BICON-PLUS® - Plus Orthopedics

BICON-PLUS ®
Non-cemented Acetabular System
Author: Prof. Dr. med. K. Zweymüller
Product Information
Know-how brings motion back to life. SM

Clinically Proven for over 10 Years
For over 10 years the BICON-PLUS ® cup has proven to be an excellent biconical
screw cup in more than 200’000 implantations all over the world.
Stable anchoring
The principle of biconical cup anchoring provides the best conditions for maximum stability
and the best protection against cup migration. The unique action of the biconical design that
is easy on the bone and the self-tapping thread ensure excellent primary stability.
Individualised management
The “STANDARD” and “POROUS” variants of the BICON-PLUS ® cup allow optimum management
in primary and revision interventions in hard and porotic bones as well as in dysplastic hips.
Perfect system
The BICON-PLUS ® cup forms a unique, precision-adjusted hip prosthetic system in combination
with the non-cemented SL-PLUS ® stem.

BICON-PLUS ®
Double cone principle
The anatomical approximation to the acetabulum requires less bone resection, increases the
bone contact and ensures extremely high tilt stability.
Optimum thread and tooth profile
The thread and tooth profile is anatomically adapted for all cup sizes.
Suitable for any bone quality
Choice of “STANDARD” or “POROUS” cup. The tooth form of the “STANDARD” cup type
is designed for normal and sclerotic bone and that of the “POROUS” cup type for soft and
porotic bone.
Cup inlays
All inserts are available in standard and antiluxation versions.
Articulation pairings
Depending on the requirement of the situation, the surgeon can select from hard/soft
(metal/PE or ceramic/PE) and hard/hard pairings (ceramic/ceramic or metal/metal).
Surgical instrumentation
The instruments in the EasyTrayTM system are user-friendly, clearly presented and safe.
Implantation
Conventional or navigated with PiGalileo ® NAV.

BICON-PLUS ®
The 7 PLUS Points
Tooth Surface mm 2
6000
5000
4000
3000
2000
1000
Tooth Surfaces Porous/Standard
1
2
3
4
Porous +46%
5
6
System
0
40 45 50 55 60 65 70 75 80
Cup Diameter mm
7
8
9
Standard
The double cone
Anatomic approximation to the spherical form of the
acetabulum
Less bone resection in the area of cup floor while ensuring
optimal primary and tilt stability
Broad seating in the acetabulum, especially at the front
end of the cup
Possibility to fully screw into the previously reamed bony
bed, thanks to the optimal tooth and thread form
The tooth form
Tooth size, tooth thickness and tooth height matched to
cup size
Thread and tooth size increase with increasing cup size:
– smaller cup – smaller thread and tooth form
– larger cup – larger thread and tooth form
The surface roughness
The average roughness of the titanium shells is 4 to 6 µm
The macrostructure of the thread teeth and the microstructure
of the rough surface combine to ensure reliable
primary stability and thus long-term osteointegration.

The closed rim
A direct PE-bone contact can be fully avoided (also in the
rim area)
Implantation easy on soft tissue and bone

The sector closure
Open sectors allow full view during the implantation procedure
Spongiosaplasty can be performed through these openings,
if necessary
After screwing in the cup shell, the sectors are closed with
an instrument to avoid any polyethylene-bone contact
The articulation pairings
PE standard and antiluxation version for ball heads 22,
28 and 32 mm
REXPOL ® (highly cross-linked PE) standard and antiluxation
version for ball heads 28 and 32 mm
Standard and antiluxation version ceramic/PE insert
28 mm for ceramic/ceramic pairing
Standard and antiluxation version metal/PE insert 28 mm
for metal/metal pairing
PE retention inlay for ball heads 28 and 32 mm
More information on articulation pairings:
Lit. No. 1101
BICON-PLUS ® cup with ceramic/ceramic pairing
Lit. No. 1351
Highly latticed polyethylene REXPOL ®
Lit. No. 1061
Metal/metal pairing for BICON-PLUS ® cup
The cup duo
Two versions with different thread tooth profiles are available
for various qualities of bone:
BICON-PLUS ® STANDARD – for hard and sclerotic bone
BICON-PLUS ® POROUS – for soft and porotic bone
Anchoring of the PE insert
in the titanium cup by means
of four conus connections
TITANIUM CUP / PE INSERT
Axial form closure
due to snap lock
TITANIUM CUP /
PE CERAMIC-CERAMIC INSERT
▲
▲
▲

MATERIALS
BICON-PLUS ®
System
The Range of Nine Standard and Two Special Sizes Optimally
Covers All Size Requirements.
BICON-PLUS ® cup shell
high-grade-forged pure titanium
according to ISO Standard 5832-2
PE inserts
UHMW polyethylene according to ISO
standard 5834-1/2
REXPOL ® PE inserts
highly cross-linked polyethylene
made of form-pressed GUR-1020
UHMW-PE according to ISO 5834-2
Ceramic/PE inserts
high-grade aluminium-oxide-sintered
ceramic (AI203) BIOLOX ® forte according
to ISO standard 6474
Metal/PE inserts
CoCrMo-forged alloy PLUSMET ®
according to ASTM F 799
PE-/REXPOL ® Standard
SHELLS
Size / Ø mm
0 1/ 37
0 / 40
1 / 43
2 / 46
3 / 49
4 / 52
5 / 56
6 / 59
7 / 63
8 / 68
9 / 72
BICON-PLUS ® Standard
PE-/REXPOL ® Antilux PE-/retention insert
Metal Standard (S, M, L, XL) BIOLOX ® forte (S, M, L)
Standard
x
x
x
x
x
x
x
x
x
x
x
Porous
BICON-PLUS ® , PLUSMET ® , REXPOL ® and SL-PLUS ® are trademarks of Plus Orthopedics AG, Switzerland,
registered in Switzerland and other selected countries.
x
x
x
x
x
x
x
x
x
x
x

BIOLOX ® forte Standard BIOLOX ® forte Antilux PLUSMET ® Standard PLUSMET ® Antilux
BIOLOX ® OPTION (S, M, L, XL)
BICON-PLUS ® Porous
PLUSMET ® (S, M, L, XL)
INSERTS Ball head Ø / Size in mm
Material
Standard PE insert
Antilux insert
REXPOL ® standard insert
REXPOL ® antilux insert
BIOLOX ® forte/PE standard insert
BIOLOX ® forte/PE antilux insert
PLUSMET ® /PE standard insert
PLUSMET ® /PE antilux insert
PE retention insert
EasyTray and PiGalileo ® are trademarks of Plus Orthopedics AG, Switzerland.
BIOLOX ® forte and BIOLOX ® OPTION are trademarks of CeramTec AG, Germany.
22
01 – 8
01 – 4
28
1 – 9
1 – 9
1 – 9
1 – 9
3 – 9
3 – 9
1 – 28
1 – 28
1 – 9
32
3 – 9
3 – 9
3 – 9
3 – 9
3 – 9

Clinical Results
Between January 1993 and May 1994, 348 of these
cups were implanted. The articulating surfaces were
ceramic and polyethylene. 215 were reviewed after
10.0 to 11.1 (mean 10.2) years. In the interval 3 cups
needed revision (1 for aseptic loosening, 1 for lowgrade
infection and 1 for cup breakage).
Cumulative Proportion Surviving
1.00
0.98
0.96
0.94
0.92
0.90
Survival Function
0 20 40 60 80 100 120 140
Survival Time (Months)
Kaplan-Meier survival rate with revision of the cup shell
because of aseptic loosening as the end point was 99.6%
(CI: 97.0 to 99.9) (n = 216).
Flexibility also in instrumentation
Optimal cutting reamers for processing the bone
New modular setting device for conventional and navigated
cup shell implantations
Sector-closing instrument for simple closure of cup floor
Complete trial system
With revision as end point, the Kaplan-Meier survival
rate was 98.8 % (CI 96.2 – 99.6). On follow-up
radiography, 3 cups of 215 were rated as loose. All
others showed good bony consolidation. Gaps between
the cup floor and the bone tended to be
spontaneously obliterated by newly formed bone.
Complete obliteration was observed even in those
cases with incomplete cranial implant coverage due
to hip dysplasia. The results show the cup to be universally
applicable in primary arthroplasties irrespective
of the diagnosis and any acetabular deformities.
Zweymüller K, Steindl M. Cup fixation. Minimum 10-year results vs.
5-year data. What difference? In: Friederich NF, Santore RF, editors.
25 years of biologic fixation anniversary symposium. Munich: Urban
& Fischer; In Press.

Distribution
Sales Partners in:
Australia
Baltic countries (EE, LT, LV)
Belarus
Bosnia
Brazil
Bulgaria
India
Indonesia
Iran
Croatia
Kuwait
Malaysia
Norway
Russia
Slovakia
Slovenia
South Africa
South Korea
Thailand
Czech Republic
Turkey
Technical changes reserved
Belgium
Plus Orthopedics Belgium Sprl
Rue du Bosquet, 2, P.I Nivelles Sud, 1400 – Nivelles
Phone +32 67 879 500, Fax +32 67 646 640
China
Plus Orthopedics (Beijing) Co., Ltd.
7th Floor, Modern Palace, No. 20 Daluyuan
Dongsanhuan Nanlu, Chaoyang District
Beijing 100022, P.R. China
Phone +86 10 8778 3322, Fax +86 10 6776 3622
Germany
Plus Orthopedics GmbH
Mainstrasse 2, 45768 Marl
Phone +49 2365 91 81 0, Fax +49 2365 91 81 10
France
Plus Orthopedics France Sarl
14, Villa des Fleurs, 92400 Courbevoie
Phone +33 1 49 97 04 60, Fax +33 1 47 68 09 36
Greece
Plus Orthopedics Hellas S.A.
Kleanthous Street 8, GR 16346 Ilioupoli, Athina
Phone +30 2 10 99 13 190, Fax +30 2 10 99 31 809
United Kingdom
Plus Orthopedics (UK) Limited
Barbury House, Stonehill Green, Westlea, Swindon SN5 7HB
Phone +44 1793 719 222, Fax +44 1793 619 222
Italy
Plus Orthopedics Italy Srl
Via Archimede 76, 20041 Agrate Brianza (MI)
Phone +39 039 657 921, Fax +39 039 657 92 35
Japan
Plus Orthopedics K.K.
Tomigaya-Ogawa Bldg. 2-41-12, Tomigaya
Shibuya-ku, Tokyo 151-0063
Phone +81 3 3467 5581, Fax +81 3 3467 5582
The Netherlands
Plus Orthopedics Netherlands BV
Postbus 785, 2700 AT Zoetermeer
Phone +31 793 41 7071, Fax +31 793 42 5601
Austria
Plus Orthopedics GmbH
Grenzgasse 38a, 2340 Mödling
Phone +43 2236/48 407-0, Fax +43 2236/41 149-4
Switzerland
Plus Orthopedics Schweiz AG
Erlenstrasse 4a, 6343 Rotkreuz
Phone +41 41 798 41 11, Fax +41 41 798 41 00
Spain
Plus Orthopedics España S.A.
c/Islas Aleutianas n 4, 28035 Madrid
Phone +34 91 376 86 20, Fax +34 91 376 86 21
USA
Plus Orthopedics USA, Inc.
10188 Telesis Court, San Diego, CA 92121
Phone +1 858 550 3800, Fax +1 858 457 56 18
Switzerland
Plus Orthopedics AG (Manufacturer)
Erlenstrasse 4a, 6343 Rotkreuz
Phone +41 41 798 41 11, Fax +41 41 798 41 00
info@plusorthopedics.com
www.plusorthopedics.com
Lit. No. 1035-e Ed. 04/06 500 Ex. 01/07