Mid-term Performance of a Guided Motion Bicruciate Stabilized Total Knee System: Results from the International Study of Over 2,000 Consecutive Primary Total Knee Arthroplasties

Abstract Background The JOURNEY™ II Bi-Cruciate Stabilizing Total Knee System (BLINDED) is a second-generation guided-motion knee implant that has been used in over 100,000 primary total knee arthroplasties (TKAs) worldwide. However, performance information is limited. Methods Data for 2,059 primary TKAs were abstracted at seven US and three European sites. Estimates of cumulative incidence of revision were compared with registry data for cemented posterior stabilized implants. Results Average age was 64.3 years (range 18-91); 58.5% were females; 12.3% TKAs were in subjects younger than 55 years. Patellae were resurfaced in 95.9%. Median time since primary TKA was 4.2 years; longest was 6.1 years; 78.9% were three years or more since primary TKA. Of 67 revisions (3.2%), 20 (30%) involved femoral or tibial component removal compared to 42% in the Australian Joint Registry (AOANJRR). All-component revisions accounted for 15/67, femoral component only for 2/67, tibial component only for 3/67, patellar component with/without tibial insert exchange for 17/67, and isolated tibial insert exchange for 30/67. In addition, there were 18 re-operations without component exchange. Component revision indications were infection (33%), mechanical loosening (21%), fracture of bone around the joint (16%), and instability (15%). Kaplan-Meier revision estimate was 3.1 and 3.6 per 100 TKAs at three and five years, respectively, compared to AOANJRR estimates of 3.1 and 4.1 per 100 TKAs. Conclusion The revision rate for the second-generation implant was similar to cemented posterior-stabilized registry controls.