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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH TRIATHLON PS X3 TIBIAL INSERT; PROSTHESIS, KNEE, PATELLO/FEMOROTIBIAL, SEMI-CONSTRAINED, UNCEMENTED, POROUS, CO

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STRYKER ORTHOPAEDICS-MAHWAH TRIATHLON PS X3 TIBIAL INSERT; PROSTHESIS, KNEE, PATELLO/FEMOROTIBIAL, SEMI-CONSTRAINED, UNCEMENTED, POROUS, CO Back to Search Results
Catalog Number 5532-G-409
Device Problems Material Deformation (2976); Insufficient Information (3190)
Patient Problems Pain (1994); Injury (2348)
Event Date 06/09/2011
Event Type  Injury  
Manufacturer Narrative
Review of the device history records indicate the devices were manufactured and accepted into final stock with no reported discrepancies.There have been no other events for the lot referenced.A supplemental report will be submitted upon completion of the investigation.
 
Event Description
Total knee revision was performed.Date of implant was identified as 2007.
 
Manufacturer Narrative
An event regarding pain involving a triathlon insert was reported.The event was not confirmed.Device evaluation and results: examination of the returned product with material analysis engineer indicated "common damage modes of in-service uhmwpe observed on insert.Explantation damage observed.Damage observed on distal end of articulating surface." medical records received and evaluation: no medical records or x-rays were made available for evaluation.Device history review: device history review indicated the devices accepted into final stock from the reported lot were free from discrepancies complaint history review: there has been no other event for the lot referenced.Conclusions: it was reported that patient had revision surgery due to pain.The event could not be confirmed nor could the root cause be determined because insufficient information was provided.The material analysis of returned device indicated that common damage modes of in-service uhmwpe and damage on distal end of articulating surface are observed on insert.Explantation damage was also observed on the product.A capa trend analysis was conducted for the reported failure mode and concluded pain may result from other factors not necessarily related to the device.No further investigation is possible at this time.Further information such as return of device, patient history, histopathology report & follow-up notes are needed to investigate this event further.If additional information and/or device becomes available, this investigation will be reopened.
 
Event Description
Total knee revision was performed.Date of implant was identified as 2007.
 
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Brand Name
TRIATHLON PS X3 TIBIAL INSERT
Type of Device
PROSTHESIS, KNEE, PATELLO/FEMOROTIBIAL, SEMI-CONSTRAINED, UNCEMENTED, POROUS, CO
Manufacturer (Section D)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer (Section G)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer Contact
brian lauro
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key6777194
MDR Text Key82157100
Report Number0002249697-2017-02428
Device Sequence Number1
Product Code MBH
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K141056
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,other
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 10/23/2017
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 Expiration Date10/05/2011
Device Catalogue Number5532-G-409
Device Lot Number22WMPA
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/07/2017
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 07/13/2017
Initial Date FDA Received08/09/2017
Supplement Dates Manufacturer Received09/25/2017
Supplement Dates FDA Received10/23/2017
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured10/05/2006
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Hospitalization; Required Intervention;
Patient Age69 YR
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