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It was reported that, following a revision surgery conducted on the patient's right hip on (b)(6) 2019, the patient experienced a dislocation on (b)(6) 2019 and required an additional revision surgery on (b)(6) 2019 to solve this adverse event.The contribution of the oxinium fem hd 12/14 28mm +8 to the reported dislocation cannot be discarded at this time.The identity of the explanted devices and the ones implanted in exchange is unknown at this time.
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H3, h6.The device was not returned for evaluation and the reported event could not be confirmed.The clinical/medical investigation concluded that with the information provided the clinical root cause of the dislocation and subsequent revision cannot be confirmed.However, the patient´s prior surgical procedures and noted ¿less anteverted position¿ of the acetabular cup cannot be ruled out as contributing factors.The patient impact beyond the revision and expected transient post-op convalescence period cannot be determined.A review of complaint history of the previous 12 months revealed similar events for the listed device, this failure mode will be monitored for future complaints for any necessary corrective actions.A review of the instructions for use documents for total hip systems revealed in preoperative warnings and precautions that improper neck selection, positioning, looseness of acetabular or femoral components, extraneous bone, penetration of the femoral prosthesis through the shaft of the femur, fracture of the acetabulum, intrapelvic protrusion of acetabular component, femoral impingement, periarticular calcification, and/or excessive reaming may increase the risk of dislocations, subluxation, decreased range of motion, or lengthening or shortening of the femur, which may lead to revision surgery.The intraoperative warnings and precautions indicate that muscle looseness and/or malpositioning of components may result in loosening, subluxation and dislocation.Additionally, ectopic bone and/or bone spurs may lead to dislocation and painful or restricted motion and proper positioning of the components is important to minimize impingement which could lead to early failure, premature wear, device related noise, and/or dislocation, all of which may lead to revision surgery.Postoperative warnings and precautions highlight the need of warning patients against unassisted activity, particularly use of toilet facilities and other activities that require excessive motion of the hip, as they may result in subluxation or dislocation.A review of the risk management file revealed this failure mode was previously identified.The anticipated risk level is still adequate.A historical review concluded that there are no prior actions related to this product and event.At this time, we have no reason to suspect that the product failed to meet any product specifications at the time of manufacture.Possible causes could include but not limited to traumatic injury, patient anatomy or abnormal loading of limb.The contribution of the device to the reported event could not be corroborated.Based on this investigation, the need for corrective action is not indicated.Without the return of the actual product involved, 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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