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Smith
Nephew
JOURNEY™ BCS
Bi-Cruciate Stabilized Knee System
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Why is precision powerful?
Why is simplicity superior?
JOURNEY◊ Active Knee Solutions
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
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Traditional TKA Implants
- Symmetric coronal and sagittal femoral condyles
- Symmetric tibial inserts
- 0° joint line
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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
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| Normal Knee |
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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
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| Traditional TKA |
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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
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| JOURNEY◊ BCS Knee |
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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
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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.
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.
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. |
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| 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. |
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| Larger medial posterior offset allows for greater flexion; extended femoral condyle allows for increased contact area in deep flexion |
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| Quadriceps mechanism is kept straight due to external rotation of femur; minimizing patellofemoral medial-lateral shear forces |
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