Journey Bicruciate Stabilised Total Knee Replacement-A Survival Analysis of a Full Single Hospital Cohort of Implants at a Minimum of 10 Years.

Abstract

Abstract: The original Journey BCS total knee arthroplasty (Smith and Nephew, Watford, United Kingdom) is a bicruciate-stabilized (BCS) total knee arthroplasty. Dislocations and anterior knee pain led to the introduction of the Journey II system in 2013. We reviewed the 10-year survival in our institution. All Journey BCS total knee replacements were included. The study period was from November 2010 to July 2013. Microsoft Excel was used. The primary outcome was 10-year survival using life tables; end points were re-operation for any reason; revision excluding dislocation-related issues; revision excluding secondary patella resurfacing; aseptic loosening; and a worst-case scenario. Secondary outcomes were 10-year Oxford and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. A total of 275 Journey BCS total knee replacements were undertaken. Mean follow-up of 10.3 years with 192 remaining. All cause revision at 10-years was 82.75% (95% CI: 87.14-77.34), excluding dislocation and patellar resurfacing 10-year survival was 95.03% (95% CI: 97.15-92.59), 10-year aseptic loosening survival rate was 97.72% (95% CI: 99.00-95.08) and 10-year worst case scenario was 82.70% (95% CI: 87.12-77.24). The mean 10-year Oxford score was 29.5, and WOMAC was 34.5. Ten-year survival shows a all cause survival rate of 82.75%. Predominant early failures were secondary patellar resurfacing and dislocations. A concerning late mode of failure in peg fracture has been identified, and further research is required.