K Number
K103466
Device Name
ARTHREX UNIVERS II SHOULDER PROSTHESIS
Manufacturer
Date Cleared
2010-12-22

(28 days)

Product Code
Regulation Number
888.3660
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Arthrex Univers II Shoulder Prosthesis is indicated in replacements(s) when conditions include severe pain or significant disability resulting from degenerative, rheumatoid, traumatic disease, or injury of the glenohumeral joint; non-union humeral head fractures of long duration; irreducible 2-and.4part proximal humeral fractures; avascular necrosis of the humeral head; or, other difficult clinical management problems where arthrodesis or resectional arthroplasty is not acceptable. The glenoid components are designed for cemented fixation in the joint and must only be used with an appropriate bone cement.
Device Description
The Arthrex Univers II Shoulder Prosthesis is a 5 mm one-piece titanium alloy humeral stem that is 105 mm long and is designed with a distal conical section, a proximal rectangular section, and with a morsetaper for mating with humeral heads. The stem's surface finish is textured for cemented or press-fit (non-cemented) implantation.
More Information

Not Found

No
The summary describes a mechanical shoulder prosthesis and does not mention any software, algorithms, or AI/ML capabilities. The "Mentions AI, DNN, or ML" section explicitly states "Not Found".

Yes
The device is a prosthesis indicated for replacement due to severe pain, disability, or injury of the glenohumeral joint, aiming to alleviate symptoms and restore function.

No
The device is a shoulder prosthesis, an implant used for joint replacement, not for diagnosing conditions.

No

The device description clearly states it is a physical prosthesis made of titanium alloy, designed for surgical implantation.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information about a person's health. This information is used for diagnosis, monitoring, or screening.
  • Device Description and Intended Use: The description and intended use of the Arthrex Univers II Shoulder Prosthesis clearly indicate it is an implantable medical device used to replace a damaged shoulder joint. It is surgically implanted into the body.
  • Lack of Specimen Analysis: There is no mention of this device being used to analyze any specimens taken from the body.

Therefore, based on the provided information, the Arthrex Univers II Shoulder Prosthesis is a surgical implant, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Arthrex Univers II Shoulder Prosthesis is indicated in replacements(s) when conditions include severe pain or significant disability resulting from degenerative, rheumatoid, traumatic disease, or injury of the glenohumeral joint; non-union humeral head fractures of long duration; irreducible 2-and.4part proximal humeral fractures; avascular necrosis of the humeral head; or, other difficult clinical management problems where arthrodesis or resectional arthroplasty is not acceptable. The glenoid components are designed for cemented fixation in the joint and must only be used with an appropriate bone cement.

Product codes

KWS, HSD

Device Description

The Arthrex Univers II Shoulder Prosthesis is a 5 mm one-piece titanium alloy humeral stem that is 105 mm long and is designed with a distal conical section, a proximal rectangular section, and with a morsetaper for mating with humeral heads. The stem's surface finish is textured for cemented or press-fit (non-cemented) implantation.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Shoulder, glenohumeral joint, humeral head

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

Arthrex Univers II Shoulder Prosthesis, K071032

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3660 Shoulder joint metal/polymer semi-constrained cemented prosthesis.

(a)
Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a shoulder 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 humeral resurfacing component made of alloys, such as cobalt-chromium-molybdenum, and a glenoid resurfacing component made of ultra-high molecular weight polyethylene, and is limited to those prostheses intended for use with bone cement (§ 888.3027).(b)
Classification. Class II. The special controls for this device are:(1) FDA's:
(i) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Devices—Part I: Evaluation and Testing,’ ”
(ii) “510(k) Sterility Review Guidance of 2/12/90 (K90-1),”
(iii) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone Cement,”
(iv) “Guidance Document for the Preparation of Premarket Notification (510(k)) Application for Orthopedic Devices,” and
(v) “Guidance Document for Testing Non-articulating, ‘Mechanically Locked’ Modular Implant Components,”
(2) International Organization for Standardization's (ISO):
(i) ISO 5832-3:1996 “Implants for Surgery—Metallic Materials—Part 3: Wrought Titanium 6-aluminum 4-vandium Alloy,”
(ii) ISO 5832-4:1996 “Implants for Surgery—Metallic Materials—Part 4: Cobalt-chromium-molybdenum casting alloy,”
(iii) ISO 5832-12:1996 “Implants for Surgery—Metallic Materials—Part 12: Wrought Cobalt-chromium-molybdenum alloy,”
(iv) ISO 5833:1992 “Implants for Surgery—Acrylic Resin Cements,”
(v) ISO 5834-2:1998 “Implants for Surgery—Ultra-high Molecular Weight Polyethylene—Part 2: Moulded Forms,”
(vi) ISO 6018:1987 “Orthopaedic Implants—General Requirements for Marking, Packaging, and Labeling,” and
(vii) ISO 9001:1994 “Quality Systems—Model for Quality Assurance in Design/Development, Production, Installation, and Servicing,” and
(3) American Society for Testing and Materials':
(i) F 75-92 “Specification for Cast Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implant Material,”
(ii) F 648-98 “Specification for Ultra-High-Molecular-Weight Polyethylene Powder and Fabricated Form for Surgical Implants,”
(iii) F 799-96 “Specification for Cobalt-28 Chromium-6 Molybdenum Alloy Forgings for Surgical Implants,”
(iv) F 1044-95 “Test Method for Shear Testing of Porous Metal Coatings,”
(v) F 1108-97 “Specification for Titanium-6 Aluminum-4 Vanadium Alloy Castings for Surgical Implants,”
(vi) F 1147-95 “Test Method for Tension Testing of Porous Metal,”
(vii) F 1378-97 “Standard Specification for Shoulder Prosthesis,” and
(viii) F 1537-94 “Specification for Wrought Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implants.”

0

Arthrex SPECIAL 510(K): Arthrex Univers' !! Shoulder Prosthesis, Size #5

4 510(k) Summary of Safety and Effectiveness

DEC 2 2 2010

Date Summary Prepared December 15: 2010 Purpose of Submission To obtain clearance of a 5 mm Arthrex Univers II Shoulder Prosthesis Manufacturer/Distributor/Sponsor Arthrex, Inc. 1370 Creekside Boulevard Naples, FL 34108-1945 USA. 510(k) Contact | Sally Foust, RAC Regulatory Affairs Project Manager Arthrex, Inc. 1370 Creekside Boulevard Naples, FL 34108-1945 USA Telephone: 239/643.5553, ext. 1251 Fax: 239/598.5508 Email: sfoust(@arthrex.com Trade Name Arthrex Univers II Shoulder Prosthesis Common Name Shoulder Prosthesis KWS - Prosthesis, Shoulder, semi constrained Product Code -Classification Name | metal/polymer, cemented HSD - Prosthesis, Shoulder, hemi-humeral, metal, uncemented Predicate Devices Arthrex Univers II Shoulder Prosthesis, K071032 Device Description and Intended Device Description: The Arthrex Univers II Use Shoulder Prosthesis is a 5 mm one-piece titanium alloy humeral stem that is 105 mm long and is designed with a distal conical section, a proximal rectangular section, and with a morsetaper for mating with humeral heads. The stem's surface finish is textured for cemented or press-fit (non-cemented) implantation. Intended Use: The Arthrex Univers II Shoulder Prosthesis is indicated in replacements(s) when conditions include severe pain or significant disability resulting from degenerative,

rheumatoid, traumatic disease, or injury of the glenohumeral joint non-union humeral head

1

. K103466(²/₂)

Arthrex 6 SPECIAL_510(k): Arthrex Univers II Shoulder Prosthesss, Size #5


:

| | fractures of long duration; irreducible 2- and 4-
part proximal humeral fractures; avascular
necrosis of the humeral head; or other difficult
clinical management problems where arthrodesis
or resectional arthroplasty is not acceptable. The
glenoid components are designed for cemented
fixation in the joint and must only be used with an
appropriate bone cement. |
|------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Substantial Equivalence
Summary | The Arthrex Univers II Shoulder Prosthesis is
substantially equivalent to the predicate Arthrex Univers
Shoulder Prosthesis in which the basic features and
intended uses are the same. The smaller size and the
one-piece design when compared and tested to the
larger and modular predicate Arthrex Univers II Shoulder
Prosthesis was determined to not raise questions
concerning safety and effectiveness. Based on design
controls and fatigue testing comparison, Arthrex, Inc. has
determined that the new Arthrex Univers II Shoulder
Prosthesis is substantially equivalent to the currently
marketed predicate device, Arthrex Univers II Shoulder
Prosthesis (K071032). |

2

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services USA. The logo features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is arranged in a circular pattern around the caduceus symbol.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Arthrex, Inc. % Ms. Sally Foust, RAC Regulatory Affairs Project Manager 1370 Creekside Boulevard Naples, Florida 34108-1945

DEC 22 2 2 . )

Re: K103466

Trade/Device Name: Arthrex Univers II Shoulder Prosthesis Regulation Number: 21 CFR 888.3660 Regulation Name: Shoulder joint metal/polymer semi-constrained cemented prosthesis Regulatory Class: Class II Product Code: KWS, HSD Dated: November 24, 2010 Received: November 24, 2010

Dear Ms. Foust:

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 adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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 comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

3

Page 2 - Ms. Sally Foust

forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportalProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

A. B. mh
fr.

Mark N. Melkerson Director Division of Surgical, Orthopedic, and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use Form ア

Indications for Use

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| | AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AN | CART CONTRACT A - CARD CONSULT CONSULT CONSULT CONSULT CONSULT CONSULTION CONSULTION CONSULTION CONSULTION CONSULTION CONSULTION CONSULTION CONSULTION CONSULTION CONSULTION C | 200000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 | | |

The Arthrex Univers II Shoulder Prosthesis is indicated in replacements(s) when conditions include severe pain or significant disability resulting from degenerative, rheumatoid, traumatic disease, or injury of the glenohumeral joint; non-union humeral head fractures of long duration; irreducible 2-and.4part proximal humeral fractures; avascular necrosis of the humeral head; or, other difficult clinical management problems where arthrodesis or resectional arthroplasty is not acceptable.

The glenoid components are designed for cemented fixation in the joint and must only be used with an appropriate bone cement.

Prescription Use X AND/OR Over-The-Counter Use (21 CFR 801 Subpart C) (Per 21 CFR 801 Subpart D)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

PAGE 1 of 1

M. Melkerson

(Division Sit n-Off) Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K103466