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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ORTHOPAEDICS-MAHWAH GMRS PROXIMAL TIBIAL STANDARD; PROSTHESIS, KNEE, FEMOROTIBIAL, CONSTRAINED, CEMENTED, METAL/POLYMER

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STRYKER ORTHOPAEDICS-MAHWAH GMRS PROXIMAL TIBIAL STANDARD; PROSTHESIS, KNEE, FEMOROTIBIAL, CONSTRAINED, CEMENTED, METAL/POLYMER Back to Search Results
Model Number 6495-3-102
Device Problem Loss of Osseointegration (2408)
Patient Problems Pain (1994); Inadequate Osseointegration (2646)
Event Date 08/11/2022
Event Type  Injury  
Manufacturer Narrative
It was noted that the device is not available for evaluation.Should additional information become available, it will be provided in a supplemental report upon completion of the investigation.
 
Event Description
A patient specific prescription form has been received "proximal tibial replacement - loosening with significant tibial stress reaction - for giant cell tumour" update (b)(6) 2022 : as reported via updated implant request form: "revision of a gmrs proximal tibia.This will be the 3rd revision.Need a distal end piece that will connect to the mrh section of the femur.".
 
Manufacturer Narrative
Reported event: an event regarding loosening involving a gmrs tibial component was reported.The event was confirmed based on medical review.Method & results: device evaluation and results: material analysis, visual, functional, and dimensional inspections could not be performed as the device was not returned.Clinician review: a review of the provided medical records by a clinical consultant indicated: the x-rays show a gmrs tka with proximally replacing tibial and distal femoral replacing hinge components with cemented stem.There are subtle lucencies around the stem indicating possible early loosening.In addition, there are calcifications at the tip of the stem consistent with stress reaction.The clinic note states that the patient had initially done quite well but 2 months prior to the visit to the clinic had gone an extensive walk and subsequently developed unrelenting significant startup pain limiting her activities.Revision surgery for tibial loosening as a result of recurrent giant cell tumor in the proximal tibia is confirmed as is anterior tibial pain.There are radiographic findings consistent with stress reaction of about the tip of the cemented tibial stem as well as lucencies suggestive of possible early loosening.The root cause of this pain and possible mechanical failure cannot be determined from this limited documentation.Should additional information become available i would be happy to further this assessment." device history review: all devices were manufactured and accepted into final stock with no relevant reported discrepancies.Complaint history review: there have been no other similar events for the reported lot.Conclusion: it was reported that the patient was revised due to loosening.The event was confirmed based on medical review.No further investigation for this event is required.If additional information becomes available to indicate further evaluation is warranted, this record will be reopened.
 
Event Description
A patient specific prescription form has been received "proximal tibial replacement - loosening with significant tibial stress reaction - for giant cell tumour." update 22/august/2022 : as reported via updated implant request form: "revision of a gmrs proximal tibia.This will be the 3rd revision.Need a distal end piece that will connect to the mrh section of the femur." update as per office note on 8/11/2022: patient developed constant pain down anterior distal shin.X-rays showed continued stress reaction around the distal tibial stem.
 
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Brand Name
GMRS PROXIMAL TIBIAL STANDARD
Type of Device
PROSTHESIS, KNEE, FEMOROTIBIAL, CONSTRAINED, CEMENTED, METAL/POLYMER
Manufacturer (Section D)
STRYKER ORTHOPAEDICS-MAHWAH
325 corporate drive
mahwah NJ 07430
Manufacturer (Section G)
STRYKER ORTHOPAEDICS-LIMERICK
raheen business park
limerick NA
EI   NA
Manufacturer Contact
diana rogers
210 centennial avenue
centennial park, elstree
borehamwood WD6 3-SJ
UK   WD6 3SJ
2082386500
MDR Report Key15342534
MDR Text Key299137682
Report Number0002249697-2022-01289
Device Sequence Number1
Product Code KRO
UDI-Device Identifier07613327048865
UDI-Public07613327048865
Combination Product (y/n)N
Reporter Country CodeUK
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 11/25/2022
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 Model Number6495-3-102
Device Catalogue Number64953102
Device Lot Number154760L
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 08/11/2022
Initial Date FDA Received09/01/2022
Supplement Dates Manufacturer Received11/09/2022
Supplement Dates FDA Received11/25/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured12/12/2019
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 Age45 YR
Patient SexFemale
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