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The reported event could not be confirmed, since the ct scan shows there is no significant sign of loosening or migration of the components.There is no clear radiolucence and no clear cysts visible.The reported pain might be associated with some impingement visible for the talar component in contact with the lateral malleolus and there might be impingement.The device inspection was not possible as the product was not returned for investigation.A review of the device history for the reported lot did not indicate any abnormalities.No corrective actions are required at this time.A review of the labeling did not indicate any abnormalities.No indications of material, manufacturing or design related problems were found during the investigation.Upon further investigation of the ct scans, healthcare professionals opined that- there is no significant sign of loosening or migration of the components.There is no clear radiolucence and no clear cysts visible.The reported pain might be associated with some impingement visible for the talar component in contact with the lateral malleolus and there might be impingement.Therefore, it is questionable, whether any revision would make sense, here, but that should be left to the discretion of the treating surgeon, having an insite on the clinical situation.As there is no clear failure of the implant visible, it is clear, that it does not make sense to assess a potential root cause.However, failure of total ankle replacement tar over time is a known complication.In case of a planned revision procedure a medical opinion aiming to determine the root cause of the failure is part of the internal investigation process.Sufficient radiological and clinical information must be provided to enable a meaningful clinical assessment and to identify possible causes of failure.In cases where a ct scan is the only available clinical source, this assessment is limited.No conclusive statement can be provided, because key clinical information e.G., clinical status, exact symptoms, and range of motion of the patient, assessment of the treating physician is missing.The root causes of radiographic findings such as radiolucent areas and bone cysts are often complex and multifactorial and cannot be determined scientifically without this decisive evidence.Due to these limitations, we are unable in such cases to provide statements about the patient, the procedure and or the device in relation to cause of the failure.More detailed information about the complaint event as well as the affected device must be available to determine the root cause of the complaint event.If the device is returned or any further information is provided, the investigation report will be reassessed.
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