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It was reported that a patient experienced a left knee revision surgery on (b)(6) 2012, due to osteolysis.Initial surgery date was (b)(6) 2011.No additional information about the event or patient has been provided.These devices are used for treatment not diagnosis.It is found in a review of the labeling and ifu 700-096-004 rev.N, it is known that device specific risks consist of: fracture, migration, loosening, subluxation, or dislocation of the prothesis or any of its components, any of which may require a second surgical intervention or revision.As part of the preoperative assessment, the surgeon must ensure that no biological, biomechanical, or other factors exist that might adversely affect the surgery and/or postoperative period.Revisions or surgical interventions are a known complication found in joint replacements.All patients should be instructed on the limitations of the prosthesis and the possibility of subsequent surgery.The patient should be cautioned to monitor activities and protect the replaced joint from unreasonable stresses and follow the written instructions of the physician with respect to follow-up care and treatment.The surgeon must be fully knowledgeable about all aspects of the surgical technique to use the implants in accordance with the indications and contraindications and be trained according to the proper use of the system instrumentation and implants.It is a known complication that a patient's age, weight, or activity level would cause the surgeon to expect early failure of the system.As noted in "why are total knee arthroplasties failing today - has anything changed after 10 years?", the top five reasons for total knee arthroplasty revision/surgical intervention account for approximately 85% of the reasons that drive revision/surgical intervention.The failure mechanisms are as follows: 39.9% for loosening; 27.4% for infection; 7.35% for instability; 4.7% for periprosthetic fracture; and 4.5 % for arthrofibrosis.In early revisions (less than two years) infection was found to be the most common failure mechanism and late revisions show aseptic loosening as the most common reason.Sharkey, p.L.(2014, september).Why are total knee arthroplasties failing today - has anything changed after 10 years?; the journal of arthroplasty, 29.Periprosthetic osteolysis is a complication of joint replacement surgery, debris (such as from bone and polyethylene/device) may accumulate in the tissue surrounding the bone causing inflammation, which in turn can cause bone degeneration.Osteolysis, retrieved from: https://www.Hss.Edu/condition-list_osteolysis.Asp.Based on review of all available information, there is no evidence to suggest that the reported event is related to any design or manufacturing issues.The revision reported was likely the result of patient conditions.There has been no patient information provided; therefore, the patient risk/clinical factors cannot be assessed.This event is being reported as part of a large group of mdr reportable events (386) received from the hospital for specialty surgery (hss).Exactech engineering became aware of unreported revisions of exactech knee product via a published abstract and poster (paper 640 what happened? extreme delamination and oxidation in modern day compression molded polyethylene brian t.Nickel, md, new york, ny lydia weitzler, ms, new york, ny douglas e.Padgett, md, new york, ny timothy m.Wright, phd, new york, ny.Exactech engineering requested access to the hss's details regarding the data used for the publication.The knee engineering team received raw data from hss documenting 386 mdr reportable events (revisions) that occurred at hss from 2001 through january 2018.
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