JOURNEY BCS

Bi-Cruciate Stabilized Knee System

 

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JOURNEY II BCS Knee System

Overview

JOURNEY BCS System

Why normal is extraordinary?

Why normal is extraordinary

Studies have shown that the replication of normal knee kinematics has yet to be achieved with conventional TKA. Aberrant kinematics are caused by alterations in soft tissue - the resection of the ACL and PCL - and hard tissue anatomy. This creates a functional deficit following TKA. Function, as described by strength, stability, and flexion, are three parameters where today's TKA patients fail to reach normality. The goal of the JOURNEY BCS Bi-Cruciate Stabilized Knee System was to enable a higher level of function for TKA patients - to not only relieve pain, but to help them regain their active lifestyles.

More normal function - stability, strength, and high flexion - is achieved with the unique features of the JOURNEY BCS system - normal shapes, normal position, and normal motion.

Welcome to Normal

Benefits

JOURNEY BCS System

Normal Shapes

Normal Knee

  • Larger medial condyle than lateral condyle
  • Higher lateral tibial plateau than medial
  • Concave medial tibial surface; convex lateral tibial surface
  • Anatomical joint line at 3°
  • Larger medial condyle posterior offset
              Normal Knee

Traditional TKA Implants

  • Symmetric coronal and sagittal femoral condyles
  • Symmetric tibial inserts
  • 0° joint line
              Traditional TKA Implants

JOURNEY BCS Implant

  • Larger medial condyle than lateral condyle
  • Higher lateral tibial plateau than medial
  • Concave medial tibial surface; gradual posterior sloped lateral tibial surface
  • Anatomical joint line at 3°
  • Highly conforming in coronal plane for low contact stress
  • Larger medial condyle posterior offset
JOURNEY BCS Implant       JOURNEY BCS Implant

Normal Position

Normal Knee    
         
In the normal knee, the femur sits nearly flush with the tibia, with minimal posterior condyle overhang   The posterior condyle overhang of 8-12mm results in paradoxical anterior sliding of the femur as the knee flexes - causing instability.   The posterior femoral component sits nearly flush with the tibia - and allows normal kinematic motion to occur



Normal Motion

Normal Knee    
Recent biomechanical studies have shown that the knee doesn't move in a simple hinge joint fashion. 1

The femur externally rotates on the tibia as the knee flexes, resulting in:
  • 0°-90° - Lateral rollback and medial pivot
  • 90°-155° - Posterior femoral transition of both condyles for deeper flexion
  Normal Knee
     
Traditional TKA    
In vivo fluoroscopy studies have shown that traditional total knee replacements move in an unanatomic way.

  • 0-90°— Paradoxical forward motion plus limited axial rotation may yield a lateral pivot
  • 90°-155°—Lack of axial rotation may lead to limited flexion or increased patellar sheer stresses
  Traditional TKA
     
JOURNEY BCS Knee    
The JOURNEY BCS knee provides near normal knee kinematics throughout the range of motion.

  • 0-90°— Rollback plus femoral external rotation yields medial pivot; resists paradoxical motion
  • 90°-155°— Posterior femoral translation of both condyles
  JOURNEY BCS

Clinical References

1. Johal P, Williams A, Wragg P, Hunt D, Gedroyc W. Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using ‘interventional' MRI. J Biomech. 2005 Feb;38(2):269-76.

Stability

Bi-Cruciate Stabilized

The normal knee's ACL provides stability in early gait during numerous daily activities, such as heel strike, stepping off a curb or walking down stairs. However, while traditional total knee replacements either spare or substitute for the posterior cruciate ligament, the ACL is excised and not replaced. The anterior cam of the JOURNEY◊ BCS knee system substitutes for the ACL, engaging the post through early flexion as needed to prevent anterior translation and provide stability in early gait. The more anatomic shape of the components leads to enhanced stability throughout flexion-extension.

Strength

The shape and position of the JOURNEY BCS knee system enhance quadriceps function and efficiency.

In extension, the tibial insert's geometry allows the femur to sit rotated internally, allowing for screwhome. This efficient stance lessens fatigue by not requiring the quadriceps to continually fire.   Tibial insert geometry
     
The increased lateral rollback of the JOURNEY BCS lengthens the quadriceps moment arm, allowing for increased quad efficiency and greater strength during chair rise and other activities.   Increased lateral rollback

Flexion

Larger medial posterior offset allows for greater flexion; extended femoral condyle allows for increased contact area in deep flexion   Larger medial posterior offset allows for greater flexion
     
Quadriceps mechanism is kept straight due to external rotation of femur; minimizing patellofemoral medial-lateral shear forces   Quadriceps mechanism is kept straight due to external rotation of femur