Journey II BCS Final Exam (Qld)

The JOURNEY II BCS utilizes PHYSIOLOGICAL Matching Technology to provide superior motion, durability, and function. This means that the prosthetic device is designed to mimic the natural movement and function of the human body, ensuring a more comfortable and efficient experience for the user. Additionally, the use of advanced materials and construction techniques enhances the durability of the device, allowing it to withstand the demands of daily activities. Overall, the JOURNEY II BCS offers unmatched performance in terms of motion, durability, and function.

The JOURNEY II Knee system offers six design parameters that are unique to the system. These include a Physiological Joint Line, an Asymmetric Posterior Cam, and an Anterior Cam. Therefore, the correct answer is "All of the above."

The JOURNEY II BCS system has several great features that set it apart from competitive systems. One of these features is the ability to chisel through a template, which allows for more precise and accurate bone preparation during surgery. Additionally, the system also allows for reaming through a femoral trial, which helps to ensure a proper fit and alignment of the implant. These features, combined with the box conserving design of the system, make the JOURNEY II BCS a superior choice compared to other systems.

The statement "Satisfaction levels and return to functional activity following TKA are the same as that of THA" is incorrect. TKA (Total Knee Arthroplasty) and THA (Total Hip Arthroplasty) are two different surgical procedures used to replace the knee and hip joints, respectively. While both procedures aim to improve function and reduce pain, the satisfaction levels and return to functional activity may vary between the two. Therefore, the correct answer is False.

The correct answer is "All of the above". This means that all of the mentioned supportive technologies (VISIONAIRE cutting guides, OrthAlign - KneeAlign technology, and VISIONAIRE digital templating) will be available with the JOURNEY II BCS knee system.

The native knee anatomy is asymmetrical, meaning that it is not the same on both sides. This is an important characteristic to understand because it can affect the function and movement of the knee joint. The asymmetry of the knee allows for different ranges of motion and stability in different directions, which is necessary for activities such as walking, running, and changing direction. Understanding this characteristic is crucial for healthcare professionals when diagnosing and treating knee-related conditions and injuries.

The correct answer is "q angle". The q angle refers to the angle formed between the quadriceps muscle and the patella tendon. It is used to assess the alignment of the knee joint and can be an indicator of potential knee issues or imbalances.

The JOURNEY II BCS knee system is designed to provide stability throughout the entire range of motion. This means that regardless of the position of the knee joint, the system is able to maintain stability and prevent any unwanted movement or instability. This is an important feature for knee replacement patients, as it allows them to have confidence in their knee joint and perform various activities without the fear of dislocation or instability. Therefore, the statement "The JOURNEY II BCS knee system delivers stability through range of motion" is true.

The JOURNEY II BCS uses PHYSIOLOGICAL Matching Technology to restore the anatomic joint line at a three-degree angle. This technology ensures that the joint line is aligned correctly, allowing for proper joint function and stability. By restoring the joint line, the JOURNEY II BCS helps to improve overall joint performance and patient outcomes.

The correct answer is OXINIUM + XLPE. JOURNEY II BCS is available in VERILAST technology, which is a combination of OXINIUM and XLPE materials.

The correct answer is JOURNEY BCS. The Journey BCS is the first guided-motion kinematically accurate knee design on the market. This system provides a more natural and accurate motion for the knee, resulting in improved patient outcomes.

Excessive external rotation and excessive posterior position of the tibial component both contribute to increased tension in the ITB. These issues can lead to abnormal biomechanics and alignment of the knee joint, causing the ITB to become tight and potentially leading to ITB syndrome. Aseptic loosening of the tibial component, on the other hand, does not directly contribute to increased tension in the ITB.

The given statement is true. The AOA NJRR Annual Report found that the JOURNEY BCS Knee had a higher than expected revision rate. The report suggests that the incidence of ITB pain (iliotibial band pain) is likely to have contributed to the higher revision rate of the JOURNEY BCS Knee in the AOA NJRR. This means that the knee replacement surgery using the JOURNEY BCS Knee had a higher likelihood of needing a revision due to ITB pain.

The correct answer is "PHYSIOLOGICAL". The explanation is that the ___MATCHING™ Technology of the JOURNEY II BCS Knee System uses proprietary virtual technology (LifeMOD) to simulate how the implant interacts with the knee's soft tissue envelope. This simulation allows for improved function and reproducibility, making the implant more compatible with the physiological aspects of the knee.

The given statement indicates that there have been no reported cases of ITB syndrome or revisions for the 67 JOURNEY II BCS knees implanted in Australia. This suggests that the knee implants have been successful and have not caused any complications or issues requiring revisions. Therefore, the answer is true.

The statement suggests that the JOURNEY II BCS knee system is marketed towards orthopaedic surgeons who are looking for alternative treatment options for knee replacements. This implies that the product offers something different or additional compared to traditional knee replacements. Therefore, the statement is true.

The JOURNEY II BCS PS box has increased in size in order to accommodate a constrained insert, which provides a bail out option. This means that if there are any complications or issues during the surgery, the surgeon can use the constrained insert as a backup plan to ensure stability and proper alignment of the knee joint. By increasing the size of the box, the surgeon has more flexibility and options during the procedure, ultimately improving the overall outcome for the patient.

The quadriceps muscle group consistently shows greater muscular effort in conventional knees compared to a non-operated leg. This means that the quadriceps muscles are working harder in a knee that has undergone surgery or is affected by a knee condition. This increased effort may be due to the need to compensate for any weakness or instability in the knee joint, or to support the overall function and movement of the leg.

The statement is false because the flexed posterior cut is indeed a unique design feature of JOURNEY II BCS. Other competitive knee systems do not share this same design feature.

The percentage of patients who experienced symptoms of iliotibial band (ITB) syndrome at a mean of six months follow-up was 7.2%. After further rehabilitation, 2% of these patients continued to experience pain during flexion, leading to surgical ITB release.

The changes made to the original JBCS insert to address the complication of dislocation include increasing the post height by an average of 2-3mm and squaring off the top of the post. This modification aims to provide better stability and prevent dislocation by increasing the contact area and improving the fit between the insert and the joint.

The JOURNEY II BCS system should be targeted to both Early Adopters and Early Majority surgeon groups in relation to customer segmentation. Early Adopters are typically the first to adopt new technologies and are willing to take risks, making them ideal candidates for introducing the JOURNEY II BCS system. On the other hand, the Early Majority group follows the Early Adopters and represents a larger portion of the market. Therefore, targeting both groups ensures a wider reach and adoption of the JOURNEY II BCS system.

The Attune and Triathlon competitive knee systems do not have an anatomical baseplate like the JOURNEY II BCS system. The Persona knee system, on the other hand, does have an anatomical baseplate. Therefore, the correct answer is A & B.

SNAPP is the correct answer because it is the name of the Smith and Nephew IPAD application that can be used as a selling aid for JOURNEY II BCS.

The rationale for a kinematic knee is provided by all of the factors mentioned. Conventional knee designs are unable to replicate the normal anatomy and kinematics of the knee, which can lead to decreased muscular efficiency. Additionally, these designs may 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 contributes to the need for a kinematic knee that can better meet their functional requirements.

In extension, the knee adopts the screw home position, which is a position of stability. This position is achieved by the femur internally rotating 5° due to the pull of the ACL. In this position, the knee joint becomes more congruent, meaning the surfaces of the femur and tibia fit together better, increasing stability. Additionally, in this position, quadriceps activity is not required as the knee is already stable.

The correct answer is Anatomic Shapes and Replication of both ACL & PCL function. These features contribute to the unmatched stability delivered by the JOURNEY II BCS system. Anatomic shapes ensure a better fit and alignment with the patient's anatomy, enhancing stability. Replication of both ACL and PCL function means that the system mimics the natural function of these ligaments, further improving stability during movement and activities. Non-anatomic shapes and none of the above are incorrect because they do not contribute to the system's stability.

The correct answer is 155 Degrees. The JOURNEY II BCS allows for anatomic deep flexion of up to 155 degrees. This means that the device provides a range of motion that allows for a significant amount of bending at the joint, enabling the user to achieve a more natural and comfortable movement.

The literature identifies three complications associated with the JBCS: Iliotibial band syndrome, dislocation, and stiffness requiring manipulation under anesthesia.

Luyckx et al (2010) suggested that excessive translation of the femur in flexion leads to increased eccentric loading of the ITB in some JBCS patients. This means that when the femur moves too much in relation to the ITB during flexion of the knee, it puts extra strain on the ITB, which can contribute to 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 this study. Therefore, the correct answer is excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients.

The study by Noble et al. (2005) found that patients who had TKA (total knee arthroplasty) experienced substantial functional impairment when compared with their age and gender matched peers. This suggests that TKA may not result in functional outcomes similar to that of their peers, and there is no evidence of substantial functional improvement. Therefore, the correct answer is "Substantial functional impairment when compared with their age and gender matched peers."

The explanation for the correct answer is that the distal condylar radius of the medial condyle of the femur is described as having a "round" shape. This means that it is more circular in shape compared to the "flat" shape of the distal condylar radius of the lateral condyle.

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.

The explanation for the answer "False" is that the statement suggests that the stiffness of the original JBCS knee system was due to excessive stresses on the soft tissues caused by limited roll back of the femoral component. However, this statement is not true.

The given statement states that the JOURNEY II BCS System has been launched in the public system in Australia. The answer "True" indicates that this statement is correct.

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 goal was to enhance the system by adding missing components, enhancing its features, and making it more reliable and consistent. By achieving all of these objectives, the JBCS system would become more comprehensive, efficient, and user-friendly.

The correct answer is A & B. Conventional knee designs can result in paradoxical motion, where the lack of ACL function leads to anterior sliding of the femur during flexion. Additionally, during flexion, the knee may pivot laterally instead of the naturally occurring medial pivot. Both of these motions can occur as a result of conventional knee designs.

The key design changes that improved kinematics by reducing early rollback (posterior cam & post engage later in flexion ~60-70⁰) are the elevation of the posterior cam superiorly and the reduction in size of the cam. Additionally, the post is shifted 2mm anteriorly and 2mm posteriorly. Both options A and B contribute to the improvement in kinematics by reducing early rollback.

The results of the study showed that the more physiological knee motion in JBCS patients 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 key changes that have addressed the ITB syndrome observed with the original JBCS are the thinning of the anterior flange and the reduction of the lateral condyle. Additionally, the post has been shifted anteriorly and the posterior cam has been elevated superiorly. These design changes aim to alleviate the complications associated with the ITB syndrome and improve the functionality and performance of the JIIBCS knee system.

The correct answer includes all three options because they are all noted as potentially contributing to soft tissue stretching. High flexion can cause the cam to rise onto the post, which could lead to dislocation if there is a loose flexion space. Low jump distance, combined with the relative position of the cam and a rounded post design, can also contribute to dislocation. Additionally, excessive femoral rollback can result in consistent stretch on soft tissues, leading to laxity, particularly in flexion.

The first global implantation of the JOURNEY II BCS system took place in December of 2011.

The correct answer states that the medial tibial condyle is concave in shape and the lateral tibial condyle is convex in shape. This means that the surface of the tibia on the inner side (medial) is curved inward, while the surface on the outer side (lateral) is curved outward. This is a characteristic of the articular geometry of the tibia. The answer also mentions that there is no constraint on AP (Anterior-Posterior) motion, meaning that the shape of the tibia does not restrict movement in the front-to-back direction.