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(b)(4).D10: concomitant devices: 42512200510 - articular surface - 65279329; 42532007101 - tibial component - 65516816; 42540000035 - patella - 65750440; 110035368 - biomet bc r cement - ax26ae0210.The device will not be returned for analysis as it remains implanted; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch will be submitted.
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It was reported that the patient had an initial bilateral knee arthroplasty.The patient reports chronic issues with both knees including pan and swelling.The patient had an mri with findings of bone necrosis, quadriceps and patella tendinosis, patellar tendon perforation, and moderate effusion.The devices remain implanted at this time.
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This follow-up report is being submitted to relay additional information.The following sections were updated: b4; b5; g3; g6; h1; h2; h3; h4; h6; h10; h11 h6: component code: mechanical (g04) - femur no product was returned or pictures provided; visual and dimensional evaluations could not be performed.The device history record was reviewed and no discrepancies relevant to the reported event were found.Medical records were provided and reviewed by a health care professional.Review of the available records identified the following: the patient reported experiencing persistent, bilateral leg issues since undergoing surgery, characterized by sensations of pulling, tightness, and pressure in the muscles, ligaments, and tendons, extending from the hips through the feet, predominantly around the knees.These sensations resemble the constriction of an inflated blood pressure cuff.Additionally, the patient noted pain in both knees, especially during activities like climbing stairs or driving, accompanied by swelling above the kneecaps.Despite consultations with various healthcare providers¿including a surgeon, general physician, and sports and exercise physician¿and adherence to prescribed physical therapy regimens, no definitive cause for these symptoms has been identified.The patient maintains a healthy lifestyle, engaging in regular low impact exercises and therapies such as massage, acupuncture, and red light therapy, though these have provided no lasting relief.An mri revealed a bone infarct in the distal femur, distal quadriceps tendinosis, patellar tendinosis with a full thickness perforation, and moderate joint effusion.A subsequent mri showed stable bone infarct size with improved surrounding bone marrow edema, a small knee effusion, and mild chronic patellar tendinosis, indicating some improvement compared to the previous study.A definitive root cause cannot be determined.This complaint can be confirmed based on the medical records provided.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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