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JOURNEY II AKS

Active Knee Solutions

JOURNEY II Active Knee Solutions family of knee replacement products

Active Knee Solutions

For orthopaedic surgeons seeking treatment solutions beyond traditional knee replacements, JOURNEY II Active Knee Solutions has been engineered to empower patients with a renewed right to an active lifestyle by breaking through traditional knee replacement barriers and delivering  Function, Motion, and Durability through PHYSIOLOGICAL MATCHING

Learn how the JOURNEY II implants are being used with the NAVIO Surgical System for both TKA and UKA


Total Knee Replacement Solutions:

JOURNEY II BCS 

JOURNEY II CR

JOURNEY II XR

Partial Knee Replacement Solutions:

JOURNEY PFJ

JOURNEY UNI

PHYSIOLOGICAL MATCHING for Function, Motion, and Durability:

Function:

Stability

Anatomic, articular surfaces are designed to help restore native anatomy and yield a normal anatomic A/P position throughout the range of motion. 

Strength

More normal muscle firing patterns are expected due to proper A/P positioning, thereby helping to prevent muscle fatigue during activities of daily living.

Satisfaction

Improving patients’ ease of activities of daily living can be expected due to the anticipated improvements of strength and stability. 

Motion:

Flexion

The normal kinematic patterns of movement provide the correct environment to allow an anatomic, deep flexion performance. 

Kinematics

Tibiofemoral

  • Extension
  • Mid-Flexion
  • Deep Flexion

Patellofemoral

  • Provides improved contact which may improve wear performance 1
  • Provides improved patella tracking which may minimize anterior pain 1, 2
  • Provides more freedom of baseplate positioning without maltracking concerns 3

 

Durability:

VERILAST Technology, the combination of OXINIUM Oxidized Zirconium and highly cross-linked polyethylene (XLPE).  Using this technology, JOURNEY II TKA is designed to match the same high standards for wear performance.   

Wear

  • OXINIUM Oxidized Zirconium is an advanced bearing material that combines the strength of metal with the wear resistance of ceramics
  • OXINIUM Technology is 4,900 times more resistant to abrasion than CoCr 4
  • OXINIUM Technology is more than twice as hard as CoCr 5
  • OXINIUM Technology has a coefficient of friction that is up to half that of CoCr 6
  • OXINIUM Alloy femoral components are available for all JOURNEY II Active Knee Solutions products

Metal Sensitivity

  • OXINIUM Oxidized Zirconium, exclusively from Smith & Nephew, addresses the needs of nickel sensitive patients by having <0.0035% nickel content, compared to 0.5% in cobalt chrome and 0.1% in titanium.7
  • Zirconium is a nearly inert material that has not reported to induce immune reactions. 7

 

References

1. Carpenter RD, et al, Magnetic resonance imaging of in vivo patellofemoral kinematics after total knee arthroplasty, The Knee (2009), doi:10.1016/j.knee.2008.12.016.

2. Brilhault J, Ries MD. Measuring patellar height using the lateral active flexion radiograph: Effect of total knee implant design. Knee. 2010 Mar;17(2):148-51. doi: 10.1016/j.knee.2009.07.008.   Epub 2009 Aug 31.

3. Lee GC, Garino JP, Kim RH, Lenz N. Contributions of Femoral, Tibial and Patellar Malposition to Patellar Maltracking in Total Knee Arthroplasty. AAOS. 2013; Poster No. 114.

4. Hunter, G., and Long, M. Abrasive Wear of Oxidized Zr-2.5Nb, CoCrMo, and Ti-6Al-4V Against Bone Cement. 6th World Biomaterials Cong. Trans., Society for Biomaterials, Minneapolis, MN, 2000, p. 835.

5. Long, M., Riester, L., and Hunter, G. no-hardness Measurements of Oxidized Zr-2.5Nb and Various Orthopaedic Materials. Trans. Soc. Biomaterials, 21, 1998, p. 528.

6. Poggie RA, Wert J, Mishra A, et al (1992). Friction and wear characterization of UHMWPE in reciprocating sliding contact with Co-Cr, Ti-6Al-4V, and zirconia implant bearing surfaces. Wear and Friction of Elastomers, Denton R and Keshavan MK, Eds., West Conshohocken, PA: ASTM International.

7. Nasser, S.: Biology of Foreign Bodies: Tolerance, Osteolysis and Allergy in Total Knee Arthroplasty, Edited by J. Bellemans, M.D. Ries and J. Victor; Springer -Verlag, Heidelberg, 2005.

TKA

The goal of the JOURNEY II Total Knee System is to enable a higher level of function for total knee replacement patients–to not only relieve pain, but to help them regain their active lifestyles. 

Function, motion and durability is achieved through the unique features of the JOURNEY II Total Knee System–anatomic alignment, kinematics and advanced bearings. 

Patient outcomes can be directly related to accurate surgical technique and precision instrumentation.

The JOURNEY II BCS, JOURNEY II CR, and JOURNEY II XR instrumentation has been developed to assist surgeons in obtaining accurate and reproducible results and reducing OR time.

Indications for use include:

  • rheumatoid arthritis;
  • post-traumatic arthritis,
  • osteoarthritis or degenerative arthritis;
  • failed osteotomies or unicompartmental replacement.

JOURNEY II TKA chart

To replicate normal knee motion, the JOURNEY II BCS, JOURNEY II CR, and JOURNEY II XR prosthesis provides more mobility in the lateral compartment than other total knee systems 1,2.  For patients that present with significant varus or valgus deformities (> 15º),morbid obesity or deficient collateral ligaments consider whether additional implant constraint is more appropriate. If patients with the above mentioned conditions are scheduled for a JOURNEY II BCS or JOURNEY II CR then assess the flexion space under full ligament tension (eg, laminar spreaders) with the patella reduced and consider having a constrained implant option on hand.

 

Tibial base plate technologies - for JOURNEY II BCS and CR 

DURAHONE Advanced Finishing Process is a patent-pending advanced manufacturing technique developed to improve our tibial baseplate polishing process.

DURAHONE Finishing results in a more consistent and streamlined manufacturing process for the baseplate, while maintaining the proven locking mechanism, anatomic keel and footprint and the highly-polished titanium surface.

JOURNEY II CR and BCS tibial baseplate with DURAHONE advanced finishing

Partial Knee

Partial Knee options

JOURNEY PFJ

  • Anatomic design conforms to patient anatomy and improves patella tracking
  • ‘S’ shaped trochlear groove is designed to provide optimal patella tracking
  • Four peg divergent design allows for superior fixation
  • Grit blasted undersurface has shown excellent long term fixation

JOURNEY UNI

  • Patella bend provides patella relief from impingement while tracking
  • Anatomic bend restores the bone with a more conforming fit and natural feel
  • Round on flat design allows for anatomically driven kinematics
  • Twin peg and scaled to provide excellent fixed bearing tibial fixation
  • Flex cut and divergent lugs ar designed to provide superior femoral fixation for active patients 

References

References

1. US Department of Health and Human Services Agency (HHSA) for Healthcare Research and Quality (AHRQ) Knee Replacements Up Dramatically Among Adults 45 to 64 Years Old. AHRQ News and Numbers, November 3, 2011. Agency for Healthcare Research and Quality, Rockville, MD. (http://www.ahrq.gov/news/nn/nn110311.htm)

2. Phil Noble et al; Does total knee replacement restore normal knee function? 2005; CORR. (431): 157-65.

3. Huch K, Müller KA, Stürmer T, Brenner H, Puhl W, Günther KP. Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study. Ann Rheum Dis. 2005 Dec; 64 (12):1715-20.

4. Comparing patient outcomes after THA and TKA: is there a difference? Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Clin Orthop Relat Res. 2010 Feb; 468(2):542-6. Epub 2009 Sep 4. (http://www.ncbi.nlm.nih.gov/pubmed/19760472)

5. Functional comparison of posterior cruciate-retained versus cruciate-sacrificed total knee arthroplasty. Dorr LD, Ochsner JL, Gronley J, Perry J. Clin Orthop Relat Res. 1988 Nov; (236):36-43. (http://www.ncbi.nlm.nih.gov/pubmed/3180584)

6. Victor J, Mueller JK, Komistek RD, Sharma A, Nadaud MC, Bellemans J. In vivo kinematics after a cruciate-substituting TKA. Clin Orthop Relat Res. 2010 Mar; 468(3):807-14.

7. Zingde SM, Sharma A, Komistek RD, Dennis, DA, Mahfouz, MR. In vivo comparison of kinematics for 1891 non-implanted and implanted knees. AAOS. 2009; Scientific Exhibit No. 22.

8. Zingde SM, Mueller J, Komistek RD, MacNaughton JM, Anderle MR, Mauhfouz MR. In vivo comparison of tka kinematics for subjects having a PS, PCR, or Bi-Cruciate Stabilizing design. Orthopedic Research Society. 2009; Paper No. 2067.

9. Bicruciate-stabilised total knee replacements produce more normal sagittal plane kinematics than posterior-stabilised designs.Ward TR, Burns AW, Gillespie MJ, Scarvell JM, Smith PN J Bone Joint Surg Br. 2011 Jul;93(7):907-13.

10. Catani F, Ensini A, Belvedere C, Feliciangeli A, Benedetti MG, Leardini A, Giannini S. In vivo kinematics and kinetics of a bi-cruciate substituting total knee arthroplasty: a combined fluoroscopic and gait analysis study. J Orthop Res. 2009 Dec;27(12):1569-75.

11. Morra EA, Rosca M, Greenwald JFI, Greenwald AS. The influence of contemporary knee design on high flexion: a kinematic comparison with the normal knee. JBJS Am. 2008; 90: 195-201.

12. The Mark Coventry Award: Articular contact estimation in TKA using in vivo kinematics and finite element analysis. Catani F, Innocenti B, Belvedere C, Labey L, Ensini A, Leardini A. Clin Orthop Relat Res.
2010 Jan; 468(1):19-28. doi: 10.1007/s11999-009-0941-4. Epub 2009 Jun 23.

13. Van Duren BH, Pandit H, Price M, Tilley S, Gill HS, Murray DW, Thomas NP. Bicruciate substituting total knee replacement: how effective are the added kinematic constraints in vivo? Knee Surg Sports
Traumatol Arthrosc. 2012 Oct; 20 (10):2002-10. Epub 2011 Nov 29.

14. Arbuthnot JE, Brink RB. Assessment of the antero-posterior and rotational stability of the anterior cruciate ligament analogue in a guided motion bi-cruciate stabilized total knee arthroplasty. J Med Eng
Technol. 2009;33(8):610-5.

15. Lester DK and Shantharam R. Objective Sagittal Instability of CR-TKA by Functional EMG During Normal Walking. AAOS. 2012; Presentation No. 810.

16.  Pritchett JW. Patient preferences in knee prostheses. J Bone Joint Surg Br. 2004 Sep; 86(7):979-82.

17.  Pritchett JW. Anterior cruciate-retaining total knee arthroplasty. J Arthroplasty. 1996 Feb; 11(2):194-7.

18. Rajgopal A; Dahiya V; Kochhar H. Bi-Cruciate Substituting Total Knee Arthroplasty Early Experience. International Society for Technology in Arthroplasty: 22 Congress. 2009; Poster No. 107.

19. Haas S. Kinematics of the Knee & JOURNEY BCS. Insall Club Annual Meeting. June 2010.

20. Banks SA; Fregly BJ; Boniforti F; Reinschmidt C; Romagnoli S. Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements. Knee Surg Sports Traumatol Arthrosc. 2005 Oct; 13(7):551-6. Epub 2005 Jan 20.

21. Mahfouz MR, Komistek RD, Dennis DA, Hoff WA. In vivo assessment of the kinematics in normal and anterior cruciate ligament-deficient knees. J Bone Joint Surg Am. 2004;86-A Suppl 2:56-61.

22. Carpenter RD, et al, Magnetic resonance imaging of in vivo patellofemoral kinematics after total knee arthroplasty, The Knee (2009), doi:10.1016/j.knee.2008.12.016

23. Brilhault J, Ries MD. Measuring patellar height using the lateral active flexion radiograph: Effect of total knee implant design. Knee. 2010 Mar;17(2):148-51. doi: 10.1016/j.knee.2009.07.008.
Epub 2009 Aug 31.

24. Leopold SS, Silverton CD, Barden RM, Rosenberg AG. Isolated revision of the patellar component in total knee arthroplasty. J Bone Joint Surg Am 2003; 85-A:41–7. (http://www.ncbi.nlm.nih.gov/pubmed/12533570)

25. Breugem SJ, van Ooij B, Haverkamp D, Sierevelt IN, van Dijk CN. No difference in anterior knee pain between a fixed and a mobile posterior stabilized total knee arthroplasty after 7.9 years. Knee Surg Sports Traumatol Arthrosc. 2012 Nov 3. [Epub ahead of print] (http://www.ncbi.nlm.nih.gov/pubmed/23124601)

26. Lee GC, Garino JP, Kim RH, Lenz N. Contributions of Femoral, Tibial and Patellar Malposition to Patellar Maltracking in Total Knee Arthroplasty. AAOS. 2013; Poster No. 114

27. Nha KW, Papannagari R, Gill TJ, Van de Velde SK, Freiberg AA, Rubash HE, Li G. In vivo patellar tracking: clinical motions and patellofemoral indices. J Orthop Res. 2008 Aug;26(8):1067-74.

28. Victor J, Ries M, Bellemans J, Robb WM, Van Hellemondt G. High-flexion, motion-guided total knee arthroplasty: who benefits the most? Orthopedics. 2007 Aug; 30 (8 Suppl): 77–9.
(http://www.ncbi.nlm.nih.gov/pubmed?term=High-flexion%2C%20motion-guided%20total%20knee%20arthroplasty%3A%20who%20benefits%20the%20most)

29. Kuroyanagi Y, Mu S, Hamai S, Robb WJ, Banks SA. In vivo knee kinematics during stair and deep flexion activities in patients with bicruciate substituting total knee arthroplasty. J Arthroplasty. 2012 Jan; 27(1):122-8. doi: 10.1016/j.arth.2011.03.005. Epub 2011 Apr 19.

30. H. M. J. McEwen, P. I. Barnett, C. J. Bell, R. Farrar, D. D. Auger, M. H. Stone and J. Fisher, The influence of design, materials and kinematics on the in vitro wear of total knee replacements, J Biomech, 2005;38(2):357-365.

31. A. Parikh, M. Morrison and S. Jani, Wear testing of crosslinked and conventional UHMWPE against smooth and roughened femoral components, Orthop Res Soc, San Diego, CA, Feb 11-14, 2007, 0021.

32. AA. Essner, L. Herrera, S. S. Yau, A. Wang, J. H. Dumbleton and M. T. Manley, Sequentially crosslinked and annealed UHMWPE knee wear debris, Orthop Res Soc, Washington D.C., 2005, 71.

33. L. Herrera, J. Sweetgall, A. Essner and A. Wang, “Evaluation of sequentially crosslinked and annealed wear debris, World Biomater Cong, Amsterdam, May 28-Jun 1, 2008, 583.

34.  C. Schaerer, K. Mimnaugh, O. Popoola and J. Seebeck, “Wear of UHMWPE tibial inserts under simulated obese patient conditions,” Orthop Res Soc, New Orleans, LA, Feb 6-10, 2010, 2329.

35.  Biomet publication, FDA Cleared Claims for E1 Antioxidant Infused Technology” http://www.biomet.com/orthopedics/getFile.cfm?id=2657&rt=inline

36.  Ref: DePuy Attune 510 K Document K101433 Dec 10, 2010

37.  Ref: Smith & Nephew OR-12-129 (on file with Smith & Nephew)

38.  Hunter, G., and Long, M. Abrasive Wear of Oxidized Zr-2.5Nb, CoCrMo, and Ti-6Al-4V Against Bone Cement. 6th World Biomaterials Cong. Trans., Society for Biomaterials, Minneapolis, MN, 2000, p. 835.

39.  Long, M., Riester, L., and Hunter, G. no-hardness Measurements of Oxidized Zr-2.5Nb and Various Orthopaedic Materials. Trans. Soc. Biomaterials, 21, 1998, p. 528.

40.  Poggie RA, Wert J, Mishra A, et al (1992). Friction and wear characterization of UHMWPE in reciprocating sliding contact with Co-Cr, Ti-6Al-4V, and zirconia implant bearing surfaces. Wear and Friction of Elastomers, Denton R and Keshavan MK, Eds., West Conshohocken, PA: ASTM International.

41.  Nasser, S.: Biology of Foreign Bodies: Tolerance, Osteolysis and Allergy in Total Knee Arthroplasty, Edited by J. Bellemans, M.D. Ries and J. Victor; Springer -Verlag, Heidelberg, 2005

42.  Cartier P, Khefacha A, Sanouiller JL, Frederick K. Unicondylar knee arthroplasty in middle-aged patients: a minimum 5-year follow-up. Orthopedics. 2007 Aug; 30 (8 Suppl):62-5.
(http://www.ncbi.nlm.nih.gov/pubmed?term=cartier%20genesis)

Surgical Showcase

 

JOURNEY II Surgical Showcase Series

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