JII BCS Exam: Knee Issues! Quiz

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| By SmithNephew1

SmithNephew1

Community Contributor

Quizzes Created: 7 | Total Attempts: 912

Questions: 12 | Attempts: 93 | Updated: Mar 20, 2023

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Questions and Answers

1.

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? Please choose all correct response/s below.
- A.
  
  Paradoxical motion
- B.
  
  Iliotibial band syndrome
- C.
  
  Dislocation
- D.
  
  Stiffness requiring manipulation under anaesthesia
Correct Answer(s)
B. Iliotibial band syndrome
C. Dislocation
D. Stiffness requiring manipulation under anaesthesia

Explanation
The complications identified in the literature are Iliotibial band syndrome, Dislocation, and Stiffness requiring manipulation under anesthesia.

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2.

ITB friction or traction syndrome is a relatively common injury associated with running and is frequently reported in relation to total knee arthroplasty.
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
ITB friction or traction syndrome is a relatively common injury associated with running, but it is not frequently reported in relation to total knee arthroplasty. Therefore, the statement is false.

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3.

Which clinical paper reported ITB syndrome in JBCS Knees?
- A.
  
  Bellman (2010)
- B.
  
  Luckyx et al (2010)
- C.
  
  Haas et al (2010)
- D.
  
  Synder et al (2010)
Correct Answer
B. Luckyx et al (2010)
4.

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)
Correct Answer
C. Arnout et al (2011)
5.

Luyckx et al (2010) reported outcomes for 1,070 JBCS knees at a mean follow up of 2.5 years. Device survival of 98% was reported, with partial or total revision as the primary endpoint. However, symptoms of iliotibial band (ITB) syndrome were observed in ___ % of patients at a mean of six months follow-up. After further rehabilitation, pain during flexion persisted in 2% of these patients resulting in surgical ITB release. (Fill in the blank)

Correct Answer
7.2
7.2%
seven point two
seven
7
7%
seven percent

Explanation
7.2%

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4
6.

The iliotibial tract or iliotibial band (also known as Maissiat's band or IT Band) is a longitudinal fibrous reinforcement of the fascia lata.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
The explanation for the given correct answer is that the iliotibial tract, also known as the iliotibial band or IT Band, is indeed a longitudinal fibrous reinforcement of the fascia lata. This band runs along the outside of the thigh, from the hip to the shin, and helps stabilize the knee joint during movement.

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7.

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
Correct Answer
C. Excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients

Explanation
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 far forward in relation to the tibia during knee flexion, it causes the ITB to be stretched and loaded in a way that it is not designed to handle. This excessive loading can contribute to the development of ITB traction syndrome. The other options, inadequate translation of the femur in flexion and the normal screw home position of the JBCS, are not mentioned as contributing factors in the study.

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8.

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
Correct Answer
D. B & C

Explanation
The excessive external rotation and excessive posterior position of the tibial component contribute to increased tension in the ITB. When the tibial component is externally rotated or positioned too far back, it can cause the iliotibial band (ITB) to become stretched and strained, leading to increased tension. This misalignment can disrupt the normal biomechanics and function of the knee joint, potentially causing pain and instability. Therefore, both excessive external rotation and excessive posterior position of the tibial component are factors that contribute to increased tension in the ITB.

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9.

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
Correct Answer
D. All of the above

Explanation
The correct answer is "All of the above." This is because the factors mentioned in the options - high flexion, low jump distance, and excessive femoral rollback - were noted as potentially contributing to the posterior dislocation of the tibia relative to the femur. These factors can cause consistent soft-tissue stretch and laxity, leading to dislocation.

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10.

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
Correct Answer
A. Excessive medial and lateral tibiofemoral posterior translation

Explanation
The correct answer is excessive medial and lateral tibiofemoral posterior translation. This means that there is excessive movement of the tibia (shin bone) in relation to the femur (thigh bone) towards the back of the knee joint. This excessive posterior translation can lead to stiffness and anterolateral joint pain. The other options, such as patella maltracking, excessive anterior translation, and chronic preoperative osteoarthritis, do not directly explain the reported cases of stiffness and pain.

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11.

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
Correct Answer
D. B & C

Explanation
Arnout et al (2011) recommended the use of a knee joint balancer to optimally balance the flexion space and 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. This is to overcome the issue of soft tissue stretching and dislocation of the implant.

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12.

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 NJRR.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
The given answer is true because the AOA NJRR Annual Report identified the JOURNEY BCS Knee as having a higher than expected revision rate. The statement also suggests that the incidence of ITB pain likely contributed to this higher revision rate. Therefore, it can be concluded that the incidence of ITB pain is likely to have contributed to the Journey BCS revision rate in the AOA NJRR.

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Current Version
Mar 20, 2023

Quiz Edited by
ProProfs Editorial Team
Nov 30, 2014

Quiz Created by
SmithNephew1

JII BCS Exam: Knee Issues! Quiz

ITB friction or traction syndrome is a relatively common injury associated with running and is frequently reported in relation to total knee arthroplasty.

Which clinical paper reported ITB syndrome in JBCS Knees?

Which clinical paper reported dislocation in JBCS Knees?

The iliotibial tract or iliotibial band (also known as Maissiat's band or IT Band) is a longitudinal fibrous reinforcement of the fascia lata.

What did Luyckx et al (2010) suggest contributed to the ITB traction syndrome?

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?

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?

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…

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?

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 NJRR.