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Review of the manufacturing records of the involved lot was performed and indicated that it was manufactured in accordance with company specifications without deviations.The explant was returned and a visual assessment identified signs of wear.The x-ray imaging points to improper patient positioning on the operating table and malpositioning of the tops implant, resulting in accelerated wear.Based on the available information, it was concluded that the reason for the subsequent surgery was probably related to the surgical technique in the original surgery and not to the tops system.Revisions, associated with signs of wear, have been previously reported in a small number of cases where the implant was revised, without any sequelae.The cause for the revision surgery in such cases may be multifactorial, including patient and procedure related factors.The rate of revisions for the tops system is lower than the reported rates in the literature for similar systems.
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