JII BCS Exam Questions! Trivia Quiz!

The native knee anatomy is asymmetrical, meaning that it is not symmetrical or evenly balanced on both sides. This means that the structures and components of the knee joint are not identical or mirrored on both sides. Understanding this characteristic is important for properly diagnosing and treating knee issues and injuries.

The original JBCS insert was modified by increasing the post height by an average of 2-3mm and squaring off the top of the post. This change was made to address the complication of dislocation.

The study by Noble et al. (2005) found that patients who had total knee arthroplasty (TKA) experienced substantial functional impairment when compared with their age and gender matched peers. This suggests that undergoing TKA did not result in functional outcomes similar to their peers or substantial functional improvement.

The normal screw home position of the JBCS refers to the natural position of the knee joint where it rests in its anatomical position. In this position, the quadriceps muscle does not need to exert additional effort to maintain stability in extension. Therefore, the statement is true.

The original JBCS post being "rounded" at the top means that it had a curved or rounded shape at the upper part. This curvature made it more prone to varus/valgus dislocation, which refers to the inward or outward displacement of a bone or joint. Therefore, the statement is true because the rounded shape of the post increased its vulnerability to varus/valgus dislocation.

The rationale for a kinematic knee is contributed by all of the factors mentioned. Conventional knee designs do not replicate the normal anatomy of the knee, which leads to an inability to restore normal kinematics and muscular efficiency. Additionally, these designs do not provide the same levels of satisfaction and return to function as seen in total hip arthroplasty (THA). The prevalence of younger and more demanding patients also plays a role in the rationale for a kinematic knee, as they require a knee replacement that can better meet their needs and expectations.

The statement is false because satisfaction levels and return to functional activity following Total Knee Arthroplasty (TKA) are generally lower compared to Total Hip Arthroplasty (THA). TKA involves replacing the knee joint, which is a weight-bearing joint and can lead to more pain and longer recovery time compared to THA, which involves replacing the hip joint. Consequently, patients who undergo TKA may experience lower satisfaction levels and take longer to return to their normal level of activity compared to THA patients.

The JBCS Knee System is able to restore normal knee function by increasing anterior-posterior stability throughout knee flexion and promoting a normal kinematic pattern. These two factors work together to ensure that the knee joint functions properly and moves in a way that is natural and efficient. By improving stability and promoting a normal pattern of movement, the JBCS Knee System helps to alleviate pain and improve overall function of the knee joint. Therefore, the correct answer is A & B.

The higher than expected revision rate of the JOURNEY BCS Knee identified in the AOA NJRR Annual Report is likely due to the incidence of ITB pain. This suggests that patients who underwent the JOURNEY BCS Knee procedure experienced ITB pain, which may have led to the need for revision surgeries. Therefore, the statement "True" is correct.

The correct answer is JOURNEY BCS (JBCS). This knee design was the first 'guided-motion' kinematically accurate knee system on the market.

The correct answer is A & C. The JBCS tibial insert was designed to mimic the native articular surfaces by having a concave medial and convex lateral shape, which provides medial stability and increased posterior translation of the lateral condyle during flexion. This design feature helps to replicate the natural movement and stability of the knee joint, enhancing the overall performance and function of the implant.

The high-level rationale behind evolving the original JOURNEY BCS (JBCS) System was to complete the system, improve functionality, and increase repeatability. This means that the original system may have been incomplete, lacked certain functionalities, or was not able to be repeated consistently. Therefore, the decision to evolve the system was made to address these issues and ensure that the system is fully functional, has improved features, and can be repeated reliably.

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The correct answer is excessive medial and lateral tibiofemoral posterior translation. This means that there is excessive movement of the tibia (shinbone) and femur (thighbone) in the backward direction. This can lead to stiffness and the need for manipulation under anesthesia. Digennaro et al (2014) suggest that this excessive posterior translation is the cause of reported cases of stiffness and anterolateral joint pain in JBCS complications.

Luyckx et al (2010) suggested that excessive translation of the femur in flexion leads to increased eccentric loading of the ITB in some patients. This means that when the femur moves too much in relation to the tibia during flexion of the knee, it puts more stress on the ITB, which can contribute to the development of ITB traction syndrome. The inadequate translation of the femur in flexion and the normal screw home position of the JBCS are not mentioned as factors contributing to ITB traction syndrome in the given information. Therefore, the correct answer is excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients.

The correct answer is B & C. According to Ries et al (2010), excessive external rotation and excessive posterior position of the tibial component contribute to increased tension in the ITB. These issues affect the alignment of the tibial component relative to the femoral component, which are coupled by the guided motion mechanism. Aseptic loosening of the tibial component is not mentioned as a contributing factor to increased tension in the ITB.

The statement suggests that the stiffness of the original JBCS knee system was caused by the limited rollback of the femoral component, which placed excessive stresses on the soft tissues. However, the correct answer is false, meaning that this statement is not accurate. Therefore, the explanation for the correct answer is that the stiffness of the original JBCS knee system was not attributed to the limited rollback of the femoral component, contradicting the statement given.

The complications identified in the literature for the Journey BCS knee system (JBCS) include Iliotibial band syndrome, dislocation, and stiffness requiring manipulation under anesthesia. These complications have been highlighted in four key clinical papers, despite the published evidence supporting the efficacy of the JBCS in terms of kinematics.

The correct answer is A & B. Conventional knee design can result in paradoxical motion in two ways. First, the lack of ACL function can lead to anterior sliding of the femur during flexion, which is contradictory to the normal movement. Second, during flexion, the knee may pivot laterally instead of the naturally occurring medial pivot. Both of these motions are paradoxical and can occur as a result of conventional knee design.

Arnout et al (2011) recommended 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, as well as the use of a knee joint balancer in order to optimally balance the flexion space.

The correct answer is A & B. The key design changes that improved kinematics by reducing early rollback were elevating the posterior cam superiorly and reducing its size, as well as shifting the post 2mm anteriorly. These changes allowed for a later engagement of the posterior cam in flexion, specifically around 60-70 degrees.

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The key changes to address IT band syndrome include thinning the anterior flange and reducing the lateral condyle, as well as shifting the post anteriorly and elevating the posterior cam superiorly. These changes help to alleviate the complications associated with the JBCS and provide a better solution for IT band syndrome.

The correct answer is that the JOURNEY II BCS Knee full market release took place in March 2013 at the AAOS in the US, and more than 20,000 JOURNEY II BCS procedures have been completed. Additionally, in Australia, the first JOURNEY II BCS knee was implanted in August 2013.

The results of the study showed that 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. Additionally, all patients demonstrated a combination of relatively normal locomotion and gait, coupled with clear femoral external rotation and translation.

The correct answer is that the anterior cam and post replicate the function of the ACL, preventing anterior tibial translation (posterior femoral translation) and providing stability early in gait. The posterior cam and post replicate the function of the PCL, providing posterior stability and limiting posterior translation of the tibia (femoral anterior translation).

The JII PS box has increased in size in order to accept a constrained insert (bail out option). This means that the box has been made larger to accommodate the insertion of a specific type of insert that is designed to provide additional support or stability in certain situations. By increasing the size of the box, the JII PS can now accept this insert and provide the desired functionality.

The given correct answer is "All of the above." This means that all three factors mentioned - high flexion, low jump distance, and excessive femoral rollback - were noted as potentially contributing to the dislocation of the tibia relative to the femur.

The correct answer is that over 40,500 JBCS knees have been implanted globally by over 250 surgeons, and 2300 of these were implanted in Australia. Additionally, over 65,000 JBCS knees have been implanted globally by over 600 surgeons, and 3346 of these were implanted in Australia. The global full market release of the JBCS knee system took place in March 2006 at the AAOS, where it won the most innovative product award.