MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH TRIDENTII TRITANIUM CLUSTER56F; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, POROUS UNCEMENTED

Catalog Number 702-04-56F

Device Problems Corroded (1131); Loss of Osseointegration (2408)

Patient Problems Pain (1994); Osteolysis (2377); Ambulation Difficulties (2544); Fibrosis (3167); Metal Related Pathology (4530)

Event Date 07/20/2023

Event Type  Injury  

Manufacturer Narrative

Reported event: an event regarding corrosion involving a trident ii shell was reported.The event was confirmed via the provided photographs of the device.Method & results: product evaluation and results: the reported device was not returned; however, photographs were provided for review.The photograph of the shell shows evidence of possible corrosion/degradation on the inner locking mechanism of the device.The provided photographs of the mating mdm liner showed evidence of corrosion of the outer spherical surface of the liner that interfaces with the shell.-clinician review: a review of the provided medical information by a clinical consultant indicated: "this case concerns a 51-year-old gentleman who underwent a primary right total arthroplasty using cementless implants and an mdm articulation.Approximately 18 months after implantation, the patient had to be revised for increasing pain and what sounds like metallosis.Although most likely metallosis could come from the trunnion articulation, i have no information regarding the etiology.I can confirm that the patient had a primary total hip arthroplasty with the above components since i was able to review the operation report.I cannot confirm the revision or what was found at the revision since i only have a notation of explantation in the product summary.The root cause of this patient's early total hip arthroplasty failure due to trunnionosis and metallosis cannot be determined with certainty.The causes of trunnionosis and metallosis are multifactorial.They include surgical technique factors, patient factors such as activity level, lifestyle and bmi, and possible implant factors." -product history review: could not be performed as the device lot details were not provided.-complaint history review: could not be performed as the device lot details were not provided.Conclusions: it was reported that the patient was revised due to pain and "corroded metal on metal".The reported device was not returned; however, photographs were provided for review.The photograph of the shell shows evidence of possible corrosion/degradation on the inner locking mechanism of the device.The provided photographs of the mating mdm liner showed evidence of corrosion of the outer spherical surface of the liner that interfaces with the shell.This damage appears consistent with the interaction between the mdm metal liner and the shell.Black debris is observed on the mating surfaces.The appearance of the debris is consistent with a corrosion product and material transfer from the shell/biological material.A review of the provided medical records was unable to confirm the event or determine the etiology of the potential metallosis.Further information such as pathology reports, pre- and post-operative x-rays and the revision operative report as well as patient history and follow-up notes are needed to complete the investigation for determining root cause.No further investigation for this event is possible at this time.If additional information becomes available to indicate further evaluation is warranted, this record will be reopened.H3 other text : device not returned.

Event Description

Patient left voicemail on patient hotline reporting a revision due to pain and "corroded metal on metal" with his right stryker dual mobility hip.Update: metallosis, osteolysis.My bone was decomposing.I had to have the hip revised.

Manufacturer Narrative

An event regarding corrosion and loosening involving a trident ii shell was reported.Corrosion was confirmed via the provided photographs of the device and clinician review of the provided medical records.Loosening was not confirmed.Method & results: product evaluation and results: the reported device was not returned; however, photographs were provided for review.The photograph of the shell shows evidence of possible corrosion/degradation on the inner locking mechanism of the device.The provided photographs of the mating mdm liner showed evidence of corrosion of the outer spherical surface of the liner that interfaces with the shell.Clinician review: a review of the provided medical information by a clinical consultant indicated: "this case concerns a 51-year-old gentleman who underwent a primary right total arthroplasty using cementless implants and an mdm articulation.Approximately 18 months after implantation, the patient had to be revised for increasing pain and what sounds like metallosis.Although most likely metallosis could come from the trunnion articulation, i have no information regarding the etiology.I can confirm that the patient had a primary total hip arthroplasty with the above components since i was able to review the operation report.I cannot confirm the revision or what was found at the revision since i only have a notation of explantation in the product summary.However, based upon the new information provided for this second addendum, i can confirm that the revision procedure took place, and that findings included metallosis between the acetabular cup and the mdm metal liner.The root cause of this patient's early total hip arthroplasty failure due metallosis cannot be determined with certainty.The causes of metallosis are multifactorial.They include surgical technique factors, especially in the preparation and proper implantation of the mdm liner into the acetabular cup.No special mention was made of any particular preparation.Patient factors such as activity level, lifestyle and bmi, and possible implant factors may also be contributory.I am also concerned that there was no specific mention of the preparation of the trunnion for implantation of the femoral head.In my experience corrosion beneath a ceramic head can happen but it is exceedingly rare." product history review: could not be performed as the device lot details were not provided.Complaint history review: could not be performed as the device lot details were not provided.Conclusions: it was reported that the patient was revised due to pain and "corroded metal on metal".The reported device was not returned; however, photographs were provided for review.The photograph of the shell shows evidence of possible corrosion/degradation on the inner locking mechanism of the device.The provided photographs of the mating mdm liner showed evidence of corrosion of the outer spherical surface of the liner that interfaces with the shell.This damage appears consistent with the interaction between the mdm metal liner and the shell.Black debris is observed on the mating surfaces.The appearance of the debris is consistent with a corrosion product and material transfer from the shell/biological material.A review of the provided medical records also confirmed the event and indicated the following: "the causes of metallosis are multifactorial.They include surgical technique factors, especially in the preparation and proper implantation of the mdm liner into the acetabular cup.No special mention was made of any particular preparation.Patient factors such as activity level, lifestyle and bmi, and possible implant factors may also be contributory." no further investigation for this event is possible at this time.If additional information becomes available to indicate further evaluation is warranted, this record will be reopened.

Event Description

Patient left voicemail on patient hotline reporting a revision due to pain and "corroded metal on metal" with his right stryker dual mobility hip.Update: "metallosis, osteolysis.My bone was decomposing.I had to have the hip revised.".

• Brand Name: TRIDENTII TRITANIUM CLUSTER56F
• Type of Device: PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, POROUS UNCEMENTED
• Manufacturer (Section D): STRYKER ORTHOPAEDICS-MAHWAH; 325 corporate drive; mahwah NJ 07430
• Manufacturer (Section G): STRYKER ORTHOPAEDICS-CORK; ida industrial estate; carrigtwohill NA ; EI NA
• Manufacturer Contact: brad curtis ; 325 corporate drive; mahwah, NJ 07430 ; 2018315000
• MDR Report Key: 18044734
• MDR Text Key: 327017124
• Report Number: 0002249697-2023-01298
• Device Sequence Number: 1
• Product Code: LPH
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K171768
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer
• Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date: 02/06/2024

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Catalogue Number: 702-04-56F
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 10/04/2023
• Initial Date FDA Received: 10/31/2023
• Supplement Dates Manufacturer Received: 01/12/2024
• Supplement Dates FDA Received: 02/06/2024
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention; Hospitalization
• Patient Age: 52 YR
• Patient Sex: Male
• Patient Weight: 91 KG