K Number
K130365
Device Name
X-ALT HIGHLY CROSS LINKED VE ACETABULAR LINER
Date Cleared
2013-09-23

(222 days)

Product Code
Regulation Number
888.3358
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Joint replacement is indicated for patients suffering from disability due to: - noninflammatory degenerative joint disease including osteoarthritis and avascular necrosis of the natural femoral head; - rheumatoid arthritis; - correction of functional deformity; - femoral fracture. This device may also be indicated in the salvage of previously failed surgical attempts. This device is intended for cementless use only
Device Description
A highly cross linked polyethylene acetabular liner infused with pure liquid phamnaceutical grade alpha-tocopheral. The liners are the same dimensions and size offerings as the currently cleared Highly Cross Linked Poly liners (K072154) (28mm, 32mm, 36mm, 40mm, and 44mm 1D, with neutral, 10° and 20° hooded configurations available in each ID).
More Information

Not Found

No
The device description and performance studies focus on the material properties and mechanical performance of a joint replacement component, with no mention of AI or ML.

No.
The device is a component of a joint replacement system (acetabular liner) intended to replace damaged hip joints, which is a structural rather than a therapeutic function.

No

Explanation: The device described is an acetabular liner for joint replacement, intended for treatment of joint degeneration and fractures. It is a prosthetic implant and not used for diagnosing medical conditions.

No

The device description clearly states it is a physical acetabular liner made of polyethylene, which is a hardware component. The testing described is also focused on the mechanical properties of this physical device.

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 device for joint replacement surgery, addressing conditions like osteoarthritis, rheumatoid arthritis, and femoral fractures. This is a surgical implant, not a diagnostic test performed on samples from the body.
  • Device Description: The device is described as a polyethylene acetabular liner, which is a component of a hip replacement implant. This is a physical device implanted into the body.
  • Lack of IVD Characteristics: There is no mention of analyzing samples (blood, urine, tissue, etc.), detecting biomarkers, or providing diagnostic information about a patient's condition based on in vitro testing.

Therefore, this device falls under the category of a surgical implant or prosthetic device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

Joint replacement is indicated for patients suffering from disability due to:

  • noninflammatory degenerative joint disease including osteoarthritis and avascular necrosis of the natural femoral head;
  • rheumatoid arthritis;
  • correction of functional deformity;
  • femoral fracture.
    This device may also be indicated in the salvage of previously failed surgical attempts.
    This device is intended for cementless use only

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

LPH, OQG

Device Description

A highly cross linked polyethylene acetabular liner infused with pure liquid phamnaceutical grade alpha-tocopheral. The liners are the same dimensions and size offerings as the currently cleared Highly Cross Linked Poly liners (K072154) (28mm, 32mm, 36mm, 40mm, and 44mm 1D, with neutral, 10° and 20° hooded configurations available in each ID).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

femoral 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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Non-Clinical Testing: Mechanical testing has demonstrated the device’s ability to perform under expected conditions. Testing included mechanical characterization testing, push out, lever out, torsion, rim impingement, fatigue crack propagation, Izod impact, small punch, tensile, FTIR, wear, optical and SEM analysis, wear particle analysis, extraction testing, animal implant for toxilogical response, and cviotoxicity. All testing has determined that the device is substantially equivalent to the predicate devices.
Clinical Testing: None provided.

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.

K072154, K091956

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

§ 888.3358 Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis.

(a)
Identification. A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a device intended to be implanted to replace a hip 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 has a femoral component made of a cobalt-chromium-molybdenum (Co-Cr-Mo) alloy or a titanium-aluminum-vanadium (Ti-6Al-4V) alloy and an acetabular component composed of an ultra-high molecular weight polyethylene articulating bearing surface fixed in a metal shell made of Co-Cr-Mo or Ti-6Al-4V. The femoral stem and acetabular shell have a porous coating made of, in the case of Co-Cr-Mo substrates, beads of the same alloy, and in the case of Ti-6Al-4V substrates, fibers of commercially pure titanium or Ti-6Al-4V alloy. The porous coating has a volume porosity between 30 and 70 percent, an average pore size between 100 and 1,000 microns, interconnecting porosity, and a porous coating thickness between 500 and 1,500 microns. The generic type of device has a design to achieve biological fixation to bone without the use of bone cement.(b)
Classification. Class II.

0

510(k) Summary

Date: February 11, 2013

Manufacturer: Encore Medical, L.P. 9800 Metric Blvd Austin, TX 78758

Contact Person: Teffany Hutto Manager, Regulatory Affairs Phone: (512) 834-6255 Fax: (512) 834-6313 Email: teffany.hutto@djoglobal.com

ProductClassificationProduct Code
X-altTM Highly Cross Linked Acetabular
Liner with Vitamin EClass IILPH - Hip joint metal/polymer/metal semi-constrained
porous-coated uncemented prosthesis per 21 CFR 888.3358
OQG - Hip prosthesis, semi-constrained, cemented.
metal/polymer, + additive, porous, uncemented per 21 CFR
888.3358

Description: A highly cross linked polyethylene acetabular liner infused with pure liquid phamnaceutical grade alpha-tocopheral. The liners are the same dimensions and size offerings as the currently cleared Highly Cross Linked Poly liners (K072154) (28mm, 32mm, 36mm, 40mm, and 44mm 1D, with neutral, 10° and 20° hooded configurations available in each ID).

Indications for Use:

Joint replacement is indicated for patients suffering from disability due to:

  • noninflanımatory degenerative joint disease including osteoarthritis and avascular necrosis of the . natural femoral head;
  • . rheumatoid arthritis;
  • correction of functional deformity: ●
  • femoral fracture. .

This device may also be indicated in the salvage of previously failed surgical attempts. This device is intended for cementless use only

Predicate Device:

SEP 2 3 2013

  • DJO Surgical X-alt™ Highly Cross Linked Acetabular Liner K072154 .
    DJO Surgical 3DKnee Tibial Insert with Vitamin E - K091956 .

Comparable Features to Predicate Device(s): Features comparable to predicate devices include the same design features, materials, indications, sterilization, packaging and intended use.

Non-Clinical Testing: Mechanical testing has demonstrated the device's ability to perform under expected conditions. Testing included mechanical characterization testing, push out, lever out, torsion, rim impingement, fatigue crack propagation, Izod impact, small punch, tensile, FTIR, wear, optical and SEM analysis, wear particle analysis, extraction testing, animal implant for toxilogical response, and cviotoxicity. All testing has determined that the device is substantially equivalent to the predicate devices.

Clinical Testing: None provided.

1

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public I lealth Service

Food and Drug Administration 10903 New Hampshire Asenue Document Control Center - WO66-G609 Silver Spring, MI) 20993-0002

September 23, 2013

Encore Medical, L.P. Ms. Teffant Hutto Manager, Regulatory Affairs 9800 Metric Boulevard Austin, Texas 78758

Re: K130365

Trade/Device Name: X-alt" Highly Cross Linked Acctabular Liner with Vitamin E Regulation Number: 21 CFR 888.3358 Regulation Name: Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis Regulatory Class: Class II Product Code: OQG, LPH Dated: July 15, 2013

Received: July 16, 2013

Dear Ms. Hutto:

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

2

Page 2 - Ms. Teffany Hutto

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 of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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/Reportal?roblem/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/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Eriñ I. Keith

for

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

Enclosure

3

510(k) Number (if known):

Device Name: X-alt™ Highly Cross Linked Acetabular Liner with Vitamin E

Indications for Use:

X-alt™ Highly Cross Linked Acetabular Liner with Vitamia E Indications for Use

Joint replacement is indicated for patients suffering from disability due to:

  • noninflammatory degenerative joint disease including osteoarthritis and avascular . necrosis of the natural femoral head;
  • . rheumatoid arthritis;
  • correction of functional deformity; .
  • femoral fracture. .

This device may also be indicated in the salvage of previously failed surgical attempts.

This device is intended for cementless use only

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Elizabeth L. Frank -S

Division of Orthopedic Devices

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