If you or a family member are facing an orthopaedic challenge, it is good to know that Excelen is at work. For over three decades, our research has resulted in more options and better results for patients. Our scientists are in the trenches, developing new innovations and solutions for complex orthopaedic challenges. Click into a category to learn more about Excelen’s experience and focus.

Excelen has a long history of research to improve the treatment of bone fractures. At Hennepin County Medical Center in Minneapolis, Dr. Ramon Gustilo was founding chairman of the Department of Orthopaedic Surgery. Currently, Drs. Richard Kyle, David Templeman, Andrew Schmidt, Thomas Varecka, Patrick Yoon, and Jonathan Haas treat patients at HCMC with complex orthopaedic trauma. This relationship with patients and physicians creates a close, productive, and crucial connection between our laboratory work, development of improved devices and techniques, clinical outcome studies, and patient care.

Much of our trauma research focuses on effectively dealing with conditions known to impair fracture healing—infection, diabetes, steroids, and nicotine. Our research findings directly contribute to the knowledge of the orthopaedic community and to options available to patients around the world.

Excelen scientists compared the outcomes of two different treatments for fractures of the tibia (shinbone). The Excelen Orthopaedic Biomechanics Laboratory is also involved in the development and evaluation of a novel method of monitoring, preventing, and treating an uncommon but devastating complication of trauma called compartment syndrome, using tissue ultrafiltration. The results of these studies are leading physicians to the most effective methods of treatment and improved care for patients.

Excelen’s involvement with total joint replacement began with Dr. Ramon Gustilo and Dr. Richard Kyle’s development of the BIAS hip replacement system. They conducted a controlled FDA study, resulting in the first FDA approved hip implant system for non-cemented use. Dr. Ramon Gustilo’s development of the Genesis I total knee system in the early 1980s resulted in one of the most popularly implanted knees for the last decade. The Reflection acetabular cup was the first on the market to tackle the problem of “backside wear” by polishing the inner surface of the metal cup, a practice that is now widely implemented. Development and evaluation work with a variety of implants and instruments continues unabated, in, association with the Excelen Orthopaedic Biomechanics Laboratory.

Areas of research include:

Joint Replacement Revisions

Most patients experience excellent results with hip and knee replacement surgery, and have one of the highest quality of life improvements per health care dollar spent for a major surgery. Unfortunately, if the implants do fail, their revisions have been much less successful. Due to the large number of patients having implants, and their longer life expectancies, the number of complex revision procedures is increasing. The ideal locations for revisions to be performed are specialty referral centers like HCMC. To meet the large and growing need for improved surgical technique and implant options, Excelen is investing in research in this area, much of it with NIH support.

Joint Replacement Components

Our surgeons and engineers continue to study ways to improve the function of joint replacements while reducing their costs. Excelen has patents covering modular revision acetabular components (to improve versatility while reducing number of components required) and an adjustable knee replacement trial device (which can vary the space between femoral and tibial components without the need for specific trial components for all sizes). We strive to provide the simplest yet most robust solutions.

The National Institutes of Health (NIH) has funded work based on our collaboration with Dr. Kjeld Søballe’s group from Aarhus, Denmark. Numerous studies have been conducted on materials and methods to encourage the growth of bone and increase stability at the implant/bone interface in the revision setting. We are also working with University of Minnesota engineers to develop ultra-small electronic sensors to provide more information to the surgeon when performing the surgery, to help them improve the accuracy of their bone cuts, soft tissue balancing, and implant placement.

The orthopaedic and infectious disease physicians collaborating with the Excelen Orthopaedic Biomechanics Laboratory are in the national and international forefront of the treatment of musculoskeletal infection, a serious, expensive, and life-threatening problem. Joint replacement infection incidence is very low (less than 1%), but broken bones that pierce the skin can have rates as high as 30%. Bacteria are attracted by foreign bodies such as implants and colonize their surfaces, which complicates their treatment. Infection destroys bone, prevents fractures from healing, and causes joint replacement components to loosen.

At Excelen, a number of biochemical and experimental studies have helped determine how the presence of an implant affects the immune system and makes it less effective in combating an infection. Excelen has designed and fabricated the only mold that allows surgeons to customize the beads impregnated with antiobiotics for implantation at infection sites.

The Musculoskeletal Sepsis Unit of Hennepin County Medical Center, directed by infectious disease expert Dr. Dean Tsukayama, is a multi-state referral center for orthopaedic infection. Drs. Tsukayama, Gustilo, Kyle, and Schmidt have developed widely accepted methods for treating infections in hip and knee replacements. These treatments have been successfully implemented around the world.

The spine research program at Excelen has yielded numerous publications to inform surgeons on the latest developments in the areas of spinal fusion, trauma, motion preservation, and scoliosis. Current research has focused on the biomechanics of new technologies for motion preservation—including cervical and lumbar disc nucleus replacements—and in techniques to treat scoliosis that can enhance and maintain spine mobility. Excelen has also performed numerous studies to evaluate spinal fusion constructs, including the use of bioresorbable plates to potentially reduce long-term complications, interbody grafts with incorporated fixation, posterior fusion constructs, and the treatment of thoracolumbar burst fractures. Excelen has established a reputation as a leading institution in the area of spine biomechanics due to the expertise developed through dozens of research studies and high-quality publications.