JII BCS Exam Questions! Trivia Quiz!
- 1.
Which factors contribute to the rationale for a kinematic knee?
- A.
Conventional knee designs do not replicate the normal anatomy of the knee and thus they are unable to restore normal kinematics and muscular efficiency
- B.
Conventional knee designs do not provide the same levels of satisfaction and return to function as seen in THA
- C.
The prevalence of younger more demanding patients
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
The rationale for a kinematic knee is contributed by all of the factors mentioned. Conventional knee designs do not replicate the normal anatomy of the knee, which leads to an inability to restore normal kinematics and muscular efficiency. Additionally, these designs do not provide the same levels of satisfaction and return to function as seen in total hip arthroplasty (THA). The prevalence of younger and more demanding patients also plays a role in the rationale for a kinematic knee, as they require a knee replacement that can better meet their needs and expectations.Rate this question:
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- 2.
A key characteristic to understand in relation to the native knee anatomy is that it is…
- A.
Asymmetrical
- B.
Symmetrical
- C.
Convex on both sides
- D.
None of the above
Correct Answer
A. AsymmetricalExplanation
The native knee anatomy is asymmetrical, meaning that it is not symmetrical or evenly balanced on both sides. This means that the structures and components of the knee joint are not identical or mirrored on both sides. Understanding this characteristic is important for properly diagnosing and treating knee issues and injuries.Rate this question:
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- 3.
Satisfaction levels and return to functional activity following TKA are the same as that of THA.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The statement is false because satisfaction levels and return to functional activity following Total Knee Arthroplasty (TKA) are generally lower compared to Total Hip Arthroplasty (THA). TKA involves replacing the knee joint, which is a weight-bearing joint and can lead to more pain and longer recovery time compared to THA, which involves replacing the hip joint. Consequently, patients who undergo TKA may experience lower satisfaction levels and take longer to return to their normal level of activity compared to THA patients.Rate this question:
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- 4.
A study by Noble et al. (2005) concluded that patients who had TKA experience…
- A.
Substantial functional impairment when compared with their age and gender matched peers
- B.
Functional outcomes similar to that of their age and gender matched peers
- C.
Substantial functional improvement when compared with their age and gender matched peers
- D.
None of the above
Correct Answer
A. Substantial functional impairment when compared with their age and gender matched peersExplanation
The study by Noble et al. (2005) found that patients who had total knee arthroplasty (TKA) experienced substantial functional impairment when compared with their age and gender matched peers. This suggests that undergoing TKA did not result in functional outcomes similar to their peers or substantial functional improvement.Rate this question:
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- 5.
What paradoxical motion can occur as a result of conventional knee design?
- A.
The lack of ACL function leads to paradoxical anterior sliding of the femur during flexion
- B.
During flexion the knee may pivot laterally, as opposed to the naturally occurring medial pivot
- C.
During flexion the knee may pivot medially, as opposed to the naturally occurring lateral pivot
- D.
A & B
Correct Answer
D. A & BExplanation
The correct answer is A & B. Conventional knee design can result in paradoxical motion in two ways. First, the lack of ACL function can lead to anterior sliding of the femur during flexion, which is contradictory to the normal movement. Second, during flexion, the knee may pivot laterally instead of the naturally occurring medial pivot. Both of these motions are paradoxical and can occur as a result of conventional knee design.Rate this question:
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- 6.
Which TKA system was the first ‘guided-motion’ kinematically accurate knee design on the market?
- A.
Triathlon CR
- B.
Vanguard PS
- C.
JOURNEY BCS (JBCS)
- D.
ADVANCE Medial-Pivot Knee
Correct Answer
C. JOURNEY BCS (JBCS)Explanation
The correct answer is JOURNEY BCS (JBCS). This knee design was the first 'guided-motion' kinematically accurate knee system on the market.Rate this question:
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- 7.
The JBCS Knee System restored normal knee function by…
- A.
Increasing anterior-posterior stability throughout knee flexion
- B.
Promoting a normal kinematic pattern
- C.
Placing the femur more posteriorly during full extension to reduce paradoxical motion
- D.
A & B
Correct Answer
D. A & BExplanation
The JBCS Knee System is able to restore normal knee function by increasing anterior-posterior stability throughout knee flexion and promoting a normal kinematic pattern. These two factors work together to ensure that the knee joint functions properly and moves in a way that is natural and efficient. By improving stability and promoting a normal pattern of movement, the JBCS Knee System helps to alleviate pain and improve overall function of the knee joint. Therefore, the correct answer is A & B.Rate this question:
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- 8.
Which features of the JBCS tibial insert design mimic the native articular surfaces to provide medial stability and increased posterior translation of the lateral condyle during flexion?
- A.
The JBCS tibial insert was designed to be symmetrical in shape to mimic the native tibial plateau
- B.
As with the native tibial plateau the tibial insert was designed with a concave medial and convex lateral shape
- C.
As with the native tibial plateau the tibial insert was designed with a concave lateral and convex medial shape
- D.
A & C
Correct Answer
B. As with the native tibial plateau the tibial insert was designed with a concave medial and convex lateral shapeExplanation
The correct answer is A & C. The JBCS tibial insert was designed to mimic the native articular surfaces by having a concave medial and convex lateral shape, which provides medial stability and increased posterior translation of the lateral condyle during flexion. This design feature helps to replicate the natural movement and stability of the knee joint, enhancing the overall performance and function of the implant.Rate this question:
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- 9.
The normal screw home position of the JBCS allowed the knee to rest in its normal anatomical position and thus as in the normal knee, the quadriceps muscle was not required to maintain stability in extension.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The normal screw home position of the JBCS refers to the natural position of the knee joint where it rests in its anatomical position. In this position, the quadriceps muscle does not need to exert additional effort to maintain stability in extension. Therefore, the statement is true.Rate this question:
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- 10.
The JBCS Knee system featured an anterior and posterior cam. Which of the following statements are correct?
- A.
The anterior cam and post replicated the function of the ACL preventing posterior tibial translation (anterior femoral translation) and providing stability early in gait
- B.
The anterior cam and post replicated the function of the ACL preventing anterior tibial translation (posterior femoral translation) and providing stability early in gait
- C.
The posterior cam and post replicated the function of the PCL, providing posterior stability and limiting posterior translation of tibia (femoral anterior translation)
Correct Answer(s)
B. The anterior cam and post replicated the function of the ACL preventing anterior tibial translation (posterior femoral translation) and providing stability early in gait
C. The posterior cam and post replicated the function of the PCL, providing posterior stability and limiting posterior translation of tibia (femoral anterior translation)Explanation
The correct answer is that the anterior cam and post replicate the function of the ACL, preventing anterior tibial translation (posterior femoral translation) and providing stability early in gait. The posterior cam and post replicate the function of the PCL, providing posterior stability and limiting posterior translation of the tibia (femoral anterior translation).Rate this question:
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- 11.
According to published literature by Morra et al (2004) which knee system most closely replicated the kinematics of a healthy un-operated Knee?
- A.
PFC Rotating Platform
- B.
Vanguard PS
- C.
Triathlon CR
- D.
JBCS
- E.
ADVANCE Medial-Pivot Knee
Correct Answer
D. JBCS -
- 12.
In published literature by Cantani et al (2009) Knee joint kinematics were assessed in 16 JBCS patients using video-fluoroscopy and electromyography (EMG) during activities of daily-living including stair climbing, chair rising and sitting, and step up/down test. What did the results of this study show?
- A.
All JBCS patients demonstrated femoral external rotation and translation similar to that of other conventional knee designs
- B.
This more physiological knee motion resulted in recovery of normal extensor and flexor muscle function which was attributed to the more anatomical knee design
- C.
All patients demonstrated a combination of relatively normal locomotion and gait, coupled with clear femoral external rotation and translation
Correct Answer(s)
B. This more pHysiological knee motion resulted in recovery of normal extensor and flexor muscle function which was attributed to the more anatomical knee design
C. All patients demonstrated a combination of relatively normal locomotion and gait, coupled with clear femoral external rotation and translationExplanation
The results of the study showed that all JBCS patients demonstrated femoral external rotation and translation similar to that of other conventional knee designs. This more physiological knee motion resulted in recovery of normal extensor and flexor muscle function, which was attributed to the more anatomical knee design. Additionally, all patients demonstrated a combination of relatively normal locomotion and gait, coupled with clear femoral external rotation and translation.Rate this question:
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- 13.
Although published clinical evidence supports the efficacy of the Journey BCS knee system (JBCS) in relation to kinematics, there are four key clinical papers that have highlighted complications associated with the JBCS. What are the complications identified in this literature?
- A.
Paradoxical motion
- B.
Iliotibial band syndrome
- C.
Dislocation
- D.
Stiffness requiring manipulation under anaesthesia
Correct Answer(s)
B. Iliotibial band syndrome
C. Dislocation
D. Stiffness requiring manipulation under anaesthesiaExplanation
The complications identified in the literature for the Journey BCS knee system (JBCS) include Iliotibial band syndrome, dislocation, and stiffness requiring manipulation under anesthesia. These complications have been highlighted in four key clinical papers, despite the published evidence supporting the efficacy of the JBCS in terms of kinematics.Rate this question:
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- 14.
Which clinical paper reported dislocation in JBCS Knees?
- A.
Bourne et al (2011)
- B.
Laskin (2011)
- C.
Arnout et al (2011)
- D.
Hass et al (2011)
Correct Answer
C. Arnout et al (2011) -
- 15.
What did Luyckx et al (2010) suggest contributed to the ITB traction syndrome?
- A.
Inadequate translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients
- B.
The normal screw home position of the JBCS which allowed the knee to rest in its normal anatomical position
- C.
Excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients
- D.
A & B
Correct Answer
C. Excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patientsExplanation
Luyckx et al (2010) suggested that excessive translation of the femur in flexion leads to increased eccentric loading of the ITB in some patients. This means that when the femur moves too much in relation to the tibia during flexion of the knee, it puts more stress on the ITB, which can contribute to the development of ITB traction syndrome. The inadequate translation of the femur in flexion and the normal screw home position of the JBCS are not mentioned as factors contributing to ITB traction syndrome in the given information. Therefore, the correct answer is excessive translation of the femur in flexion leading to increased eccentric loading of the ITB in some patients.Rate this question:
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- 16.
Arnout et al (2011) reported on four cases (0.3%) of posterior dislocation of the tibia relative to the femur in a series of 1,350 cases. The authors concluded that consistent soft-tissue stretch occurred in these patients. Which factors were noted as potentially contributing to dislocation?
- A.
High flexion - during flexion the cam rises onto the post towards maximal flexion and in the case of a loose flexion space the cam could in theory become dislocated over the post
- B.
Low jump distance - due to the relative position of the cam, low height of the post combined with a rounded post design
- C.
Excessive femoral rollback - may contribute to consistent stretch on soft tissues leading to laxity, especially in flexion
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
The given correct answer is "All of the above." This means that all three factors mentioned - high flexion, low jump distance, and excessive femoral rollback - were noted as potentially contributing to the dislocation of the tibia relative to the femur.Rate this question:
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- 17.
The final JBCS complication reported in the literature was that of stiffness requiring manipulation under anesthesia (MUA). Digennaro et al (2014) attribute the reported cases of stiffness and anterolateral joint pain to…
- A.
Excessive medial and lateral tibiofemoral posterior translation
- B.
Patella maltracking
- C.
Excessive medial and lateral tibiofemoral anterior translation
- D.
Chronic preoperative osteoarthritis
Correct Answer
A. Excessive medial and lateral tibiofemoral posterior translationExplanation
The correct answer is excessive medial and lateral tibiofemoral posterior translation. This means that there is excessive movement of the tibia (shinbone) and femur (thighbone) in the backward direction. This can lead to stiffness and the need for manipulation under anesthesia. Digennaro et al (2014) suggest that this excessive posterior translation is the cause of reported cases of stiffness and anterolateral joint pain in JBCS complications.Rate this question:
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- 18.
The Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR) Annual Report identified the JOURNEY BCS Knee as having a higher than expected revision rate. The Incidence of ITB pain is likely to have contributed to the Journey BCS revision rate in the AOA NJR.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The higher than expected revision rate of the JOURNEY BCS Knee identified in the AOA NJRR Annual Report is likely due to the incidence of ITB pain. This suggests that patients who underwent the JOURNEY BCS Knee procedure experienced ITB pain, which may have led to the need for revision surgeries. Therefore, the statement "True" is correct.Rate this question:
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- 19.
Of primary importance is the alignment of the JBCS tibial component relative to the femoral component as the two are coupled by the guided motion mechanism. According to Ries et al (2010) which of the following tibial component issues contribute to increased tension in the ITB?
- A.
Aseptic loosening of the tibial component
- B.
Excessive external rotation of the tibial component
- C.
Excessive posterior position of the tibial component
- D.
B & C
Correct Answer
D. B & CExplanation
The correct answer is B & C. According to Ries et al (2010), excessive external rotation and excessive posterior position of the tibial component contribute to increased tension in the ITB. These issues affect the alignment of the tibial component relative to the femoral component, which are coupled by the guided motion mechanism. Aseptic loosening of the tibial component is not mentioned as a contributing factor to increased tension in the ITB.Rate this question:
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- 20.
Which of the following did Arnout et al (2011) recommend in relation to JBCS to overcome the issue of soft tissue stretching and dislocation of the implant?
- A.
Design modification allowing the femur to rest posteriorly in full extension
- B.
The use of a knee joint balancer in order to optimally balance the flexion space
- C.
Design modifications in regards to the height of the polyethylene post in the JBCS implant as well as the relative position of the cam on the femoral component
- D.
B & C
Correct Answer
D. B & CExplanation
Arnout et al (2011) recommended design modifications in regards to the height of the polyethylene post in the JBCS implant as well as the relative position of the cam on the femoral component, as well as the use of a knee joint balancer in order to optimally balance the flexion space.Rate this question:
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- 21.
Which of the following statements are correct?
- A.
The JOURNEY II BCS Knee full market release took place in March 2013 at the AAOS in the US
- B.
>20,000 JOURNEY II BCS procedures have been completed
- C.
In Australia the first JOURNEY II BCS knee was implanted in August 2013
- D.
>10,000 JOURNEY II BCS procedures have been completed
Correct Answer(s)
A. The JOURNEY II BCS Knee full market release took place in March 2013 at the AAOS in the US
B. >20,000 JOURNEY II BCS procedures have been completed
C. In Australia the first JOURNEY II BCS knee was implanted in August 2013Explanation
The correct answer is that the JOURNEY II BCS Knee full market release took place in March 2013 at the AAOS in the US, and more than 20,000 JOURNEY II BCS procedures have been completed. Additionally, in Australia, the first JOURNEY II BCS knee was implanted in August 2013.Rate this question:
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- 22.
What was the high-level rationale behind evolving the original JOURNEY BCS (JBCS) System?
- A.
Complete the system
- B.
Improve functionality
- C.
Increase repeatability
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
The high-level rationale behind evolving the original JOURNEY BCS (JBCS) System was to complete the system, improve functionality, and increase repeatability. This means that the original system may have been incomplete, lacked certain functionalities, or was not able to be repeated consistently. Therefore, the decision to evolve the system was made to address these issues and ensure that the system is fully functional, has improved features, and can be repeated reliably.Rate this question:
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- 23.
Which key design changes improved kinematics by reducing early rollback (posterior cam & post engage later in flexion ~60-70⁰)?
- A.
Posterior cam elevated superiorly and cam reduced in size
- B.
Post shifted 2mm anteriorly
- C.
Post shifted 2mm posteriorly
- D.
A & B
- E.
A & C
Correct Answer
D. A & BExplanation
The correct answer is A & B. The key design changes that improved kinematics by reducing early rollback were elevating the posterior cam superiorly and reducing its size, as well as shifting the post 2mm anteriorly. These changes allowed for a later engagement of the posterior cam in flexion, specifically around 60-70 degrees.Rate this question:
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- 24.
Why has the JII PS box increased in size?
- A.
Reduce early rollback
- B.
Reduced strain of popliteal tendon
- C.
Reduced strain of IT and IT patella band
- D.
To accept a constrained insert (bail out option)
- E.
A & D
Correct Answer
D. To accept a constrained insert (bail out option)Explanation
The JII PS box has increased in size in order to accept a constrained insert (bail out option). This means that the box has been made larger to accommodate the insertion of a specific type of insert that is designed to provide additional support or stability in certain situations. By increasing the size of the box, the JII PS can now accept this insert and provide the desired functionality.Rate this question:
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- 25.
Although there are a number of changes it is most important to understand those that have specifically addressed the complications as seen with the JBCS. What are the Key changes to address IT band syndrome?
- A.
Post height decreased (on average 2-3mm)
- B.
Thinned anterior flange and reduced lateral condyle
- C.
Post shifted posteriorly & posterior cam lowered inferiorly
- D.
Post shifted anteriorly & posterior cam elevated superiorly
Correct Answer(s)
B. Thinned anterior flange and reduced lateral condyle
D. Post shifted anteriorly & posterior cam elevated superiorlyExplanation
The key changes to address IT band syndrome include thinning the anterior flange and reducing the lateral condyle, as well as shifting the post anteriorly and elevating the posterior cam superiorly. These changes help to alleviate the complications associated with the JBCS and provide a better solution for IT band syndrome.Rate this question:
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- 26.
What changes to the original JBCS insert have been made to address the complication of dislocation?
- A.
Post height increased (on average 2-3mm) and top of post “squared off”
- B.
Post height decreased (on average 2-3mm) and top of post “rounded off”
- C.
Post widened (on average 1-2mm)
- D.
B & C
Correct Answer
A. Post height increased (on average 2-3mm) and top of post “squared off”Explanation
The original JBCS insert was modified by increasing the post height by an average of 2-3mm and squaring off the top of the post. This change was made to address the complication of dislocation.Rate this question:
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- 27.
The original JBCS post was “rounded ” at the top which made it more susceptible to varus/valgus dislocation.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The original JBCS post being "rounded" at the top means that it had a curved or rounded shape at the upper part. This curvature made it more prone to varus/valgus dislocation, which refers to the inward or outward displacement of a bone or joint. Therefore, the statement is true because the rounded shape of the post increased its vulnerability to varus/valgus dislocation.Rate this question:
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- 28.
The stiffness associated with the original JBCS knee system was attributed to the excessive stresses placed on the soft tissues as a result of the limited rollback of the femoral component.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The statement suggests that the stiffness of the original JBCS knee system was caused by the limited rollback of the femoral component, which placed excessive stresses on the soft tissues. However, the correct answer is false, meaning that this statement is not accurate. Therefore, the explanation for the correct answer is that the stiffness of the original JBCS knee system was not attributed to the limited rollback of the femoral component, contradicting the statement given.Rate this question:
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- 29.
Which of the following statements regarding the JBCS knee system are true? Please choose all the correct response/s below.
- A.
Over 40,500 JBCS knees have been implanted globally by over 250 surgeons. 2300 of these were implanted in Australia
- B.
Over 65,000 JBCS knees have been implanted globally by over 600 surgeons. 3346 of these were implanted in Australia
- C.
The global full market release took place in March 2006 at the AAOS where it won the most innovative product award
Correct Answer(s)
A. Over 40,500 JBCS knees have been implanted globally by over 250 surgeons. 2300 of these were implanted in Australia
B. Over 65,000 JBCS knees have been implanted globally by over 600 surgeons. 3346 of these were implanted in Australia
C. The global full market release took place in March 2006 at the AAOS where it won the most innovative product awardExplanation
The correct answer is that over 40,500 JBCS knees have been implanted globally by over 250 surgeons, and 2300 of these were implanted in Australia. Additionally, over 65,000 JBCS knees have been implanted globally by over 600 surgeons, and 3346 of these were implanted in Australia. The global full market release of the JBCS knee system took place in March 2006 at the AAOS, where it won the most innovative product award.Rate this question:
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Current Version
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Mar 20, 2023Quiz Edited by
ProProfs Editorial Team -
Jan 06, 2015Quiz Created by
SmithNephew1
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