SMITH & NEPHEW, INC. OR3O DUAL MOBILITY LINER 38/50; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, POROUS UNCEMENTED
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Model Number 71358202 |
Device Problem
Connection Problem (2900)
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Patient Problem
Joint Dislocation (2374)
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Event Date 05/22/2020 |
Event Type
Injury
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Event Description
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It was reported that, after a or3o system had been implanted in a thr surgery, the patient presented a dislocated dual mobility prosthesis.A closed reduction was performed to alleviate the problem; however, upon obtaining x-rays, eccentricities were discovered between the shell and the femoral neck on the stem, which was also confirmed with a ct scan, so the patient was scheduled for revision surgery the next day.During the revision surgery, the shell was found to be well fixed.The stem was also well fixed with the femoral head still attached to the morse taper.The dual mobility plastic bearing was detached from the femoral head and was not inside the dual mobility liner.The surgeon (i) removed both the cup and cemented stem and placed a 4mm larger r3 cup (54mm) in a more anteverted position; (ii) downsized the stem while converting to a high offset implant, placing it in a more superior position; and (iii) chose to use again an or3o dual mobility implant with this construct.The patient outcome is unknown.
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Manufacturer Narrative
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H3, h6: the device, used in treatment, was not returned for evaluation and the reported event could not be confirmed.The clinical/medical concluded that based on the provided information, the root cause of the dislocation and subsequent revision could not be definitively concluded; however, the anteversion/positioning of the primary construct and possible inadequate post-op hip precautions could not be ruled out as possible contributing factors to the reported events.The patient impact beyond the reported dislocation, probable pain, closed reduction and subsequent revision could not be determined as the patient¿s status remains unknown.No further medical assessment can be rendered at this time.Should additional clinical documentation become available in the future, the clinical/medical task may be re-evaluated.No further medical assessment is warranted at this time.A review of complaint history did not reveal additional complaints for the listed batch.A review of the manufacturing records did not reveal a manufacturing abnormality that could have caused or contributed to the reported incident.At this time, we have no reason to suspect that the product failed to meet any product specifications at the time of manufacture.A review of the risk management file and instructions for use documents revealed this failure mode and potential harm was previously identified.Possible causes could include but not limited to traumatic injury, patient anatomy or abnormal loading of limb.Based on this investigation, the need for corrective action is not indicated.Without the return of the actual product involved or product information, our investigation could not proceed.Should the device or additional information be received, the complaint will be reopened.No further investigation is warranted for this complaint; however, we will continue to monitor for future complaints and investigate as necessary.We consider this investigation closed.
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