JII BCS Exam Questions! Trivia Quiz!

30 Questions | By SmithNephew1 | Last updated: Dec 22, 2020 | Total Attempts: 64

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Questions and Answers

1.

Which factors contribute to the rationale for a kinematic knee?
- A.
  
  Conventional knee designs do not replicate the normal anatomy of the knee and thus they are unable to restore normal kinematics and muscular efficiency
- B.
  
  Conventional knee designs do not provide the same levels of satisfaction and return to function as seen in THA
- C.
  
  The prevalence of younger more demanding patients
- D.
  
  All of the above
2.

A key characteristic to understand in relation to the native knee anatomy is that it is…
- A.
  
  Asymmetrical
- B.
  
  Symmetrical
- C.
  
  Convex on both sides
- D.
  
  None of the above
3.

Satisfaction levels and return to functional activity following TKA are the same as that of THA.
- A.
  
  True
- B.
  
  False
4.

A study by Noble et al. (2005) concluded that patients who had TKA experience…
- A.
  
  Substantial functional impairment when compared with their age and gender matched peers
- B.
  
  Functional outcomes similar to that of their age and gender matched peers
- C.
  
  Substantial functional improvement when compared with their age and gender matched peers
- D.
  
  None of the above
5.

What paradoxical motion can occur as a result of conventional knee design?
- A.
  
  The lack of ACL function leads to paradoxical anterior sliding of the femur during flexion
- B.
  
  During flexion the knee may pivot laterally, as opposed to the naturally occurring medial pivot
- C.
  
  During flexion the knee may pivot medially, as opposed to the naturally occurring lateral pivot
- D.
  
  A & B
6.

Which TKA system was the first ‘guided-motion’ kinematically accurate knee design on the market?
- A.
  
  Triathlon CR
- B.
  
  Vanguard PS
- C.
  
  JOURNEY BCS (JBCS)
- D.
  
  ADVANCE Medial-Pivot Knee
7.

The JBCS Knee System restored normal knee function by…
- A.
  
  Increasing anterior-posterior stability throughout knee flexion
- B.
  
  Promoting a normal kinematic pattern
- C.
  
  Placing the femur more posteriorly during full extension to reduce paradoxical motion
- D.
  
  A & B
8.

Which features of the JBCS tibial insert design mimic the native articular surfaces to provide medial stability and increased posterior translation of the lateral condyle during flexion?
- A.
  
  The JBCS tibial insert was designed to be symmetrical in shape to mimic the native tibial plateau
- B.
  
  As with the native tibial plateau the tibial insert was designed with a concave medial and convex lateral shape
- C.
  
  As with the native tibial plateau the tibial insert was designed with a concave lateral and convex medial shape
- D.
  
  A & C
9.

The normal screw home position of the JBCS allowed the knee to rest in its normal anatomical position and thus as in the normal knee, the quadriceps muscle was not required to maintain stability in extension.
- A.
  
  True
- B.
  
  False
10.

The JBCS Knee system featured an anterior and posterior cam. Which of the following statements are correct?
- A.
  
  The anterior cam and post replicated the function of the ACL preventing posterior tibial translation (anterior femoral translation) and providing stability early in gait
- B.
  
  The anterior cam and post replicated the function of the ACL preventing anterior tibial translation (posterior femoral translation) and providing stability early in gait
- C.
  
  The posterior cam and post replicated the function of the PCL, providing posterior stability and limiting posterior translation of tibia (femoral anterior translation)
11.

According to published literature by Morra et al (2004) which knee system most closely replicated the kinematics of a healthy un-operated Knee?
- A.
  
  PFC Rotating Platform
- B.
  
  Vanguard PS
- C.
  
  Triathlon CR
- D.
  
  JBCS
- E.
  
  ADVANCE Medial-Pivot Knee
12.

In published literature by Cantani et al (2009) Knee joint kinematics were assessed in 16 JBCS patients using video-fluoroscopy and electromyography (EMG) during activities of daily-living including stair climbing, chair rising and sitting, and step up/down test. What did the results of this study show?
- A.
  
  All JBCS patients demonstrated femoral external rotation and translation similar to that of other conventional knee designs
- B.
  
  This more physiological knee motion resulted in recovery of normal extensor and flexor muscle function which was attributed to the more anatomical knee design
- C.
  
  All patients demonstrated a combination of relatively normal locomotion and gait, coupled with clear femoral external rotation and translation
13.

Although published clinical evidence supports the efficacy of the Journey BCS knee system (JBCS) in relation to kinematics, there are four key clinical papers that have highlighted complications associated with the JBCS. What are the complications identified in this literature?
- A.
  
  Paradoxical motion
- B.
  
  Iliotibial band syndrome
- C.
  
  Dislocation
- D.
  
  Stiffness requiring manipulation under anaesthesia
14.

Which clinical paper reported dislocation in JBCS Knees?
- A.
  
  Bourne et al (2011)
- B.
  
  Laskin (2011)
- C.
  
  Arnout et al (2011)
- D.
  
  Hass et al (2011)
15.

What did Luyckx et al (2010) suggest contributed to the ITB traction syndrome?
- A.
  
  Inadequate translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients
- B.
  
  The normal screw home position of the JBCS which allowed the knee to rest in its normal anatomical position
- C.
  
  Excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients
- D.
  
  A & B
16.

Arnout et al (2011) reported on four cases (0.3%) of posterior dislocation of the tibia relative to the femur in a series of 1,350 cases. The authors concluded that consistent soft-tissue stretch occurred in these patients. Which factors were noted as potentially contributing to dislocation?
- A.
  
  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
- B.
  
  Low jump distance - due to the relative position of the cam, low height of the post combined with a rounded post design
- C.
  
  Excessive femoral rollback - may contribute to consistent stretch on soft tissues leading to laxity, especially in flexion
- D.
  
  All of the above
17.

The final JBCS complication reported in the literature was that of stiffness requiring manipulation under anesthesia (MUA). Digennaro et al (2014) attribute the reported cases of stiffness and anterolateral joint pain to…
- A.
  
  Excessive medial and lateral tibiofemoral posterior translation
- B.
  
  Patella maltracking
- C.
  
  Excessive medial and lateral tibiofemoral anterior translation
- D.
  
  Chronic preoperative osteoarthritis
18.

The Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR) Annual Report identified the JOURNEY BCS Knee as having a higher than expected revision rate. The Incidence of ITB pain is likely to have contributed to the Journey BCS revision rate in the AOA NJR.
- A.
  
  True
- B.
  
  False
19.

Of primary importance is the alignment of the JBCS tibial component relative to the femoral component as the two are coupled by the guided motion mechanism. According to Ries et al (2010) which of the following tibial component issues contribute to increased tension in the ITB?
- A.
  
  Aseptic loosening of the tibial component
- B.
  
  Excessive external rotation of the tibial component
- C.
  
  Excessive posterior position of the tibial component
- D.
  
  B & C
20.

Which of the following did Arnout et al (2011) recommend in relation to JBCS to overcome the issue of soft tissue stretching and dislocation of the implant?
- A.
  
  Design modification allowing the femur to rest posteriorly in full extension
- B.
  
  The use of a knee joint balancer in order to optimally balance the flexion space
- C.
  
  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
- D.
  
  B & C
21.

Which of the following statements are correct?
- A.
  
  The JOURNEY II BCS Knee full market release took place in March 2013 at the AAOS in the US
- B.
  
  >20,000 JOURNEY II BCS procedures have been completed
- C.
  
  In Australia the first JOURNEY II BCS knee was implanted in August 2013
- D.
  
  >10,000 JOURNEY II BCS procedures have been completed
22.

What was the high-level rationale behind evolving the original JOURNEY BCS (JBCS) System?
- A.
  
  Complete the system
- B.
  
  Improve functionality
- C.
  
  Increase repeatability
- D.
  
  All of the above
23.

Which key design changes improved kinematics by reducing early rollback (posterior cam & post engage later in flexion ~60-70⁰)?
- A.
  
  Posterior cam elevated superiorly and cam reduced in size
- B.
  
  Post shifted 2mm anteriorly
- C.
  
  Post shifted 2mm posteriorly
- D.
  
  A & B
- E.
  
  A & C
24.

Why has the JII PS box increased in size?
- A.
  
  Reduce early rollback
- B.
  
  Reduced strain of popliteal tendon
- C.
  
  Reduced strain of IT and IT patella band
- D.
  
  To accept a constrained insert (bail out option)
- E.
  
  A & D
25.

Although there are a number of changes it is most important to understand those that have specifically addressed the complications as seen with the JBCS. What are the Key changes to address IT band syndrome?
- A.
  
  Post height decreased (on average 2-3mm)
- B.
  
  Thinned anterior flange and reduced lateral condyle
- C.
  
  Post shifted posteriorly & posterior cam lowered inferiorly
- D.
  
  Post shifted anteriorly & posterior cam elevated superiorly