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Bi-Cruciate Stabilized Knee System


The JOURNEY II Bi-Cruciate Stabilized knee system has been intricately designed, engineered and tested to facilitate near-normal kinematics;1,2 shown to enhance patient satisfaction and significantly improve patient-reported Knee Society Scores (KSS).3,4

Using physiological matching technology, JOURNEY II BCS has demonstrated pronounced femoral rollback upon flexion and improved mid-flexion medio-lateral stability.5

Rediscover normal

Over 90% of patients return to work within 6 months of surgery.6

23% more flexion than posterior-stabilized TKA after 1 year.3

Evidence demonstrated major revisions of around 1% at 6 years.7


Featuring VERILAST technology, with OXINIUM (oxidized zirconium) and highly cross-linked polyethylene (XLPE), for improved wear performance.8 


Near-complete elimination of paradoxical motion and anterior sliding of the femur during flexion.9-16


Designed to restore anatomic alignment and normal knee kinematic patterns throughout the full range of motion.12-16


 Designed to restore normal kinematics throughout the range of motion and help patients return to normal activities and lifestyle.17,18


Watch: JOURNEY II TKA - A Kinematic Review

The power of robotics assistance

Learn more about NAVIO’s hand held robotics technology NAVIO Handheld Robotics demonstrated that optimal implant planning can replicate the joint line and achieve a balanced range of motion in cruciate-retaining knee arthroplasty, based on individual patient needs.19

Find out more


  1. Grieco TF, Sharma A, Dessinger GM, Cates HE, Komistek RD. In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy. J Arthroplasty. 2018;33(2):565-571
  2. Iriuchishima T, Ryu K. A comparison of Rollback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty. J Knee Surg. 2018;31(6):568-572.
  3. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Tech Orthop. 2018;33:37-41.
  4. Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005;431:157-165.
  5. Verstraete MA, Van Onsem S, Van Eenoo W, et al. Posterior stabilized total knee kinematics: how anatomic do we get today? –an in vivo comparative study considering three different implants. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
  6. Harris AI, Luo TD, Lang JE, Kopjar B. Short-term safety and effectiveness of a second-generation motion-guided total knee system. Arthroplasty Today. 2018;4(2):240-243.
  7. Harris AI, Luo TD, Lang JE, Kopjar B. Performance of second-generation guided motion total knee arthroplasty system: Results from the international multicenter study of over 2,000 primary TKA with up to 6 Years follow-up. Poster presented at AAHKS Annual Meeting. November 1-4 2018. Dallas Texas, USA.
  8. Papannagari R, Hines G, Sprague J, Morrison M. Long-term wear performance of an advanced bearing knee technology. Abstract presented at: ISTA, Dubai, UAE, Oct 6-9, 2010.
  9. Victor J, Mueller JKP, Komistek RD, et al. In Vivo Kinematics after a Cruciate-Substituting TKA. Clin Orthop Relat Res. 2010;468:807-814.
  10. Zingde SM, Mueller JPK, Komistek RD, Mac Naughton JM, Anderle MR, Mahfouz MR. In Vivo Comparison of TKA Kinematics for Subjects with a PS, PCR or Bi-Cruciate Stabilizing Design. Poster presented at: Orthop Res Soc, Las Vegas, NV, Feb 22-25. 2009, Poster No. 2067.
  11. 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;93-B:907-913.
  12. Catani F, Ensini A, Belvedere C, et al. In Vivo Kinematics and Kinetics of a Bi-Cruciate Substituting Total Knee Arthroplasty: A Combined Fluoroscopic and Gait Analysis Study. J Orthop Res. 2009;27(12):1569-1575.
  13. Morra EA, Rosca M, Greenwald JFI, Greenwald AS. The Influence of Contemporary Knee Design on High Flexion: A Kinematic Comparison with the Normal Knee. J Bone Joint Surg Am. 2008;90:195-201.
  14. Catani F, Innocenti B, Belvedere C, et al. The Mark Coventry Award Articular: Contact Estimation in TKA Using In Vivo Kinematics and Finite Element Analysis. Clin Orthop Relat Res. 2010;468(1):19-28.
  15. Van Duren BH, Pandit H, Price M, T et al. Bicruciate substituting total knee replacement: how effective are the added kinematic constraints in vivo? Knee Surg Sports Traumatol Arthrosc. 2012;20(10):2002-2010.
  16. 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):610-615.
  17. Murakami K, Hamai S, Okazaki K, et al. In vivo kinematics of gait in posterior-stabilized and bicruciate-stabilized total knee arthroplasties using image-matching techniques. Int Orthop. 2018;42:2573-2581.
  18. Murakami K, Hamai S, Okazaki K, et al. Knee kinematics in bi-cruciate stabilized total knee arthroplasty during squatting and stair-climbing activities. J Orthop. 2018;15:650-654.
  19. Jaramaz B, Mitra R, Rovinsky D, Neginhal V. A Novel Image-Free Handheld Robot For Bi-Cruciate Retaining Knee Arthroplasty. Poster presented at 19th EFORT Annual Congress. May 30- June 1, 2018. Barcelona, Spain.


Indications for use include:   rheumatoid arthritis; post-traumatic arthritis, osteoarthritis or degenerative arthritis; failed osteotomies or unicompartmental replacement.

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.



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