An article ¿articular surface replacement of the hip: a prospective single surgeon series¿ by s.S.Jameson et al reports on the early clinical and radiological results of articular surface replacement (asr) resurfacings and the description of the experience of using the asr prosthesis.Between april 2004 and september 2006, 214 consecutive hips in 192 patients (129 hips in 114 males, 85 hips in 78 females).The mean follow-up was 43 months and the mean age was 56 years.Narrowing of the neck was noted in 124 hips.A (b)(6)-year-old female (case 9) with early failure of the femoral head or neck had a femoral revision to an uncemented thr comprising a modular asr xl (depuy international ltd) head and an s-rom (depuy international ltd) femoral stem.Implant was in-situ for 47 months underwent revision due to persistent pain and metal wear debris.At revision, gross swelling of pseudocapsule caused by accumulation of fluid was observed.Tissue necrosis and synovial ulceration was also seen.Increasing groin pain at three years was observed and acetabular component loose at revision.The anteversion and inclination angles were 27°/52°.The head/acetabular component size were 46/52 mm.The femoral position, in terms of neck-shaft angle, stem-neck angle and stem-shaft angle were 136°, 14°,150°.Asr hip implant was found to be associated with above reported adverse events.Impacted product: unknown hip acetabular cup (asr), unknown hip femoral head (asr).Patient code: surgical intervention, pain, accumulation of fluid, foreign body reaction, tissue necrosis, synovial ulceration, and inadequate osseointegration.Product experience code: implant position - mispositioned (unknown hip acetabular cup)-for acetabular cup malposition.Implant loosening/ bone to implant (unknown hip acetabular cup) ¿ for acetabular cup loosening.Implant bearing wear-metal (unknown hip acetabular cup and unknown hip femoral head) ¿ for metal debris.
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Depuy synthes is submitting this report pursuant to the provision of 21 cfr, part 803.The report may be based on the information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.Product complaint #: (b)(4).Investigation summary: the asr platform was voluntarily recalled from the market in august 2010, and the asr product codes are now considered inactive.Further investigation of this individual incident will not be undertaken.The investigation regarding the root cause(s) and/or corrective actions was conducted under mdd capa-001226.Ongoing post market surveillance is conducted per our procedures for this product.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
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