The JOURNEY^◊ II Total Knee Arthroplasty was designed to restore normal position, normal shapes and normal motion.  Our total knee arthroplasty portfolio offers three different products to address patient needs and disease states.  

Products in the JOURNEY II TKA portfolio:

JOURNEY II BCS

JOURNEY II CR

JOURNEY II XR

Technology and products used with the JOURNEY II TKA portfolio:

VERILAST^◊ Technology for knee replacement

VISIONAIRE^◊ Cutting Guides for knee replacement

NAVIO^◊ Surgical System, robotics-assisted solution 

Features and Benefits of JOURNEY II Total Knee Arthroplasty - Rediscover normal

• Smoother recovery
• Improved function
• Higher patient satisfaction

Smoother recovery

JOURNEY II TKA has been demonstrated to significantly improve flexion by enabling 23º range of motion improvement earlier in the recovery period.³

Improved function

The normal knee designs of JOURNEY II TKA have shown to deliver improvements in both knee function and motion with increased medial/lateral (M/L) stability mid-flexion.^4-6

Higher patient satisfaction

Quicker recovery, improved function and normal kinematic patterns of motion lead to high levels of patient satisfaction.^3-5

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References

1. JOURNEY II TKA Design Rationale 11.17 00225V3 

2. J Orthop. 2017 Jan 7;14(1):201-206. doi: 10.1016/j.jor.2016.12.005. eCollection 2017. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range 

3. Short-term Range of Motion is Increased after TKA with an asymmetric bicruciate stabilized implant. Accepted Poster Presentation, AAOS 2018 New Orleans. Kaitlin M. Carroll, Peter K. Sculco, Brian CMichaels,Richard L. Murphy, Seth A, Jerabek, David J. Mayman 

4. A comparison of Rolback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty. DOI: 10.1055/s-0037-1604445. ISSN 1538-8506. The Journal of Knee Surgery. Takanori Iriuchishima, Keinosuke Ryu 

5. In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy Trevor F. Grieco, MS a, *, Adrija Sharma, PhD a, Garett M. Dessinger, BS a, Harold E. Cates, MD b, Richard D. Komistek, PhD. The Journal of Arthroplasty, September 2017 https://doi.org/10.1016/j.arth.2017.09.035 

6. Grieco, Trevor F., et al. “In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy.” The Journal of Arthroplasty, 2017, doi:10.1016/j.arth.2017.09.035. 

7. Victor, J., Mueller, J.K.P., Komistek, R.D. et al. Clin Orthop Relat Res (2010) 468: 807. https://doi.org/10.1007/s11999-009-1072-7 

8. Ref: Smith & Nephew OR-11-172

9. Data on file with Smith & Nephew.

Bi-Cruciate Stabilized Knee System

The JOURNEY^◊ II Bi-Cruciate Stabilized knee system has been intricately designed, engineered and tested to facilitate near-normal kinematics;^1,2 shown to enhance patient satisfaction and significantly improve patient-reported Knee Society Scores (KSS).^3,4

Using physiological matching technology, JOURNEY II BCS has demonstrated pronounced femoral rollback upon flexion and improved mid-flexion medio-lateral stability.⁵

Rediscover normal

Over 90% of patients return to work within 6 months of surgery.⁶

23% more flexion than posterior-stabilized TKA after 1 year.³

Evidence demonstrated major revisions of around 1% at 6 years.⁷

 Featuring VERILAST^◊ technology, with OXINIUM^◊ (oxidized zirconium) and highly cross-linked polyethylene (XLPE), for improved wear performance.⁸ 

WATCH: JOURNEY II BCS surgeon webcast

Stability: Near-complete elimination of paradoxical motion and anterior sliding of the femur during flexion.^9-16

Strength: Designed to restore anatomic alignment and normal knee kinematic patterns throughout the full range of motion.^12-16

Satisfaction: Designed to restore normal kinematics throughout the range of motion and help patients return to normal activities and lifestyle.^17,18

Watch: JOURNEY II TKA - A Kinematic Review

The power of robotics assistance

 NAVIO^◊ Handheld Robotics demonstrated that optimal implant planning can replicate the joint line and achieve a balanced range of motion in cruciate-retaining knee arthroplasty, based on individual patient needs.¹⁹

Find out more

Surgeon resources

JOURNEY II BCS and CR Design Rationale

JOURNEY II TKS (BCS and CR) Tray Layouts

JOURNEY II TKA (BCS and CR) Surgical Technique 

JOURNEY II BCS Short version

For further information on JOURNEY II BCS, or to arrange a discussion with a Smith & Nephew representative:

Contact us

References:
1)   Grieco TF, Sharma A, Dessinger GM, Cates HE, Komistek RD. In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy. J Arthroplasty. 2018;33(2):565-571.
2)   Iriuchishima T, Ryu K. A comparison of Rollback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty. J Knee Surg. 2018;31(6):568-572.
3)   Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Tech Orthop. 2018;33:37-41.
4)   Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005;431:157-165.
5)   Verstraete MA, Van Onsem S, Van Eenoo W, et al. Posterior stabilized total knee kinematics: how anatomic do we get today? –an in vivo comparative study considering three different implants. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
6)   Harris AI, Luo TD, Lang JE, Kopjar B. Short-term safety and effectiveness of a second-generation motion-guided total knee system. Arthroplasty Today. 2018;4(2):240-243.
7)   Harris AI, Luo TD, Lang JE, Kopjar B. Performance of second-generation guided motion total knee arthroplasty system: Results from the international multicenter study of over 2,000 primary TKA with up to 6 Years follow-up. Poster presented at AAHKS Annual Meeting. November 1-4 2018. Dallas Texas, USA.
8)   Papannagari R, Hines G, Sprague J, Morrison M. Long-term wear performance of an advanced bearing knee technology. Abstract presented at: ISTA, Dubai, UAE, Oct 6-9, 2010.
9)   Victor J, Mueller JKP, Komistek RD, et al. In Vivo Kinematics after a Cruciate-Substituting TKA. Clin Orthop Relat Res. 2010;468:807-814.
10) Zingde SM, Mueller JPK, Komistek RD, Mac Naughton JM, Anderle MR, Mahfouz MR. In Vivo Comparison of TKA Kinematics for Subjects with a PS, PCR or Bi-Cruciate Stabilizing Design. Poster presented at: Orthop Res Soc, Las Vegas, NV, Feb 22-25. 2009, Poster No. 2067.
11) Ward TR, Burns AW, Gillespie MJ, Scarvell JM, Smith PN. Bicruciate-stabilised total knee replacements produce more normal sagittal plane kinematics than posterior-stabilised designs. J Bone Joint Surg Br. 2011;93-B:907-913.
12) Catani F, Ensini A, Belvedere C, et al. In Vivo Kinematics and Kinetics of a Bi-Cruciate Substituting Total Knee Arthroplasty: A Combined Fluoroscopic and Gait Analysis Study. J Orthop Res. 2009;27(12):1569-1575.
13) Morra EA, Rosca M, Greenwald JFI, Greenwald AS. The Influence of Contemporary Knee Design on High Flexion: A Kinematic Comparison with the Normal Knee.  J Bone Joint Surg Am. 2008;90:195-201.
14) Catani F, Innocenti B, Belvedere C, et al. The Mark Coventry Award Articular: Contact Estimation in TKA Using In Vivo Kinematics and Finite Element Analysis. Clin Orthop Relat Res. 2010;468(1):19-28.
15) Van Duren BH, Pandit H, Price M, T et al. Bicruciate substituting total knee replacement: how effective are the added kinematic constraints in vivo? Knee Surg Sports Traumatol Arthrosc. 2012;20(10):2002-2010.
16) Arbuthnot JE, Brink RB. Assessment of the antero-posterior and rotational stability of the anterior cruciate ligament analogue in a guided motion bi-cruciate stabilized total knee arthroplasty. J Med Eng Technol. 2009;33(8):610-615.
17) Murakami K, Hamai S, Okazaki K, et al. In vivo kinematics of gait in posterior-stabilized and bicruciate-stabilized total knee arthroplasties using image-matching techniques. Int Orthop. 2018;42:2573-2581.
18) Murakami K, Hamai S, Okazaki K, et al. Knee kinematics in bi-cruciate stabilized total knee arthroplasty during squatting and stair-climbing activities. J Orthop. 2018;15:650-654.
19) Jaramaz B, Mitra R, Rovinsky D, Neginhal V. A Novel Image-Free Handheld Robot For Bi-Cruciate Retaining Knee Arthroplasty. Poster presented at 19th EFORT Annual Congress. May 30- June 1, 2018. Barcelona, Spain.

Posterior Cruciate Ligament Retaining Knee System

To achieve patient satisfaction and help patients rediscover normal, the JOURNEY II knee is designed to replicate normal knee shapes, positions and motions. ^1-3

JOURNEY II CR has demonstrated significantly improved functional outcomes, compared to conventional cruciate-retaining (CR) total knee arthroplasty.^4,5

Demonstrated improved short-term functional outcomes and an improvement in mean Knee Society Scores (KSS) at 24-month follow-up.*⁴

Designed to enhance patient satisfaction, and has demonstrated an improved range of motion.*⁴

Rediscover normal

Stability: The convex lateral surface is designed to promote native rollback, with a prominent posterior medial lip for mid-flexion stability.⁴

Function: Designed to accurately replicate an anatomic, asymmetric femoral profile with mechanical axis and 3° physiological joint line.⁴

Satisfaction: Designed to restore normal kinematics throughout the range of motion, helping patients return to normal activities and lifestyle.⁵

 Featuring VERILAST^◊ technology, with OXINIUM^◊ (oxidized zirconium) and highly cross-linked polyethylene (XLPE), for improved wear performance.⁶

The power of robotics assistance

 NAVIO^◊ Handheld Robotics demonstrated that optimal implant planning can replicate the joint line and achieve a balanced range of motion in cruciate-retaining knee arthroplasty, based on individual patient needs.⁷

Find out more

Normal motion, for improved patient satisfaction⁵

• Internally-rotated femur and minimal posterior femoral overhang in the sagittal plane for more natural positioning⁴
• Maximum quadriceps efficiency through external femur rotation, with a near-complete elimination of paradoxical motion to optimize stability⁴
• Significant posterior femoral rollback for deep, 155° flexion performance⁴

View more evidence

Surgeon resources

JOURNEY◊ II TKA Surgical Technique (CR and BCS)
JOURNEY II CR Short Surgical Technique version
JOURNEY II CR product brochure
JOURNEY II CR Achieving Normal Kinematics brochure

For further information on JOURNEY II CR, or to arrange a discussion with a Smith+Nephew representative:

Contact us

*compared to conventional cruciate-retaining total knee arthroplasty

References:
1)  Murakami K, Hamai S, Okazaki K, et al. Knee kinematics in bi-cruciate stabilized total knee arthroplasty during squatting and stair-climbing activities. J Orthop. 2018;15:650-654.
2)  Grieco TF, Sharma A, Dessinger GM, Cates HE, Komistek RD. In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy. J Arthroplasty. 2018;33(2):565-571.
3)  Iriuchishima T, Ryu K. A comparison of Rollback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty. J Knee Surg. 2018;31(6):568-572.
4)  Data on file with Smith & Nephew. 00225 V3 JOURNEY II Design Rationale 1117.
5)  Lutes W and Fitch D. Comparison of functional outcomes following total knee arthroplasty with a conventional implant design or one designed to mimic natural knee kinematics. Presented at: 39th SICOT Orthopaedic World Congress; October 10-13, 2018; Montreal, Canada.
6)  Papannagari R, Hines G, Sprague J, Morrison M. Long-term wear performance of an advanced bearing knee technology. Abstract presented at: ISTA, Dubai, UAE, Oct 6-9, 2010.
7)  Jaramaz B, Mitra R, Rovinsky D, Neginhal V. A Novel Image-Free Handheld Robot For Bi-Cruciate Retaining Knee Arthroplasty. Poster presented at: 19th EFFORT Annual Congress; May 30- June 1, 2018; Barcelona, Spain.

ACL preservation

The next step to normal

The JOURNEY^◊ II XR bi-cruciate retaining knee system is designed to replicate normal motion by preserving crucial kinematics, proprioception and stability. Where traditional systems can sever the ACL, JOURNEY II XR offers a less invasive retention of cruciate and collateral ligaments, facilitating improved lateral compartment mobility.^1,2

Featuring two independent, uniquely designed medial and lateral inserts, JOURNEY II XR aims to restore knee anatomy and function for higher patient satisfaction.

Designing normal, for kinematic function and stability

Aim to restore patients to a normal, active lifestyle

Shape – Anatomical shape and ACL retention is designed to restore stability through the range of motion.

Position – Designed to restore the anatomic joint line and anterior-posterior position whilst retaining the ACL, for a more normal knee position.³

Motion – Restoring kinematic patterns and retaining the ACL helps more normal muscular firing patterns and proprioception throughout the range of motion.⁴

Proprietary VERILAST^◊ technology with OXINIUM^◊, combined with highly cross-linked polyethylene (XLPE), provides a unique ceramicized metal composition, capable of reducing wear by up to 98%, compared to Cobalt Chrome (CoCr).*⁵

The power of robotics assistance

 The JOURNEY II Total Knee System is compatible with NAVIO™ Handheld Robotics for CT-free navigation, intraoperative planning, and accurate bone resection and gap analysis in knee replacement surgery.^6-14

Find out more

Surgeon resources

JOURNEY II XR Messaging Brochure
JOURNEY II XR Design Rationale and Bone & Joint Science results
JOURNEY II XR Surgical Technique
JOURNEY II XR Measurements
JOURNEY II XR Evidence in Focus Boese summary
JOURNEY II XR Evidence in Focus Arnout summary

View more evidence

For further information on JOURNEY II XR, or to arrange a discussion with a Smith+Nephew representative:

Contact us

*Wear testing for VERILAST based on the LEGION™ CR Knee System

References:
1)   Mont MA, John M, Johnson A. Bicruciate Retaining Arthroplasty. Surg Technol Int. 2012;22:236-242.
2)   Moro-oka T, Muenchinger M, Canciani JP, Banks SA. Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2007;15:93-99.
3)   Arbuthnot JE, Brink RB. Assessment of the antero-posterior and rotational stability of the anterior cruciate ligament analogue in a guided motion bi-cruciate stabilized total knee arthroplasty. Journal of Medical Engineering & Technology. 2009;33(8):610-615.
4)   Pritchett JW. Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. J Arthroplasty. 2011;26(2):224-228.
5)   Papannagari R, Hines G, Sprague J, Morrison M. Long-term wear performance of an advanced bearing knee technology. Abstract presented at: ISTA, Dubai, UAE, Oct 6-9, 2010.
6)   Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop. 2017;41:2265-2271.
7)   Batailler C, White N, Ranaldi F, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESS­KA) 2018.
8)   Jaramaz B, Nikou C, Casper M, Grosse S, Mitra R. Accuracy validation of semi-active robotic application for patellofemoral arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
9)   Jaramaz B, Mitra R, Nikou C, Kung C. Technique and Accuracy Assessment of a Novel Image-Free Handheld Robot for knee Arthroplasty in Bi-Cruiciate Retaining Total Knee Replacement. EPiC Series in Health Sciences. 2018;2:98-101. K.
10) Data on file Smith & Nephew. Sg2 Healthcare Intelligence: Technology guide. 2014.
11) Gregori A, Picard F, Bellemans J, Smith J, Simone A. Handheld precision sculpting tool for unicondylar knee arthroplasty. A clinical review. Abstract presented at: 15th EFORT Congress; June 4-6, 2014; London, UK.
12) Smith JR, Picard F, Lonner J, Hamlin B, Rowe P, Riches P, Deakin A. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. 4-9 August, 2013. Natal, Brazil.
13) Gustke K, Golladay G, Roche MW, Jerry G, Elson LC, Anderson CR. Increased Patient Satisfaction After Total Knee replacement using sensor-guided technology. Bone Joint J 2014;96-B:1333–8.
14) Gregori A, Picard F, Lonner J, Smith J, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada

The JOURNEY^◊ II Total Knee System has a full compendium of clinical evidence and corresponding surgeon resources.

For implant-specific resources, please refer to individual JOURNEY II BCS, CR and XR pages.

Clinical Evidence

To view clinical evidence highlights for the JOURNEY II Total Knee System, view the Evidence in Focus page. 

Additional surgeon resources

JOURNEY II Total Knee Arthroplasty

JOURNEY II Total Knee Balancer Surgical Technique Addendum

JOURNEY II TKA Universal Instruments Surgical Technique

Registry Data

• Australian Orthopaedic Association National Joint Replacement Registry - Annual reports
• National Joint Registry for England, Wales, Northern Ireland and the Isle of Man - Annual reports
• New Zealand Joint Registry - Annual reports
• Register of the Orthopaedic Prosthetic Implants (Italy) - Annual reports