Bicruciate Substituting Design Does Not Improve Maximal Flexion in Total Knee Arthroplasty

Schimmel, Janneke J. P.; Defoort, Koen C.; Heesterbeek, Petra J.C.; Wymenga, A. B.; Jacobs, Wilco C. H.; Hellemondt, Gijs G. van

doi:10.2106/jbjs.m.00277

Cited by 22 publications

(21 citation statements)

References 23 publications

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“…This in contrast to stiffness rates with the original BCS I design of 22.6% [7], 2.7% [6], and 2.2% [4] reported in the literature. It remains unclear whether the absence of stiffness in our series was supported by the kinematic rotational alignment obtained using an extension-first surgical technique.…”

Section: Discussioncontrasting

confidence: 59%

“…Other authors have reported a high rate of early complications following implantation of the Journey BCS [4, 5, 7]. Of specific concern was a study reporting an increased risk of postoperative iliotibial band (ITB) friction syndrome (7.2%) with this device after a mean follow-up time of 2.5 years (range, 1 – 5 years), which eventually led to a surgical release of the ITB in 2% of these subjects [5].…”

Section: Introductionmentioning

confidence: 99%

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Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

Hommel¹,

Wilke²

2017

TOORTHJ

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Background:Previous studies have shown a high incidence of complications with a bi-cruciate stabilized (BCS) guided-motion total knee arthroplasty (TKA) design, which led to recent modifications of the design by the manufacturer.Objective:The current study was undertaken to assess whether the use of this TKA system with an extension-first surgical technique is associated with a similar rate of short-term adverse outcome as reported in literature.Material and Methods:This retrospective study enrolled 257 consecutive patients (257 knees) undergoing TKA for osteoarthritis of the knee, with the first 153 receiving cemented Journey BCS I implants and the remaining 104 receiving cemented Journey BCS II implants when these became available.Results:Mean follow-up time for the cohort was 24.5 ± 7.8 months (range, 12 - 36 months). There were no cases of stiffness. Incidence of iliotibial friction syndrome was considered low: three (2.0%) knees in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). Five (2.5%) knees presented with mild instability in midflexion, three (2.0%) in the BCS I group and two (1.9%) in the BCS II group (p = 0.676). One patient with a BCS I implant required reoperation for aseptic loosening 23 months postoperatively. At one-year follow-up, there were no clinically relevant differences in any of the clinical outcomes.Conclusion:When used in combination with an extension-first surgical technique, good early functional results with an acceptable rate of complications were obtained with both the original and the updated Journey BCS knee implant.

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Section: Discussioncontrasting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

Hommel¹,

Wilke²

2017

TOORTHJ

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“…_ 1 0 ) T D $ F I G ] maximum flexion angle at post-operative 2years follow-up. 11 Mugnai et al reported a comparison of Journey. BCS and Nonrestrictive Geometry (NRG: posteriorstabilized knee system.…”

Section: Discussionmentioning

confidence: 99%

Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range

Kaneko

Kono

Mochizuki

et al. 2017

Journal of Orthopaedics

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“…However, most studies did not consider the impact of these factors when analyzing the correlation between PCO and ROM. In addition, the difference in the weight-bearing status can affect the flexion angle [ 15 – 17 ]. Even under the same weight-bearing status, active and passive ROM may also differ significantly [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the difference in the weight-bearing status can affect the flexion angle [ 15 – 17 ]. Even under the same weight-bearing status, active and passive ROM may also differ significantly [ 17 , 18 ]. Shi et al reported that an increase in the PTS can significantly increase the postoperative maximal knee flexion in PS TKA [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Effects of Posterior Condylar Offset and Posterior Tibial Slope on Quadriceps Force and Joint Contact Forces in Posterior-Stabilized Total Knee Arthroplasty

Kang

Koh

Son

et al. 2017

BioMed Research International

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This study aimed to determine the biomechanical effect of the posterior condylar offset (PCO) and posterior tibial slope (PTS) in posterior-stabilized (PS) fixed-bearing total knee arthroplasty (TKA). We developed ±1, ±2, and ±3 mm PCO models in the posterior direction and −3°, 0°, 3°, and 6° PTS models using a previously validated FE model. The influence of changes in the PCO and PTS on the biomechanical effects under deep-knee-bend loading was investigated. The contact stress on the PE insert increased by 14% and decreased by 7% on average as the PCO increased and decreased, respectively, compared to the neutral position. In addition, the contact stress on post in PE insert increased by 18% on average as PTS increased from −3° to 6°. However, the contact stress on the patellar button decreased by 11% on average as PTS increased from −3° to 6° in all different PCO cases. The quadriceps force decreased by 14% as PTS increased from −3° to 6° in all PCO models. The same trend was found in patellar tendon force. Changes in PCO had adverse biomechanical effects whereas PTS increase had positive biomechanical effects. However, excessive PTS should be avoided to prevent knee instability and subsequent failure.

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Bicruciate Substituting Design Does Not Improve Maximal Flexion in Total Knee Arthroplasty

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 22 publications

References 23 publications

Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

Good Early Results Obtained with a Guided-Motion Implant for Total Knee Arthroplasty: A Consecutive Case Series

Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range

Biomechanical Effects of Posterior Condylar Offset and Posterior Tibial Slope on Quadriceps Force and Joint Contact Forces in Posterior-Stabilized Total Knee Arthroplasty

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