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An event regarding range of motion (rom) and wear involving an accolade stem was reported.The event was confirmed via clinician review of the provided medical records.Method & results: product evaluation and results: material analysis, visual, functional and dimensional inspections could not be performed as the device remains implanted.Clinician review: a review of the provided medical information by a clinical consultant indicated: "this inquiry concerns a patient who underwent a total hip arthroplasty with bilateral cementless implants and approximately three years later was found to have notches in both femoral prosthetic necks.I am able to confirm that this event occurred since i was able to review x-rays with the notches present.The root cause of this event cannot be determined with certainty.The causes of notching are multifactorial.However given the position of the acetabular components this may well be due to impingement of the femoral neck on the acetabular component.The possibility of abnormal position of the femoral component is less likely.Also possibly contributing to this phenomena would be the patient's activity level with lifestyle choices such as extreme positions in yoga, etc.Having said that, in my experience, with well positioned implants this notching does not occur.The patient should have at the very least, true cross table lateral views to determine the anteversion of the acetabular component and a ct scan to determine both the anteversion of the acetabular component and the femoral component." product history review: review of the device history records indicate 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 lot referenced.Conclusions: it was reported that the stem neck had been "shaved off." a review of the provided medical information by a clinical consultant indicated: "this inquiry concerns a patient who underwent a total hip arthroplasty with bilateral cementless implants and approximately three years later was found to have notches in both femoral prosthetic necks.I am able to confirm that this event occurred since i was able to review x-rays with the notches present.The root cause of this event cannot be determined with certainty.The causes of notching are multifactorial.However given the position of the acetabular components this may well be due to impingement of the femoral neck on the acetabular component.The possibility of abnormal position of the femoral component is less likely.Also possibly contributing to this phenomena would be the patient's activity level with lifestyle choices such as extreme positions in yoga, etc.Having said that, in my experience, with well positioned implants this notching does not occur.The patient should have at the very least, true cross table lateral views to determine the anteversion of the acetabular component and a ct scan to determine both the anteversion of the acetabular component and the femoral component." no further investigation for this event is possible at this time.If devices and/or additional information become available to indicate further evaluation is warranted, this record will be reopened.
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