K Number
K040964
Device Name
SCORPIO TOTAL KNEE SYSTEM - POSTERIOR STABILIZED TIBIAL INSERTS
Date Cleared
2004-05-28

(44 days)

Product Code
Regulation Number
888.3560
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Scorpio® Knce System components are for use in total knee arthroplasty as a result of: - Painful, disabling joint disease of the knee resulting from degenerative arthritis, . rheumatoid arthritis or post-traumatic arthritis - Post-traumatic loss of knee joint configuration and function . - Moderate varus, valgus or flexion deformity in which the ligamentous structures can be . returned to adcquate function and stability; - Revision of previous unsuccessful knee replacement or other procedure; . - Ligamentous instability requiring implant bearing surface geometries with increased . constraint; - Absent or non-functioning posterior cruciate ligament. . These components are single use only and are intended for implantation with bone cenient.
Device Description
This submission is intended to address a design modification to the Scorpio Total Knee System Posterior Stabilized tibial insert component. The tibial insert components were redesigned to provide for improved hyperextension.
More Information

Not Found

Not Found

No
The document describes a design modification to a knee implant component and focuses on mechanical performance testing, with no mention of AI or ML.

Yes

The device is a total knee arthroplasty system intended to treat painful and disabling joint disease, loss of joint configuration and function, and deformities, which are conditions that impair body function and require restoration.

No.
The device is described as a component for total knee arthroplasty, and its intended uses are related to treating joint diseases and deformities, not diagnosing them.

No

The device description clearly states it is a "design modification to the Scorpio Total Knee System Posterior Stabilized tibial insert component," which is a physical implant, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly describes a surgical implant for total knee arthroplasty to treat painful and disabling joint disease. This is a therapeutic intervention, not a diagnostic test performed on samples from the body.
  • Device Description: The device is a component of a total knee system, specifically a tibial insert. This is a physical implant designed to replace or augment a part of the knee joint.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens (blood, tissue, etc.) to provide information for diagnosis, monitoring, or screening.

IVD devices are used in vitro (outside the body) to analyze samples and provide diagnostic information. This device is used in vivo (inside the body) as a surgical implant.

N/A

Intended Use / Indications for Use

The Scorpio® Knce System components are for use in total knee arthroplasty as a result of:

  • Painful, disabling joint disease of the knee resulting from degenerative arthritis, . rheumatoid arthritis or post-traumatic arthritis
  • Post-traumatic loss of knee joint configuration and function .
  • Moderate varus, valgus or flexion deformity in which the ligamentous structures can be . returned to adcquate function and stability;
  • Revision of previous unsuccessful knee replacement or other procedure; .
  • Ligamentous instability requiring implant bearing surface geometries with increased . constraint;
  • Absent or non-functioning posterior cruciate ligament. .

These components are single use only and are intended for implantation with bone cenient.

Product codes (comma separated list FDA assigned to the subject device)

87 JWH, JWH

Device Description

This submission is intended to address a design modification to the Scorpio Total Knee System Posterior Stabilized tibial insert component. The tibial insert components were redesigned to provide for improved hyperextension.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Knee Joint

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

A risk analysis, testing and analysis have been performed to demonstrate equivalence of the subject device to the predicate device. The testing includes range of constraint testing, analysis of tibial insert post stress and contact stress/area analysis. The results demonstrate equivalence.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

Not Found

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 888.3560 Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis.

(a)
Identification. A knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a knee joint. The device limits translation and rotation in one or more planes via the geometry of its articulating surfaces. It has no linkage across-the-joint. This generic type of device includes prostheses that have a femoral component made of alloys, such as cobalt-chromium-molybdenum, and a tibial component or components and a retropatellar resurfacing component made of ultra-high molecular weight polyethylene. This generic type of device is limited to those prostheses intended for use with bone cement (§ 888.3027).(b)
Classification. Class II.

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K040964 Page 1 of 2

Design Modification to the Scorpio® Posterior Stabilized Tibial Inserts Components

Special 510(k) Summary of Safety and Effectiveness: MAY 2 8 2004 Design Modification to the Scorpio® Total Knee System: Posterior Stabilized Tibial Insert Components

Proprietary Name:Scorpio® Total Knee System – Posterior Stabilized Tibial Inserte
Proposed Regulatory Class:Class II
Classification:Knee Joint; Patellofemorotibial; Polymer/metal/polymer; Semi-
constrained; Cemented prosthesis: 21 CFR 888.3560 ·
Device Product Code:87 JWH
For Information contact:Karen Ariemma
Regulatory Affairs Specialist
Howmedica Osteonics Corp.
325 Corporate Drive
Mahwah, NJ 07430
Telephone: (201) 831-5718
Fax: (201) 831-6038
Email: karen.ariemma@stryker.com
Date Summary Prepared:April 13, 2004

Predicate Device Identification:

The Scorpio Total Knee System consists of various sizes of femoral, tibial and patellar components.

Description of Device Modification:

This submission is intended to address a design modification to the Scorpio Total Knee System Posterior Stabilized tibial insert component. The tibial insert components were redesigned to provide for improved hyperextension.

Indications for Use:

The Scorpio " Total Knee System tibial insert components are for use in total knee arthroplasty for painful, disabling joint disease of the kncc rcsulting from degenerative arthritis, rheumatoid arthritis or post-traumatic arthritis; post-traumatic loss of knee joint configuration and function;

1

K040964 Page 2 of 2

Special 510(k) Premarket Notification

moderate varus, valgus or flexion deformity in with the ligamentous structures can be returned to adequate function and stability; and/or revision of previous unsuccessful knee replacement or other procedure.

Statement of Technological Comparison:

The subject components share the same intended use and basic design concept as that of the predicate devices. A risk analysis, testing and analysis have been performed to demonstrate equivalence of the subject device to the predicate device. The testing includes range of constraint testing, analysis of tibial insert post stress and contact stress/area analysis. The results demonstrate equivalence.

2

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services (HHS) of the United States of America. The seal features a stylized eagle with three lines forming its body and wings, symbolizing health and human services. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Public Health Service

MAY 2 8 2004

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Karen Ariemma Regulatory Affairs Specialist Stryker Howmedica Osteonics 325 Corporate Drive Mahwah, New Jersey 07430

Re: K040964

Trade/Device Name: Scorpio® Knee System - Tibial Inserts Regulation Number: 21 CFR 888.3560 Regulation Name: Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis Regulatory Class: II Product Codes: JWH Dated: May 10, 2004

Dear Ms. Ariemma:

Reccived: May 11, 2004

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adultcration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must

3

Page 2 - Ms. Karen Ariemma

comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (301) 594-_. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrb/dsma/dsmamain.html

Sincerely yours,

Mark McMillan

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and

Radiological Health

Enclosure

4

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Device Name: Scorpio Knee System - Tibial Inserts_____________________________________________________________________________________________________________________________

Indications for Use:

The Scorpio® Knce System components are for use in total knee arthroplasty as a result of:

  • Painful, disabling joint disease of the knee resulting from degenerative arthritis, . rheumatoid arthritis or post-traumatic arthritis
  • Post-traumatic loss of knee joint configuration and function .
  • Moderate varus, valgus or flexion deformity in which the ligamentous structures can be . returned to adcquate function and stability;
  • Revision of previous unsuccessful knee replacement or other procedure; .
  • Ligamentous instability requiring implant bearing surface geometries with increased . constraint;
  • Absent or non-functioning posterior cruciate ligament. .

These components are single use only and are intended for implantation with bone cenient.

Prescription Use Over-The-Counter Use (21 CFR 807 Subpart C) (Part 21 CFR 801 Subpart D)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

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(Division Sign-Off)
Division of General, Restorative,
and Neurological Devices
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510(k) NumberK040969
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