Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

Abstract

Background:Previous studies have shown a high incidence of complications with a bi-cruciate stabilized (BCS) guided-motion total knee arthroplasty (TKA) design, which led to recent modifications of the design by the manufacturer.Objective:The current study was undertaken to assess whether the use of this TKA system with an extension-first surgical technique is associated with a similar rate of short-term adverse outcome as reported in literature.Material and Methods:This retrospective study enrolled 257 consecutive patients (257 knees) undergoing TKA for osteoarthritis of the knee, with the first 153 receiving cemented Journey BCS I implants and the remaining 104 receiving cemented Journey BCS II implants when these became available.Results:Mean follow-up time for the cohort was 24.5 ± 7.8 months (range, 12 - 36 months). There were no cases of stiffness. Incidence of iliotibial friction syndrome was considered low: three (2.0%) knees in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). Five (2.5%) knees presented with mild instability in midflexion, three (2.0%) in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). One patient with a BCS I implant required reoperation for aseptic loosening 23 months postoperatively. At one-year follow-up, there were no clinically relevant differences in any of the clinical outcomes.Conclusion:When used in combination with an extension-first surgical technique, good early functional results with an acceptable rate of complications were obtained with both the original and the updated Journey BCS knee implant.

Does Postoperative Mechanical Axis Alignment Have an Effect on Clinical Outcome of Primary Total Knee Arthroplasty? A Retrospective Cohort Study

“…Standard instrumentation was used for the proximal tibial and the distal femoral cuts. The “extension gap-first technique” was used to perform gap balancing with a balancer device [ 11 , 12 ]. A balancer device was used to distract the femur from the proximal tibia.…”

Second-generation bi-cruciate stabilized total knee system has a lower reoperation and revision rate than its predecessor

“…Hommel and Wilke assessed differences between JOURNEY™ I and JOURNEY™ II in 257 patients with osteoarthritis of the knee [ 35 ]. The first 153 patients received JOURNEY™ I and the remaining 104 patients received JOURNEY™ II.…”

“…The re-designed JOURNEY™ II was introduced in 2012, featuring a design modification of the femoral component and the polyethylene insert. One study published in 2017 compared the performance of JOURNEY™ I and JOURNEY™ II, but the follow-up period was brief and certain important variables differed between the two treatment groups [ 35 ]. Currently, there are no studies with long-term follow-up describing the clinical performance of JOURNEY™ II.…”

Guided-Motion Bicruciate-Stabilized Total Knee Arthroplasty Reproduces Native Medial Collateral Ligament Strain

“…The goal of guided-motion BCS TKA is to facilitate guided motion that is closest to normal knee kinematics. A growing body of evidence supports that guided-motion BCS TKA can mimic native knee kinematics, improve recovery and activity, and provide more natural knee sensations compared to conventional TKA [5,6,[8][9][10][11]. However, the biomechanical mechanisms that underlie these improved results remain unclear.…”

“…Medicina 2022, 58, 1751 2 of 9 recovery and activity, and provide more natural knee sensations compared to conventional TKA [5,6,[8][9][10][11]. However, the biomechanical mechanisms that underlie these improved results remain unclear.…”