Initial Experience of the Journey-Deuce Bicompartmental Knee Prosthesis A Review of 36 Cases Brian T. Palumbo, MD,* Eric R. Henderson, MD,* Paul K. Edwards, MD,* R. Brandon Burris, MD,* Sergio Gutiérrez, PhD, y and Steven J. Raterman, MD* Abstract: We evaluated the effectiveness of a novel bicompartmental knee arthroplasty prosthesis for the treatment of degenerative disease affecting the medial and patellofemoral compartments. The study included 36 knees in 32 patients with a mean follow-up of 21 months. The mean Knee Society functional survey and Western Ontario McMaster Osteoarthritic Index Survey scores were 65.4 and 75.8, respectively. Thirty-one percent of patients were unsatisfied with the surgery, and 53% stated that they would not repeat the surgery. We report an overall survival rate of 86% with one catastrophically failed tibial baseplate. We conclude that this prosthesis provides inconsistent pain relief and unacceptable functional results for bicompartmental arthritis. Short-term survival of this prosthesis was unacceptably low, and therefore, we no longer implant it at our institution. Keywords: Journey-Deuce bicompartmental knee prosthesis, degenerative disease, total knee arthroplasty, unicompartmental knee arthroplasty. © 2011 Elsevier Inc. All rights reserved. Bicompartmental degenerative disease of the knee has traditionally been treated with total knee arthroplasty (TKA). Although good results can be obtained in most cases, resurfacing of healthy joint surfaces, sacrifice of cruciate ligaments, and removal of greater bone stock are arguments against such an approach, especially in younger patients. In an effort to preserve ligamentous restraints and improve function, use of “tissue sparing” knee resurfacing systems has risen substantially. The rising popularity of unicompartmental arthroplasty (UKA) is an example of this trend. The average yearly increase of UKA in the United States from 1998 to 2005 was 32%, whereas the rate of increase for TKA was 9.5% over the same period [1]. When performed for the appropriate indications, UKA can be effective in improving pain and function; in some studies, results approach those of TKA [2-8]. Bicompartmental knee arthroplasty (BKA) involves resurfacing the patellofemoral (PF) compartment in combination with UKA. It has emerged as an option to address bicompartmental degenerative disease [9,10]. Proposed benefits of this technique are the ability for implantation through minimally invasive approaches, decreased rehabilitation time, and preservation of the cruciate ligaments to maintain natural knee kinematics [11-15]. In theory, concomitant resurfacing of the PF joint with the medial compartment eliminates the anterior knee as a potential source of pain and disease progression: a controversial issue in the UKA literature [2,16]. A recent report demonstrated improved function and diminished pain after BKA; however, long-term survivorship was inferior to TKA in this series [17]. The Journey-Deuce BKA (Smith & Nephew, Memphis, Tenn) is a novel design with a single femoral component that resurfaces the medial condyle and trochlear groove. Introduced in 2005 for the treatment of concomitant medial and PF arthritis, few reports document the device's safety and clinical effectiveness. Engh [12] reported on a series of 20 patients in which he obtained good results with its use, but objective clinical and radiographic data were not included. The present report reviews the short-term clinical and radiographic results of the Journey-Deuce bicompartmental prosthesis. Materials and Methods From January 2008 to January 2009, 36 BKAs (Smith & Nephew) were implanted in 32 patients. All From the *University of South Florida Department of Orthopaedic Surgery, Tampa, Florida; and yFoundation for Orthopaedic Research and Education (FORE), Tampa, Florida. Submitted January 9, 2011; accepted March 11, 2011. The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.03.026. Reprint requests: Brian T. Palumbo, MD, 1887 Paradise Ln, Clearwater, FL 33756. © 2011 Elsevier Inc. All rights reserved. 0883-5403/2606-0009$36.00/0 doi:10.1016/j.arth.2011.03.026 40 The Journal of Arthroplasty Vol. 26 No. 6 Suppl. 1 2011