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This follow-up report is being submitted to relay additional information.The following sections were updated: b4, b5, d4 (expiration date, udi #), g3, g6, h2, h3, h6, h11.Corrected: h4.The reported event was confirmed by review of pictures.Visual examination of the provided pictures identified the revised proximal body with the head still assembled on and covered in bio debris.A fractured off section of the distal taper stem can be seen stuck inside the proximal body.No other observations could be noted based on the image alone.No product was returned; further visual and dimensional evaluations could not be performed.Review of the device history records identified no deviations or anomalies during manufacturing.Radiographs were provided and reviewed by a health care professional.Review of the available records identified the following: single ap radiograph of the left hip shows presence of total hip arthroplasty with zmr femoral stem system.The proximal femoral stem exhibits loosening.The femoral taper stem is fractured at the level of the distal cone body.Generalized reduced bone mineral density is a risk factor for femoral stem loosening.Femoral stem loosening is a risk factor for femoral stem fracture.The images were further reviewed for adequate proximal support and determination of whether the fracture or loosening occurred first.It was identified the proximal support is not adequate.The loose proximal component (cone body) is a known risk factor for distal femoral stem taper fracture.However, without prior imaging and sequence of events it cannot be determined whether the fracture or loosening occurred first.A definitive root cause cannot be determined.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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