Aesculap® Excia® T

Hip Endoprosthesis System

Aesculap Orthopaedics
 Aesculap® Excia® T
Hip Endoprosthesis System

2
Content

Excia® T Concept 4
Preoperative Planning 10
Surgical Technique 12
Article Overview 18
Plasmafit® Acetabular Cup System 22

3
 Aesculap® Excia® T Concept
Hip Endoprosthesis System

4
Excia® T Cementless Design OrthoPilot® Navigation

The universal and distally slim implant design and the Excia® T can be implanted using the OrthoPilot® navigation
standardized implantation technique allow the implant to system. Stem navigation tools allow intra-operative con-
be used in different femoral anatomies. Excia® T implants trol and documentation of leg length and offset changes.
are also suitable for narrow femur canals. OrthoPilot® navigation also supports minimally invasive
surgical techniques.
Essential design characteristics of the proximally fixating
implant are the trochanter-preserving rounded shoulder
and the modern stem length.
These features support minimally invasive surgical tech-
niques, especially the direct anterior approach. Excia® T Geometry
The Excia® T double taper design as well as the proximal
bilateral flanges provide a high primary stability.
Size Length Standard Lateralized
The 12 / 14 taper with a distally reduced neck diameter CCD Offset CCD Offset
increases the range of motion.
8 131.4 mm 135° 37.7 mm 128° 43.7 mm
Excia T is available as standard as well as a high-offset
®

implant, which supports an individual offset reconstruction. 9 135.9 mm 135° 38.9 mm 128° 44.9 mm

10 140.4 mm 135° 40.1 mm 128° 46.1 mm

11 144.9 mm 135° 41.3 mm 128° 47.3 mm

Plasmapore® Coating 12 149.4 mm 135° 42.5 mm 128° 48.5 mm

13 153.9 mm 135° 43.7 mm 128° 49.7 mm

For osseous integration into the proximal bone structure,
the cementless Excia® T stem, which is made of ISOTAN®F 14 158.4 mm 135° 44.9 mm 128° 50.9 mm
titanium alloy, is coated with the proven microporous
Plasmapore® titanium spray. 15 162.9 mm 135° 46.1 mm 128° 52.1 mm

During the Plasmapore® coating process, pure titanium 16 167.4 mm 135° 47.3 mm 128° 53.3 mm
powder, with a thickness of 0.35 mm and a microporosity
up to 40 % is sprayed on the proximal anchoring area of 17 171.9 mm 135° 48.5 mm 128° 54.5 mm
the implant. The very rough Plasmapore® structure also
supports the implant’s primary stability. 18 176.4 mm 135° 49.7 mm 128° 55.7 mm

19 180.9 mm 135° 50.9 mm 128° 56.9 mm

20 185.4 mm 135° 52.1 mm 128° 58.1 mm

5
 Aesculap® Excia® T Concept
Hip Endoprosthesis System

6
Excia® T Cemented Design CoCr Material

The universal implant design with the trochanter-preserving The cemented Excia® T differs from the cementless version
shoulder geometry and the modern stem length has also in implant material that is used, the ISODUR®F cobalt chrome
been adopted for the cemented Excia® T stem. alloy. The implant surface is not coated.

The bilateral flanges in the trochanter area support the

proximal fit of the implant in the cement mantle.

The geometry of the cemented Excia® T is parametric to the

cementless Excia® T stem. The stem design is 6 mm shorter
OrthoPilot® Navigation
for all sizes and has been radially reduced by 1 mm along
the complete stem. This design supports a constant cement The cemented Excia® T can also be implanted using the
mantle for all implant sizes. OrthoPilot® navigation system. To navigate the cemented
stems, the recommended implant size is displayed according
The adjustment of the profiler design with the cemented to the last used profiler size.
implant allows an influence of the desired nominal cement
mantle thickness when choosing the stem size based on the
last profiler size used. The distal stem alignment in the cement
can be achieved with a centralizer.

The cemented Excia® T implant is also available as standard

and lateralized version, which supports individual offset
reconstruction.

7
 Aesculap® Excia® T Concept
Hip Endoprosthesis System

8
Excia® T Profiler – Design Excia® T System Approach

The design of the profilers allows for a smooth preparation The essential benefit of the Excia® T instruments can be
of the implant bed. Proximal compression planes of the found in the system approach. Excia® T supports the im-
profilers support a compaction of the cancellous bone in plantation with or without bone cement for all surgical
anterior and posterior direction and herewith the preservation approaches with one single set of instruments. Excia® T
of bone material. herewith provides a great intraoperative flexibility.

An effective rasping is supported by chip flutes in the distal The Excia® T approach of using one instrument system for
part of the broaches. The flutes also facilitate the cleaning cementless and cemented implantations furthermore sig-
of the broaches from blood and bone material. nificantly reduces the intra-operatively necessary number
of instruments. The combination of a reduced number of
The asymmetrical tip of the implant and the profiler prevent instruments and an intelligent OrthoTray storage enables
a distal-lateral load transmission and provide a safe intra- that all Excia® T instruments fit into one single tray. Hence
medullary guidance of the profiler during the implantation. the OrthoTray needs low storage capacity and reduces the
costs for instrument processing and sterilization.
The Excia® T profiler are thus manufactured, that a trial
reposition with trial neck and trial head allow for a precise
evaluation of the joint function. Standard as well as later-
alized modular trial necks are available to check the offset
situation and simulate the expectable joint stability. Aesculap Instrument Platform

Profiler handles of the new generation allow for the implan-

tation of all Aesculap hip stems with the same handles.
Herewith not only the number of necessary instruments is
reduced but also the effort when different implant systems
are in use. Depending on the approach and patient position
in supine or lateral position ten different profiler handle
versions are available.

9
 Aesculap® Excia® T Preoperative Planning
Hip Endoprosthesis System

Leg length difference 3 mm

10
Aims of Preoperative Planning Excia® T Stem Implants

Based on the indication preoperative planning considers The broad size range as well as a precisely adjusted size
the position and size selection of the implant components. growth for Excia® T cementless and cemented implants
Anatomical circumstances are evaluated with an AP view allow for an individual selection of the implant size.
of the complete pelvis as well as the view of the contralateral
side to the indicated hip joint. Offset versions of the standard stem with 135° CCD angle
and the lateralized stem with 128° CCD angle and 6 mm
On the basis of the preoperative planning it is possible to offset increase support the reconstruction of the femoral
already identify intraoperative challenges in the forefront offset.
of the surgery. According to bone quality and shape preop-
erative planning indicates the possible fixation of the stem
component, position of the rotation center, offset and leg
length circumstances as well as the position of the femoral
osteotomy. Possibilities of Preoperative
Planning

Procedure of Preoperative Planning Excia® T X-ray templates with a scale of 1.15:1 are available
for manual planning. Furthermore Excia® T is integrated into
several digital planning systems.
1. Drawing in of the pelvis base line and the reference
to the trochanter minor
2. Determination of the femoral hip center
3. Position of the cup component, which indicates the
rotation center X-Ray Images
4. Selection of the appropriate stem implant after the
following requirements:
 �Proximal medial fit of the stem For the planning of Excia® T a deeply regulated pelvis over-
 �Distal axial stem position view and an image of the lateral view of the indicated hip
 �Without oversizing of the distal part of the implant should be available.
5. Adjustment of offset and leg length via the rotation
center of the stem component in relation to the cup
component
6. Marking of the 45° osteotomy line for the intraoperative
orientation with 10 -15 mm reference to the trochanter
minor

11
 Aesculap® Excia® T Surgical Technique
Hip Endoprosthesis System

12
Patient Position Landmark Determination

Depending on the surgical technique and approach the Bony landmarks at the trochanter need to be defined before
patient is positioned either in supine or in lateral position. luxation and resection of the femoral head. According to
preoperative and intraoperative measurements of these
The following images underlining the explanation of the landmarks leg length changes can be followed. The aim is
surgical technique are related to a lateral patient position to achieve the leg length situation that has been determined
and the utilization of a posterior approach. during the preoperative planning.

Approaches

Generally Excia® T supports all common approaches also in

minimally invasive technique.

Due to the trochanter preserving proximal rounded design

of the implant Excia® T is especially well suitable for the
direct anterior approach.

13
 Aesculap® Excia® T Surgical Technique
Hip Endoprosthesis System

1. Osteotomy

45°

The exact position of the osteotomy is determined by

the preoperative planning. The resection is done approx.
10 -15 mm above the trochanter minor.

The osteotomy angle is 45° to the femoral axis. All markings

on the instruments and implants are aligned with 45°.
To verify the osteotomy angle a resection guide with 45°
reference (ND054R) is available.

2. Opening the Femoral Canal

The femoral canal can be opened with a box osteotome

(NT903R). The osteotome can be attached to the appropriate
profiler handle.

The box osteotome is positioned postero-lateral with the

desired antetorsion angle. The box osteotome then is
impacted until a sufficient opening of the femoral canal
for further preparation with the broaches is achieved.

14
3. Profiler

The femoral canal is prepared with profilers in ascending

order until a good stability and an impacting depth of the
profiler up to the resection line is achieved.

Note: In order to not change the antetorsion angle of the

femur and to profiler the implant bed open too widely in
the proximal area, checking the stability by rotating the
profiler needs to be avoided.

4. Trial Reposition

standard lateral

The trial reposition is done with trial neck adapters with

standard offset (CCD 135°) or high offset of plus 6 mm
(CCD 128°), which are connected to the inserted Excia® T
profiler. Trial heads with a neck length from S to XXL
allow for a precise simulation of the implant geometry.

15
 Aesculap® Excia® T Surgical Technique
Hip Endoprosthesis System

5.a Excia® T Cementless –

Implantation
For the cementless implantation of Excia® T the appropriate
implant size corresponds to the last used profiler size.

Depending on the utilized approach a curved impaction

device (ND945R) or a straight impacting device (ND944R)
is available. These instruments allow for a rotational stable
impaction of the implant.

16
5.b Excia® T Cemented –
Implantation
For the implantation with bone cement the implant size is In case of distally widened femoral canals and after mea-
selected in relation to the last utilized profiler as well as suring the canal width it is also possible to use a bigger
the desired nominal thickness of the cement mantle. On centralizer in order to achieve a distal canal fitting.
the packaging of each Excia® T cemented implant the size
of the corresponding centralizer is stated.

Profiler size 10 11 12 13 14 15 16 17 18 19 20

Excia® T cemented 10 12 14 16 18 20

Centralizer Ø mm 8 9 10 11 12 13

Cement mantle mm 1 1.5 1 1.5 1 1.5 1 1.5 1 1.5 1

17
 Aesculap® Excia® T Article Overview
Hip Endoprosthesis System

Excia® T Cementless Excia® T Cemented Distal IMSET Plug

Centralizer

Size Standard T Lateral TL Size Standard T Lateral TL mm Centralizer mm Plug

8 NU208T NU228T 10 NU270K NU290K 8 NK088 8 NK908

9 NU209T NU229T 12 NU272K NU292K 9 NK089 10 NK910

10 NU210T NU230T 14 NU274K NU294K 10 NK090 12 NK912

11 NU211T NU231T 16 NU276K NU296K 11 NK091 14 NK914

12 NU212T NU232T 18 NU278K NU298K 12 NK092 16 NK916

13 NU213T NU233T 20 NU280K NU300K 13 NK093 18 NK918

ISODUR®F Composition:
14 NU214T NU234T 14 NK094
50 % Gelatine (from pigs)
30 % Glycerine
15 NU215T NU235T 15 NK095 20 % Water
2% Methylparahydroxy-
benzoate
16 NU216T NU236T 16 NK096

17 NU217T NU237T 17 NK097

18 NU218T NU238T 18 NK098

19 NU219T NU239T PMMA

20 NU220T NU240T

ISOTAN®F

Implant materials:

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

ISOTAN®F Titanium forged alloy (Ti6Al4V / ISO 5832-3)
ISODUR®F Cobald-chromium forged alloy (CoCrMo / ISO 5832-12)
PMMA Polymethylmethacrylate

18
Ceramic Heads Metal Heads
12 / 14 12 / 14

Size 28 mm 32 mm 36 mm 40 mm Size 28 mm 32 mm 36 mm 40 mm

S NK460D NK560D NK650D NK750D S NK429K NK529K NK669K NK769K

M NK461D NK561D NK651D NK751D M NK430K NK530K NK670K NK770K

L NK462D NK562D NK652D NK752D L NK431K NK531K NK671K NK771K

XL – NK563D NK653D NK753D XL NK432K NK532K NK672K NK772K

Biolox® delta XXL NK433K NK533K NK673K NK773K

ISODUR®F

Excia® T Cementless

Excia® T Cemented

Implant materials:

Biolox® delta Aluminium oxide matrix ceramic (Al2O3 / ZiO2 / ISO 6474-2)
ISODUR®F Cobalt-chromium forged alloy (CoCrMo / ISO 5832-12)

19
 Aesculap® Excia® T Article Overview
Hip Endoprosthesis System

Excia® T NT900 Basic Set

Consisting of:

Excia® T tray NT901R Trial prosthesis head, S, 32 mm NT366

Graphic template for NT901R TF109 Trial prosthesis head, M, 32 mm NT367

Lid for OrthoTray JA455R Trial prosthesis head, L, 32 mm NT368

Excia® T extraction adapter NT904R Trial prosthesis head, XL, 32 mm NT369

Excia® T trial neck 12 / 14 NT905R Trial prosthesis head, XXL, 32 mm NT370

Excia® TL trial neck 12 / 14 NT906R Trial prosthesis head, S, 36 mm NT376

Head impactor ND060 Trial prosthesis head, M, 36 mm NT377

Cross bar for profiler handles ND017R Trial prosthesis head, L, 36 mm NT378

Trial prosthesis head, S, 28 mm NT356 Trial prosthesis head, XL, 36 mm NT379

Trial prosthesis head, M, 28 mm NT357 Trial prosthesis head, XXL, 36 mm NT380

Trial prosthesis head, L, 28 mm NT358 Note: The recommended container for Excia® T Basic Set NT900 is
Aesculap basic container 592 x 285 x 153 mm.

Trial prosthesis head, XL, 28 mm NT359

Trial prosthesis head, XXL, 28 mm NT360

Please order separately:

Trial prosthesis head, S, 40 mm NT386

Trial prosthesis head, M, 40 mm NT387

Trial prosthesis head, L, 40 mm NT388

Trial prosthesis head, XL, 40 mm NT389

Trial prosthesis head, XXL, 40 mm NT390

20
Excia® T Small Tray

Excia® T profiler Please order separately:

Form profiler size 8 NT908R Straight insertion instrument ND844R

Form profiler size 9 NT909R Curved insertion instrument ND845R

Form profiler size 10 NT910R Profiler handle lateral approach, straight * NT001R

Form profiler size 11 NT911R Profiler handle posterior approach, straight * NT002R

Form profiler size 12 NT912R Profiler handle anterior approach, straight * NT003R

Form profiler size 13 NT913R Profiler handle lateral approach, offset left * NT004R

Form profiler size 14 NT914R Profiler handle lateral approach, offset right * NT005R

Form profiler size 15 NT915R Profiler handle anterior approach, offset left * NT006R

Form profiler size 16 NT916R Profiler handle anterior approach, offset right * NT007R

Form profiler size 17 NT917R Profiler handle lateral approach, straight * NT008R

Form profiler size 18 NT918R Profiler handle lateral approach, offset left * NT009R

Form profiler size 19 NT919R Profiler handle lateral approach, offset right * NT010R

Form profiler size 20 NT920R Femoral head saw guide 45° ND054R

Excia® T Modular box osteotome NT903R * three profiler handles can be stored in the tray

Please order separately:

Excia® T cemented X-ray templates NT922

scale 1.15:1

Excia® T cementless X-ray templates NT923

scale 1.15:1

21
 Aesculap® Plasmafit®
Cementless Acetabular Cup System

22
Acetabular Cup System Plasmafit® Poly

In addition to the Excia® T stem components the Plasmafit® Plasmafit® Poly is a dedicated cup implant line exclusively
cementless acetabular cup system is available. for the use with polyethylene liners and allows the optional
use of correction liners.

Plasmafit® Surface
Plasmafit® Plus
The precise profile structure of the Plasmafit® surface en-
ables the surgeon to skip the step of trial cup implantation Plasmafit® Plus designed for combined treatments with
in most cases. ceramic or polyethylene articulation materials. The increased
wall thickness compared to Plasmafit® Poly allows additional
The high intraoperative primary stability of Plasmafit® re- screw holes for an optional use of cancellous fixation screws.
duces the need for additional screw fixation to only a few
cases and allows implantations under difficult conditions All Plasmafit® Plus cup implants can be combined with
and easy revision treatments. modular Vitelene® polyethylene liners made of vitamin E
stabilized highly cross-linked polyethylene.

Insert Selection

The wall thickness of both Plasmafit® implant lines offers For further information about the Plasmafit® acetabular
an improved articulation choice for highly crosslinked poly- cup system please refer to the Aesculap brochure O45502.
ethylene and ceramic cup liners.

23
 The main product trademark “Aesculap” and
the product trademarks “Excia”, “ISODUR”,
“ISOTAN”, “OrthoPilot”, “Plasmafit”,
“Plasmapore” and “Vitelene” are registered
trademarks of Aesculap AG.
“Biolox” is a registered trademark of CeramTec
GmbH, Plochingen.

Subject to technical changes. All rights reserved.

This brochure may only be used for the exclusive
Aesculap AG | Am Aesculap-Platz | 78532 Tuttlingen | Germany purpose of obtaining information about our
products. Reproduction in any form partial or
Phone +49 7461 95-0 | Fax +49 7461 95-2600 | www.aesculap.com otherwise is not permitted.

Aesculap – a B. Braun company Brochure No. O56002 0715/0.5/2