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It was reported the patient underwent an initial hip arthroplasty.Subsequently, the patient is being revised three months post implantation due to implant loosening.It was reported that the multihole dm was implanted with a gap in the anterior cranial.The gap was filled with bone substitute and 3 screws.The bone substitute was not stable enough resulting in loosening of the screws followed by pushing out the dual mobility liner.The liner was loose in the cup resulting in metal abrasion of internal cup rim.The acetabular component, liner, and screws were exchanged.
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This follow-up report is being submitted to relay additional and/or corrected information.One g7 osseoti multihole 62mm h item# (b)(4) lot# 66269346 and one g7 dual mobility liner 50mm h item# 110024466 lot# 65987805 were returned and evaluated.Upon visual inspection the outer diameter of the liner had scuffing and wear marks.The shell has scuffing and scratches to the inside radius of the device.A review of the device history records identified no related deviations or anomalies during manufacturing.Medical records/radiographs were provided and reviewed by a health care professional.A review of the available records identified findings of the reported issues: interval revision surgery for a right total hip arthroplasty with acetabular cup liner replacement.The root cause of the reported issue is attributed to off-label use, a tm augment was initially needed to support the cup, the cup was implanted without the support of the augment which led to the subsequent loose screws and the disassociation of the liner from the cup.This is considered off-label as dislocation and subluxation due to inadequate fixation, malalignment, malposition, excessive, unusual and/or awkward movement and/or activity, trauma, weight gain, or obesity and improper positioning.Muscle and fibrous tissue laxity can also contribute to these conditions.Additionally, bone or musculature compromised by disease, infection, or prior implantation that cannot provide adequate support or fixation for the prosthesis.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
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