FDA Adverse Event Injury Summary report: N

UNKNOWN HIP ACETABULAR CUP

MDR report key: 9203419 · Received October 17, 2019

Report

Report Number
1818910-2019-110449
Event Type
Injury
Date Received
October 17, 2019
Date of Event
July 7, 2017
Report Date
September 20, 2019
Manufacturer
DEPUY ORTHOPAEDICS INC US
Product Code
LPH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY ==> NO DEVICE WAS RECEIVED. ROOT CAUSE UNDETERMINED. DEPUY SYNTHES CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION MAY BE RE-OPENED AS NECESSARY. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). (B)(4). IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. THE ATTACHMENTS WERE TOO LARGE FOR MEDWATCH SUBMISSION

Description of Event or Problem · 1

LITERATURE ARTICLE ENTITLED, ¿SUBTROCHANTERIC SHORTENING OSTEOTOMY DURING CEMENTLESS TOTAL HIP ARTHROPLASTY IN YOUNG PATIENTS WITH SEVERE DEVELOPMENTAL DYSPLASIA OF THE HIP¿ BY DUAN WANG, ET AL, PUBLISHED BY BMC MUSCULOSKELETAL DISORDERS (2017), VOL. 18, 13 PAGES, DOI 10.1186/S12891-017-1857-X, WAS REVIEWED FOR MDR REPORTABILITY. THIS RETROSPECTIVE STUDY WAS DESIGNED TO DETERMINE COMPLICATIONS, FUNCTIONAL AND RADIOGRAPHIC RESULTS OF TRANSVERSE SUBTROCHANTERIC OSTEOTOMY DURING CEMENTLESS, MODULAR TOTAL HIP ARTHROPLASTY (THA) IN A SERIES OF ACTIVE PATIENTS YOUNGER THAN 45 YEARS WITH CROWE TYPE-III OR IV DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH). SEVERE PAIN UNRESPONSIVE TO NON-OPERATIVE MANAGEMENT, PELVIC OBLIQUITY, AND FUNCTIONAL IMPAIRMENT WITH LIMP IN DAILY ACTIVITIES WERE THE INDICATION FOR SURGERY. THERE WERE 9 MALES AND 40 FEMALES WITH MEAN AGE OF 36.9 YEARS AT THE TIME OF INDEX THA. PREVIOUS SCHANZ OSTEOTOMY WAS PERFORMED IN TWO PATIENTS. MODULAR FEMORAL STEM (S-ROM, DEPUY) WITH POROUS-COATED ACETABULAR COMPONENT (PINNACLE, POROCOAT, DEPUY) WAS IDENTICAL IN ALL HIPS. THERE WERE 8 MOP AND 48 COC ARTICULATIONS USED. THERE WERE 26 28-MM, 22 32-MM, AND 8 36-MM FEMORAL HEADS INSERTED. BONE UNION OF OSTEOTOMY SITE WAS ARCHIVED IN FIFTY-FOUR HIPS WITH NO COMPLICATION. SERIAL RADIOGRAPHS SHOWED TWO CASES (4.1%) OF NONUNION AT OSTEOTOMY SITE. ASYMPTOMATIC BROOKER CLASS-I AND II HETEROTOPIC OSSIFICATION WERE OBSERVED IN THREE AND TWO HIPS, RESPECTIVELY. FOCAL OSTEOLYSIS WAS OBSERVED IN FIVE HIPS ON FOLLOW-UP RADIOGRAPHS, BUT THE CUPS SHOWED BONY INCORPORATION AND NO SURGERY WAS REQUIRED. 4 PATIENTS COMPLAINED OF POST-OPERATIVE LIMB ASYMMETRY. THERE WERE NO REPORTED INFECTIONS, DVTS. OR VASCULAR INJURIES. THERE WERE 3 CASES OF POST-OPERATIVE DISLOCATION, 3 CASES OF TRANSIENT NERVE PALSY THAT WERE FULLY RESOLVED, AND TWO CASES OF INTRAOPERATIVE FRACTURE. THE AUTHORS NOTE THAT THE OSTEOTOMY CARRIED AND RISK OF NERVE INJURY AND FURTHER NOTED THAT THEIR SURGICAL TECHNIQUE AT THE BEGINNING OF THE STUDY MAY HAVE CONTRIBUTED TO THE PALSY. THE NERVE PALSY RESOLVED WITHIN ONE YEAR WITHOUT FUNCTIONAL DEFECT FOR ALL PATIENTS. THE AUTHORS PROVIDED DETAIL REGARDING THE PATIENTS REQUIRING INTERVENTION LABELED WITHIN THIS GUIDANCE DOCUMENT LABELED CASE 1-13. THE AUTHORS DO NO PROVIDE INFORMATION REGARDING THE MATERIAL MAKE-UP OR SIZE OF EACH PATIENT¿S IMPLANTS. THE PARENT PC CAPTURES THE PATIENT EVENTS NOT IDENTIFIED BY PATIENT NUMBER. IN TOTAL, THERE WERE 7 PATIENTS WHO REQUIRED REOPERATIONS OR REVISION SURGERY. ALL COMPONENTS USED WITHIN THIS STUDY WERE DEPUY PRODUCTS. PATIENT HAD FRACTURE OF ACETABULUM 5 YEARS AFTER INDEX THA. THE FRACTURE CASED A LOOSENED CUP. TX: REVISION SURGERY OF THE CUP AND LINER WITH ACETABULAR BONE GRAFTING. NO FURTHER COMPLICATIONS. SURGEON NOTES THE CUP LOOSENING WAS DUE TO THE ACETABULAR FRACTURE AND DOES NOT ATTRIBUTE THE FRACTURE TO THE ACETABULAR COMPONENTS. MATERIAL MAKE UP OF THE ACETABULAR LINER IS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
996447 UNKNOWN HIP ACETABULAR CUP HIP ACETABULAR CUP LPH DEPUY ORTHOPAEDICS INC US NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention