Conventional knee designs do not replicate the normal anatomy of the knee and thus they are unable to restore normal kinematics and muscular efficiency
Conventional knee designs do not provide the same levels of satisfaction and return to function as seen in THA
The prevalence of younger more demanding patients
All of the above
Asymmetrical
Symmetrical
Convex on both sides
None of the above
True
False
Substantial functional impairment when compared with their age and gender matched peers
Functional outcomes similar to that of their age and gender matched peers
Substantial functional improvement when compared with their age and gender matched peers
None of the above
The lack of ACL function leads to paradoxical anterior sliding of the femur during flexion
During flexion the knee may pivot laterally, as opposed to the naturally occurring medial pivot
During flexion the knee may pivot medially, as opposed to the naturally occurring lateral pivot
A & B
Triathlon CR
Vanguard PS
JOURNEY BCS (JBCS)
ADVANCE Medial-Pivot Knee
Increasing anterior-posterior stability throughout knee flexion
Promoting a normal kinematic pattern
Placing the femur more posteriorly during full extension to reduce paradoxical motion
A & B
The JBCS tibial insert was designed to be symmetrical in shape to mimic the native tibial plateau
As with the native tibial plateau the tibial insert was designed with a concave medial and convex lateral shape
As with the native tibial plateau the tibial insert was designed with a concave lateral and convex medial shape
A & C
True
False
The anterior cam and post replicated the function of the ACL preventing posterior tibial translation (anterior femoral translation) and providing stability early in gait
The anterior cam and post replicated the function of the ACL preventing anterior tibial translation (posterior femoral translation) and providing stability early in gait
The posterior cam and post replicated the function of the PCL, providing posterior stability and limiting posterior translation of tibia (femoral anterior translation)
PFC Rotating Platform
Vanguard PS
Triathlon CR
JBCS
ADVANCE Medial-Pivot Knee
All JBCS patients demonstrated femoral external rotation and translation similar to that of other conventional knee designs
This more physiological knee motion resulted in recovery of normal extensor and flexor muscle function which was attributed to the more anatomical knee design
All patients demonstrated a combination of relatively normal locomotion and gait, coupled with clear femoral external rotation and translation
Paradoxical motion
Iliotibial band syndrome
Dislocation
Stiffness requiring manipulation under anaesthesia
Bourne et al (2011)
Laskin (2011)
Arnout et al (2011)
Hass et al (2011)
Inadequate translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients
The normal screw home position of the JBCS which allowed the knee to rest in its normal anatomical position
Excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients
A & B
High flexion - during flexion the cam rises onto the post towards maximal flexion and in the case of a loose flexion space the cam could in theory become dislocated over the post
Low jump distance - due to the relative position of the cam, low height of the post combined with a rounded post design
Excessive femoral rollback - may contribute to consistent stretch on soft tissues leading to laxity, especially in flexion
All of the above
Excessive medial and lateral tibiofemoral posterior translation
Patella maltracking
Excessive medial and lateral tibiofemoral anterior translation
Chronic preoperative osteoarthritis
True
False
Aseptic loosening of the tibial component
Excessive external rotation of the tibial component
Excessive posterior position of the tibial component
B & C
Design modification allowing the femur to rest posteriorly in full extension
The use of a knee joint balancer in order to optimally balance the flexion space
Design modifications in regards to the height of the polyethylene post in the JBCS implant as well as the relative position of the cam on the femoral component
B & C
The JOURNEY II BCS Knee full market release took place in March 2013 at the AAOS in the US
>20,000 JOURNEY II BCS procedures have been completed
In Australia the first JOURNEY II BCS knee was implanted in August 2013
>10,000 JOURNEY II BCS procedures have been completed
Complete the system
Improve functionality
Increase repeatability
All of the above
Posterior cam elevated superiorly and cam reduced in size
Post shifted 2mm anteriorly
Post shifted 2mm posteriorly
A & B
A & C
Reduce early rollback
Reduced strain of popliteal tendon
Reduced strain of IT and IT patella band
To accept a constrained insert (bail out option)
A & D
Post height decreased (on average 2-3mm)
Thinned anterior flange and reduced lateral condyle
Post shifted posteriorly & posterior cam lowered inferiorly
Post shifted anteriorly & posterior cam elevated superiorly
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