JOURNEY II BCS | Smith & Nephew

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Bi-Cruciate Stabilized Knee System


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



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.