technology is more than twice as hard as CoCr. 5
  • OXINIUM Technology has a coefficient of friction that is up to half that of CoCr. 6
  • OXINIUM Alloy femoral components are available for all JOURNEY II Active Knee Solutions productsMetal Sensitivity.
  • OXINIUM Oxidized Zirconium, exclusively from Smith & Nephew, addresses the needs of nickel sensitive patients by having <0.0035% nickel content, compared to 0.5% in cobalt chrome and 0.1% in titanium.
  • Zirconium is a nearly inert material that has not reported to induce immune reactions. 7

 

 

Referenties

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.

Market Information

The goal of the JOURNEY II Total Knee System is to enable a higher level of function for total knee replacement patients–to not only relieve pain, but to help them regain their active lifestyles. Function, motion and durability is achieved through the unique features of the JOURNEY II Total Knee System–anatomic alignment, kinematics and advanced bearings.



Patient outcomes can be directly related to accurate surgical technique and precision instrumentation. The JOURNEY II BCS and JOURNEY II CR instrumentation has been developed to assist surgeons in obtaining accurate and reproducible results and reducing OR time.

This system is designed for use in patients in primary total knee replacement surgery, where the anterior and posterior cruciate ligaments are incompetent and the collateral ligaments remain intact. 

To replicate normal knee motion, the JOURNEY II BCS and JOURNEY II CR prosthesis provides more mobility in the lateral compartment than other total knee systems 1,2.  For patients that present with significant varus or valgus deformities (> 15º), morbid obesity or deficient collateral ligaments consider whether additional implant constraint is more appropriate. If patients with the above mentioned conditions are scheduled for a JOURNEY II BCS or JOURNEY II CR then assess the flexion space under full ligament tension (eg, laminar spreaders) with the patella reduced and consider having a constrained implant option on hand.

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.1-8

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. 5-10

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. 11,12

Referenties

1. 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.  2. 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.  3. 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.  4. Ward TR, Burns AW, Gillespie MJ, Scarvell JM, Smith PN. Bicruciate-stabilised total knee replacements produce more normal sagittal plane kinematics than posterior-stabilised designs. J Bone Joint Surg Br. 2011 Jul;93(7):907-13.   5. 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.   6. 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.  7. Innocenti B, Belvedere C, Labey L, Ensini A, Leardini A. The Mark Coventry Award: Articular contact estimation in TKA using in vivo kinematics and finite element analysis. Catani F, Clin Orthop Relat Res. 2010 Jan; 468(1):19-28. doi: 10.1007/s11999-009-0941-4. Epub 2009 Jun 23.   8. 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.   9. 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.   10. Lester DK and Shantharam R. Objective Sagittal Instability of CR-TKA by Functional EMG During Normal Walking. AAOS. 2012; Presentation No. 810.   11. 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.   12. Haas S. Kinematics of the Knee & JOURNEY BCS. Insall Club Annual Meeting. June 2010.