Journey Bicruciate Stabilised Total Knee Replacement - A Survival Analysis of a Full Single Hospital Cohort of Implants at a Minimum of Ten-years

Background The original Journey BCS total knee arthroplasty (Smith & Nephew, Watford, UK) is a bicruciate stabilised (BCS) total knee arthroplasty. Dislocations and anterior knee pain led to the introduction of the Journey II system in 2013. We reviewed the ten-year survival in our institution. Methods All Journey BCS total knee replacements were included. Study period was November 2010 to July 2013. Microsoft Excel was used. The primary outcome was ten-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 ten-year Oxford and WOMAC scores. Results 275 Journey BCS total knees were untaken. Mean follow up of 10.3 years with 192 remaining. All cause revision at ten-years was 82.75%(95% CI 87.14 – 77.34%), excluding dislocation and patellar resurfacing ten-year survival was 95.03% (95% CI: 97.15 - 92.59%), ten-year aseptic loosening survival rate was 97.72% (95% CI: 99.00 - 95.08%) and ten-year worst case scenario was 82.70% (95% CI: 87.12 - 77.24%). Mean ten-year Oxford score was 29.5 and WOMAC was 34.5. Conclusion Ten-year survival shows a re-operation rate of 82.75%. Predominant early failures were secondary patellar resurfacing and dislocations. Although a comparable aseptic loosening rate to other implants. A concerning late mode of failure in peg fracture has been identified, and further research is required.