Product complaint # (b)(4).Investigation summary = > the device associated with this report was not received for examination.Depuy synthes considers the investigation closed at this time.Should additional information be received, the information will be reviewed and the investigation may be re-opened as necessary.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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The literature article entitled ¿management of bone defects in revision total knee arthroplasty with use of a stepped, porous-coated metaphyseal sleeve¿ by marc r.Angerame, md, et al.Published in the journal of bone and joint surgery, 2019, 9 (2): e14(1-14) on 24 april 2019, was reviewed.Products used: pfc sigma (depuy) the article reports that metaphyseal sleeve fixation in revision total knee arthroplasties with large femoral or tibial bone defects provides reliable stability of the construct while decreasing shear and torsional stresses at the cement-bone interface by sharing load with the metaphysis through biologic fixation.The authors describe the indications and contraindications for the use of metaphyseal fixation in revision tka prior to detailing the surgical technique.It is also stated that while the technique described is for the pfc sigma implant system, technique variations exist with sleeve systems from different manufacturers, although the principles described apply to most of the sleeve systems.Results: aseptic loosening is one of the most common failure modes of revision tka.The authors¿ center performed a review of metaphyseal sleeves used for severe femoral and tibial bone loss in revision tka.116 revision tka with the use of 152 metaphyseal sleeves (111 tibial and 41 femoral) were evaluated.16.4% required reoperation, most commonly for infection.Only one sleeve demonstrated failed osseointegration radiographically but did not require revision.There were three intraoperative fractures while broaching.Survivorship at 5.3 years based on all-cause sleeve revision was 97.8%.Longer follow-up is needed to determine the long-term durability of this methodology.Due to insufficient information, it cannot be determined that depuy implants were used in the initial operation.
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