Clinical and Hospital Related Outcomes of Journey II Knee System Compared to Other Knee Systems in the Management of Total Knee Arthroplasty (TKA) Patients

OBJECTIVES: Healthcare providers are tasked with reducing healthcare costs while maintaining or improving the quality of health outcomes. The objective of this study was to evaluate the hospital-related clinical and economic outcomes of TKA patients using the JOURNEY II knee system comprising of (93% oxidized zirconium and 7% cobalt chrome materials) compared to other knee systems.

METHODS: A retrospective analysis was conducted on primary TKA patients from the Premier PINC AI Healthcare Database from 2017 to March 2023. Patients under 21 years old, with bilateral TKA, partial, revision/resurfacing procedure, diagnosis of malignant neoplasm, mechanical complications, periprosthetic fractures, without 6-month baseline and 36-month follow-up period were excluded from the study. Identification of JOURNEY II patients involved keyword analysis in billing records. A 1:3 propensity score matching was used to balance baseline characteristics between cohorts. Generalized linear models were used to estimate discharge status, length of stay, pain medication, and hospital-related costs.

RESULTS: The study matched 6,123 JOURNEY II patients with 18,369 using other systems. Patients with the JOURNEY II system had 28% higher odds of being discharged to home/home health care (p<.0001), 15% lower odds of being discharged to Skilled Nursing Facility (p=0.0011), and 40% lower odds to Inpatient Rehabilitation Facility/Long Term Acute Care facility (p<.0001). Patients with the JOURNEY II system also had 10% shorter length of stay on the index admission (p<.0001), 5% lower total hospital-related costs (p<.0001), primarily attributed to reduced room and boarding, central supply, and physical medicine and rehab costs and 13.98mg less consumption of pain medication measured in Morphine Milligram Equivalent (p<.0001).

CONCLUSIONS: This study demonstrated that JOURNEY II knee system has superior clinical and cost outcomes compared to other knee systems. This finding could help healthcare providers and payers make informed decisions regarding knee system choices.