title: Consecutive series of 226 journey bicruciate substituting total knee replacements: early complication and revision rates.
abstract: BACKGROUND
  The Journey bicruciate substituting (BCS) total knee replacement (TKR) is intended to improve knee kinematics by more closely approximating the surfaces of a normal knee. The purpose of this analysis was to address the safety of Journey BCS knees by studying early complication and revision rates in a consecutive case series.
  
  
  METHODS
  Between December 2006 and May 2011, a single surgeon implanted 226 Journey BCS total knee prostheses in 191 patients (124 women, 67 men) who were eligible for study. Mean age at surgery was 68 years (41-85 years).Outcome measures were early complications and minor and major revision rates. All complications were considered, irrespective of whether conservative treatment or revision was required.
  
  
  RESULTS
  The average implantation time was 3.5 years (range 1.3-5.8 years). Thirty-three complications (14.6% of 226 knees) required minor or major revision surgery in 25 patients. The remaining eight patients were treated conservatively. Sixteen minor revisions were performed in 12 patients. Thirteen major revisions were required in 13 patients, which results in a rate of 1.65 major revisions per 100 component years. The linear trend of the early complication rate by treatment year was not significant (p = .22).Multivariate logistic regression showed no significant predictors for the occurrence of a complication or for revision surgery. A tendency towards higher complication rates was observed in female patients, although it was not significant (p = .066).
  
  
  CONCLUSIONS
  The complication and revision rates of the Journey BCS knee implant are high in comparison with those reported for other established total knee systems. Caution is advised when using this implant, particularly for less experienced knee surgeons.
authors.affiliation: Department of Orthopaedic Surgery, Salem Spital, Schänzlistrasse 39, 3000 Bern 25, Switzerland. bernhard.christen@ortho-klinik.ch.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Christen
authors.forename: Michal
authors.initials: M
authors.lastname: Neukamp
authors.forename: Emin
authors.initials: E
authors.lastname: Aghayev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011475:Prosthesis Failure / Q000009:adverse effects* / Q000639:trends*; D012086:Reoperation / Q000639:trends; D012189:Retrospective Studies; D016896:Treatment Outcome