Aesculap Orthopaedics Plasmacup® · Plasmacup® design 7 Plasmacup ... Press fit of the polyethylene liner nearly eliminates micromotion and ... adjacent to the screw holes

Aesculap OrthopaedicsPlasmacup®

Cementless Acetabular Cup System

OrthoPilot®Plasmapore®

Plasmacup®

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Content

Plasmacup® system 4

Plasmacup® implants 5

Plasmapore® surface 6

Plasmacup® design 7

Plasmacup® surgical technique 8

Plasmacup® cup position 9

Plasmacup® implantation 10

OrthoPilot® THA navigation 11

Plasmacup® ordering information

Instruments 12

Implants 15

Liners 15

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Plasmacup® system

The Plasmacup® system, which has proven

effective itself in clinical practice since

1992, is based on three essential elements:

Microporous Plasmapore® titanium

coating for excellent primary and

secondary stability

Press fit of the polyethylene liner

nearly eliminates micromotion and

backside wear

The world’s leading navigation

technology in hip arthroplastyPlasmacup® design

Plasmapore® coating OrthoPilot® navigation

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Plasmacup® implants

Plasmacup® SC µ-CaP

The Plasmacup® SC standard

implant features three holes for

optional fixation with 6.5 mm

screws. The Plasmacup® SC µ-CaPhas an additional resorbable

calcium phosphate layer.

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Plasmapore® surface

Plasmapore® Primary stability Plasmapore® µ-CaP

Plasmapore® coated implants have beenused by Aesculap since 1986. In a vacuumcoating process, pure titanium powder isapplied to the surface of cementless implants to form a 0.35 mm thick layerwith up to 40% microporosity.

The pore size of the Plasmapore® coating ranges between 50 and 200 µm to allow direct bone apposition.

The rough surface of the Plasmapore®

structure supports a more stable primaryfixation of the implants than other implantsurface types. Stability measurementsdemonstrate the superior primary stabilityachieved with Plasmapore® compared withother implant surfaces.

The newly developed Plasmapore® µ-CaPcoating uses calcium phosphate as anadditional layer.

A 20 µm layer of high-purity dicalciumphosphate dihydrate (DCPD) is

electro-chemically applied to thePlasmapore® coating. The thin µ-CaPcoating dissolves within eight to twelveweeks without the involvement ofmacrophages.

The Plasmacup® SC implants are availablewith Plasmapore® or Plasmapore® µ-CaPsurfaces.

Cup A Cup B Cup C Plasmacup® Cup E

Ischium Pubis Ilium

0

50

100

150

200

250

300

350

400

µm

Primary stability ofvarious press-fit cups in biomechanical experiments (Pitto 1997)

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Design Inner surfaceStability

way, both polyethylene and ceramic liners*are safely fixed. The drill holes are locatedin the cranial region of the cup, outside theconical attachment surface. The roughtitanium inner surface reduces relativemovements to only a few micro ns, whichprevents the formation of abrasionparticles on the back side of the liner.

The conical fixation surface of thePlasmacup® polyethylene liners also formsa seal against the migration of polyethyleneparticles from the articulating joint, andthus reduces the risk of an osteolysis adjacent to the screw holes.

The polyethylene liners are strongest whenthe load is directed cranially. In the primaryload area, Plasmacup® polyethyleneimplants are at least 6 mm thick. The fixation is highly stable against tilting androtation forces in-vivo.

The polyethylene used conforms toestablished standards and long-termclinical experience. The implants aremanufactured from high density PE plates,using CNC technology. The material issterilized by radiation in a nitrogenatmosphere, and packaged to preventoxidation.

In-vivo wear of the Plasmacup® polyethyleneliners with a ceramic 28 mm head is0.1 mm per year, which is below thethreshold that would cause osteolysis.Higher wear can occur with metal heads,by third-body wear, through incorrect cuppositioning, or as a result of implantloosening.

*Ceramic cup liners are not available in the U.S.

The Plasmacup® is characterized by goodpress-fit stability and safe attachment of modular polyethylene or ceramic liners.*

The external shape of Plasmacup® is hemispherical with a slightly flattenedapex. With standard liners, the center ofrotation is located at the exact center ofthe sphere. Plasmacup® is suitable for eitherpoly ethylene (PE) or ceramic cup liners.*

The Plasmacup® liners are attached by apress-fit cone with a large surface areaand, in case of the PE liners, through fullcontact with the base of the cup. In this

Plasmacup® design

Hip range of motion withdifferent head diametersand prosthesis cone sizes.

28 mm 32 mm 36 mm

130

140

150

cone 12/14

cone 8/10

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Acetabular reamers Trial cups Plasmacup® implant

The Plasmacup® implantation instrumentshave undergone continuous developmentduring more than 10 years of clinicalapplication. The optional use of theOrthoPilot® hip navigation system sets thetrend for a safe and reproducible operatingtechnique (see p. 12).

In order to have a good press-fit fixation ofthe Plasmacup® implant, there must be agood bony structure and proper surgicaltechnique. Acetabular exposure removal ofthe articular cartilage and osteophytes arerequired for the proper preparation of theacetabulum.

This is done using spherical reamers, whichare driven by a low-speed motor handpiece.During the reaming procedure, allcartilaginous material must be ablateddown to the subchondral bone untilbleeding occurs.

For non-dysplastic cases, care must be taken that the center of rotation of the joint is not medialized unnecessarily. Thesocket edges should be prepared for a sufficiently large bony fixation surface.

In cases of dysplastic changes, a cupposition in the region of the primary socket

is recommended, provided the shorteningof the leg can be compensated. The caudal edge of the socket should be at the level ofthe tear drop figure. A cranial bone graft isperformed, if necessary, before the socketbase is deepened to provide sufficient cranial roofing.

The size of the Plasmacup® implantscorresponds to the size of the lastacetabular reamer used and include theproper press-fit conditions.

The final selection of the implant is onlydetermined after a trial cup has beenseated firmly. A stable fit of this trial cup is achieved when the pelvis of the patient canbe moved by gently moving the trial cup byabout 10°. The trial implant can be easilylevered out from the in-vivo trial positionby moving beyond this angle.

Plasmacup® surgical technique

Reaming of the acetabulum

Plasmacup® trial cup

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After completing the Plasmacup® surgerysteps of acetabular exposure, reaming,assessment of the cup bed with the trialimplant and implantation of the cup, thetrial liner is inserted. The final selection ofthe modular liner is determined only afterthe stem is implanted and the final trialreduced.

Aiming device lateral decubitus position

Plasmacup® cup position

The safe and stable assembly of thePlasmacup® implant on the impactor shaftmust be checked by a surgical assistantand the surgeon prior to implantation. Aslotted hammer on the impactor shaft issuitable for shifting and correcting theposition of the Plasmacup® implant.

Aiming device supine position

Plasmacup® with trial liner

Aiming devices are available for Plasmacup®

to measure inclination and anteversion forboth standard and navigated surgeries.These devices, which have been designedfor supine or lateral decubitus positions,can be mounted on the cup impactor shaft.

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Generally, in good bone, Plasmacup® can beimplanted without additional screws. As a stability check, the cup impactor is movedthrough ± 20° until the patient’s pelvismoves. Under these conditions, Plasmacup®

SC can also be rotated 180° prior toimplantation, placing the screw holes inthe non-load bearing caudal region sincethey are not needed cranially. If there isany doubt concerning the intraoperativeprimary stability, fixation screws must beused or the implant must be replaced.

For cases where additional stability withfixation screws is necessary, Plasmacup® SCfeatures three holes in the cranial region.To protect the medial blood vessels, themiddle and lateral screw positions can beused and the medial hole is usually leftopen.

Prior to inserting the self- tapping 6.5 mmscrews, the drill holes are prepared with aflexible 3.2 mm drill (or with a 4 mm drillfor severely sclerotic bone). The requiredscrew length is measured and the screwsare implanted using a screw holdingforceps and a cardan-jointed screwdriver.

Plasmacup® implantation

Plasmacup®

fixation screws

The pivot angle of the 6.5 mm Plasmacup® screws

is 20°. Before implanting the modular liner, the

surgeon must make certain that none of the

screw head protrudes into the liner anchoring

zone.

Instruments for screw implantation

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OrthoPilot® THA navigation

OrthoPilot® navigation of acetabular reaming

OrthoPilot® hip navigation of leg length and offset

OrthoPilot® THA navigation combines the data on theposition of Plasmacup® with the position of the stem.Stem rotation is displayed in relative to the cup position. The surgeon obtains information regarding theleg length, the offset, and the range of motion of the hipjoint.

Aesculap is the world leader in orthopaedic navigation,and Plasmacup® components can be used with OrthoPilot®

navigation technology. OrthoPilot® cup navigation workswithout CT or fluoroscopy, following the principles ofkinematic referencing.In navigated Plasmacup® surgeries, the system measuresthe inclination and anteversion angles relative to theanterior pelvic plane. During the acetabular reamingstage, the joint center, the reaming depth, and theorientation of the reamer are measured and displayed.Plasmacup® navigation with OrthoPilot® is suitable for different patient positions and surgical approaches. Italso supports less invasive surgical procedures and surgeries on dysplastic cases. Navigation of the cup is anintegral part of OrthoPilot® THA navigation.

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Plasmacup® instruments

JF217R

ND170R

ND172

ND174

NF269R

NF271R

NF275R

NF278R

NF279R

NF280R

NF281R

NF282R

NF285R

NF287R

NF292R

Plasmacup® instruments ST0204 Plasmacup® instruments ST0204

Tray 1

1/1 Size Perf Basket Lid 489 X 257 mm

Cup Inserting and Pressing Instrument

Cup Pressing Head D32 mm

Cup Pressing Head D28 mm

Plasmacup S Screw Gauge

Plasmacup S Tray Implantation Instrument

Slotted Hammer Slot Width 12 mm

Plasmacup S Drill Guide F/Screw D3.2 mm

Plasmacup S Drill Guide F/Screw D4.0 mm

Plasmacup S Flexible Drill D3.2 mm UL32 mm



Plasmacup S Articul. Screw Driver SW3.5

Screw Holding Forcepts

Plasmacup Aiming Device F/Post. Access

JF213R

JF217R

JF932

FS944R

FS947R

NF371R

JK486

JN444

Tray 2

1/1 Size Perf Basket 485 X 253 X 76 mm


Silicone Pad Blue 470 X 230 X 30 mm

Plasmacup Insertion Instru STR 305 mm

Plasmacup Insertion Instru CVD 305 mm

Ball Head Screw Driver SW8.0 L395 mm

Full-Size Lid w/ Retention Plate Blue

Full-Size Perf Bottom 187 mm

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Tray 3


Plasmacup® Tray F/NG034

Plasmacup® SC/MSC Trial Cup Size 40 mm











Plasmacup®SC/MSC Trial Cup Size 62 mm




JF217R

NG035R

NG940R

NG942R

NG944R

NG946R

NG948R

NG950R

NG952R

NG954R

NG956R

NG958R

NG960R

NG962R

NG964R

NG966R

NG968R

Tray 4


SC/MSC Tray F/NG360

SC/MSC Trial Insert 28 mm 44/46 SYM.

SC/MSC Removal Forcepts F/PE-Inserts

SC/MSC Tight.FCPS F/ASYM.Trial Inserts





SC/MSC Trial Insert 32 mm 64-68 SYM.

SC/MSC Trial Insert 32 mm 52/54 Post. Wall



SC/MSC Trial Insert 32 mm 64-68 Post. Wall



Full-size Lid w/Retention Plate Blue

Full-size Perf Bottom 187 mm

JF217R

NG035R

NG940R

NG942R

NG944R

NG946R

NG948R

NG950R

NG952R

NG954R

NG956R

NG958R

NG960R

NG962R

NG964R

NG966R

NG968R

JN444

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Plasmacup® instruments

Tray 5


Tray F/Acetabular Reamers Set 24

Acetabular Reamer Head Standard D40 mm




















JF217R

NF933R

NF940R

NF941R

NF942R

NF943R

NF944R

NF945R

NF946R

NF947R

NF948R

NF949R

NF950R

NF951R

NF952R

NF953R

NF954R

NF955R

NF956R

NF957R

NF958R

NF959R

Tray 6

OrthoPilot THA Mild Reamer Shank Zimmer

OrthoPilot THA Gloves Protection

OrthoPilot THA Reamer Shank MPR Zimmer


Tray F/Acetabular Reamers Set 13










Full-size Lid w/Retention Plate Blue

Full-size Perf Bottom 187 mm

FS935R

FS939

FS959R

JF217R

NF932R

NF960R

NF961R

NF962R

NF963R

NF964R

NF965R

NF966R

NF967R

NF968R

JK486

JN444


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Plasmacup® implants

Implant materials:ISOTAN®

F Titanium forged alloy (Ti6Al4V / ISO 5832-3)

Plasmapore® Pure titanium surface (Ti ISO 5832-2)

Plasmapore® µ-CaP Pure titanium surface with 20 µm layer of

dicalcium phosphate dihydrate (CaHPO4x2H2O)

Biolox® forte Aluminum oxide ceramics (Al2O3 / ISO 6474)

Biolox® delta Al2O3 matrix ceramics

UHMWPE Ultra-high molecular weight polyethylene (ISO 5834-2)

ISOTAN ®F

Length

16 mm

NA766T

20 mm

NA770T

24 mm

NA774T

28 mm

NA778T

32 mm

NA782T

36 mm

NA786T

40 mm

NA790T

44 mm

NA794T 6.5 mm

Plasmacup® screws 6.5 mm

UHMWPE polyethylene

—

NH191

NH192

NH193

NH194

NH195

NH196

—

—

NH202

NH203

NH204

NH205

NH206

—

NH401

NH402

NH403

NH404

NH405

NH406

—

—

—

NH413

NH414

NH415

NH416

Posterior wall

40 mm42 mm

44 mm46 mm

48 mm50 mm

52 mm54 mm

56 mm58 mm

60 mm62 mm

64 mm66 mm68 mm

Symmetrical

Ø 28 mm Ø 32 mm Ø 28 mm Ø 32 mm

Plasmacup® SC µ-CaP

ISOTAN ®F

40 mm

42 mm

44 mm

46 mm

48 mm

50 mm

52 mm

54 mm

56 mm

58 mm

60 mm

62 mm

64 mm

66 mm

68 mm

--

--

NC444T

NC446T

NC448T

NC450T

NC452T

NC454T

NC456T

NC458T

NC460T

NC462T

NC464T

NC466T

NC468T

Plasmapore® µ-CaP

Aesculap Implant Systems, Inc.

3773 Corporate ParkwayCenter Valley, PA 18034Phone: 866-229-3002

www.aesculapimplantsystems.com©2008 AESCULAP. ALL RIGHTS RESERVED. PRINTED IN THE USA. DOC565 REV. A 2M 1 /08Aesculap is an equal opportunity employer

All rights reserved. Technical alterations are possible. This leaflet may be used for no other purposes than offering, buying and selling of our products. No part may be copied or reproduced in any form. In the case of misuse we retain the rights to recall our catalogs and price lists and to take legal actions.

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Aesculap Orthopaedics Plasmacup® · Plasmacup® design 7 Plasmacup ... Press fit of the polyethylene liner nearly eliminates micromotion and ... adjacent to the screw holes