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(b)(4).D10: arcos con sz b hi 60mm, item: 11-301312, lot: 081790, unknown claw, unknown bolt.G2: foreign ¿ australia.H6: proposed code - mechanical (g04) ¿ stem.Visual examination of the provided pictures identified the revised distal stem and proximal cone body components covered in bio debris.The top of the distal stem is seen fractured.The fractured off piece is seen still assembled within the proximal body component.No other observations could be noted using the images alone.No product was returned; further visual and dimensional evaluations could not be performed.Review of the device history record 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: arcos modular femoral revision system exhibiting fracture of the femoral stem taper and disassociation of the proximal cone body and distal femoral stem components with partial pull-out of the stem taper.A risk factor for this complication is lack of fixation of the proximal cone body.Risk factors for lack of fixation of the proximal cone body include generalized reduced bone mineral density and nearby fracture fixation of the greater trochanter.It is noted the arcos proximal body and claw assembly was not assembled together using the trochanteric bolt per surgical technique 0529.5-glbl pages 49 - 52.It is not known whether this caused or contributed to the reported event.As per ifu 01-50-0997 en rev.H arcos® femoral revision system it states, improper selection, placement, positioning, alignment, and fixation of the implant components may result in unusual stress conditions which may lead to subsequent reduction in the service life of the prosthetic components.Zimmer biomet or its affiliates are not liable for complications and/or failure that may arise from the use of the device in circumstances outside of zimmer biomet or its affiliates control including, but not limited to, product selection and deviations from the device¿s indicated uses or surgical technique.If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor trends.
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