When used concurrently, the Arthrex iBalance UKA and PFJ systems create the Arthrex iBalance BiCompartmental Arthroplasty System. The Arthrex iBalance BiCompartmental Arthroplasty System is intended to be used as a multi-compartmental knee arthroplasty in patients with:

Moderately disabling joint disease of the knee resulting from painful osteoarthritis or post traumatic arthritis;
Correction of functional deformities;
Revision of previous unsuccessful partial knee replacement or other procedure;
The BiCompartmental Arthroplasty System is not intended to be used as a dual-condyle or tri-compartmental knee.
These components are single use only and are intended for implantation with bone cement

Device Description

The Arthrex iBalance BiCompartmental Arthroplasty System is comprised of a unicompartmental implant system (Arthrex iBalance UKA) and a patellofemoral implant system (Arthrex iBalance PFJ). The Arthrex iBalance UKA and Arthrex iBalance PFJ systems may be used in conjunction to create a bicompartmental patellofemorotibial replacement for the medial or lateral side of the knee.

AI/ML Overview

The provided document is a 510(k) premarket notification for the Arthrex iBalance BiCompartmental Arthroplasty System. It states that the device is substantially equivalent to legally marketed predicate devices and does not describe actual acceptance criteria or a study proving that the device meets specific acceptance criteria in the context of device performance metrics commonly associated with AI/software devices.

Instead, this document focuses on demonstrating substantial equivalence to predicate devices based on intended use, design, size ranges, materials, and biomechanical testing, rather than reporting on specific performance metrics against an acceptance criterion in a clinical study.

Here's a breakdown of the requested information based on the provided text, and where it is not applicable or not found in this specific document:

1. Table of Acceptance Criteria and the Reported Device Performance

This document does not specify quantitative acceptance criteria (e.g., sensitivity, specificity, accuracy thresholds) or provide a table of reported device performance against such metrics. The clearance is based on substantial equivalence.

2. Sample size used for the test set and the data provenance (e.g., country of origin of the data, retrospective or prospective)

Sample size for the test set: Not applicable/not provided. The document states, "Clinical data and conclusions are not needed for this device." The evaluation was based on biomechanical testing and comparison to predicates, not a clinical test set with patient data.
Data provenance: Not applicable/not provided for a clinical test set. The biomechanical testing would have been conducted in a lab setting.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g., radiologist with 10 years of experience)

Not applicable/not provided. No clinical test set or ground truth established by experts is mentioned for this 510(k) submission.

4. Adjudication method (e.g., 2+1, 3+1, none) for the test set

Not applicable/not provided. No clinical test set requiring adjudication is mentioned.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

Not applicable/not provided. This is a medical device (knee arthroplasty system) and not an AI or imaging diagnostic software. Therefore, an MRMC study related to human reader performance with or without AI assistance is not relevant to this submission.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

Not applicable/not provided. This is a physical medical implant device, not a standalone algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

Not applicable/not provided. For this type of device, "ground truth" would typically relate to mechanical performance or biocompatibility. The document mentions "biomechanical testing data" which demonstrated the "system worked well."

8. The sample size for the training set

Not applicable/not provided. This is a physical medical device, not a machine learning algorithm that requires a training set.

9. How the ground truth for the training set was established

Not applicable/not provided.

Summary of the Study that Proves the Device Meets Acceptance Criteria (as per this document):

The "study" or justification for clearance in this 510(k) submission relies on substantial equivalence to existing predicate devices. The document explicitly states:

"The submitted biomechanical testing data demonstrated the system worked well and the two systems did not impinge on one another."
"Mechanical data is unchanged from the original clearances; no further mechanical testing is necessary to demonstrate that the iBalance BiCompartmental Arthroplasty System is adequate for its intended use."
"Clinical data and conclusions are not needed for this device."

Therefore, the device meets its "acceptance criteria" by demonstrating that it is as safe and effective as previously cleared devices based on its intended use, design, materials, and biomechanical performance, without the need for new clinical data or specific quantitative performance metrics against acceptance thresholds in a clinical study.

Summary

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized graphic of three human profiles facing to the right, stacked one in front of the other. The profiles are rendered in a simple, abstract style.

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

April 12, 2016

Arthrex, Incorporated Courtnev Smith Regulatory Affairs Manager 1370 Creekside Boulevard Naples, Florida 34108-1945

Re: K160461 Trade/Device Name: Arthrex iBalance BiCompartmental Arthroplasty System Regulation Number: 21 CFR 888.3540 Regulation Name: Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis Regulatory Class: Class II Product Code: KRR., HSX Dated: February 12, 2016 Received: February 19, 2016

Dear Courtney Smith:

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 Parts 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

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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 Industry and Consumer Education 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. 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/ReportaProblem/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 Industry and Consumer Education 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,

Mark N. Melkerson -S

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

Enclosure

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2.1 INDICATIONS FOR USE

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: December 31, 2013 See PRA Statement on last page.

510(k) Number (if known)

K160461

Device Name

Arthrex iBalance BiCompartmental Arthroplasty System

Indications for Use (Describe)

. Moderately disabling joint disease of the knee resulting from painful osteoarthritis or post traumatic arthritis;
Correction of functional deformities; ●
Revision of previous unsuccessful partial knee replacement or other ● procedure;

The BiCompartmental Arthroplasty System is not intended to be used as a dual-condyle or tricompartmental knee

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

Type of Use (Select one or both, as applicable)

☑ Prescription Use (Part 21 CFR 801 Subpart D)

□ Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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Date Summary Prepared	April 6, 2016
Manufacturer/Distributor/Sponsor	Arthrex, Inc.
	1370 Creekside Boulevard
	Naples, FL 34108-1945 USA
510(k) Contact	Courtney Smith
	Regulatory Affairs Manager
	Arthrex, Inc.
	1370 Creekside Boulevard
	Naples, FL 34108-1945 USA
	Telephone: 239/643.5553, ext. 1720
	Fax: 239/598.5508
	Email: courtney.smith@arthrex.com
Trade Name	iBalance BiCompartmental Arthroplasty System
Common Name	Knee Prosthesis
Product Code -Classification NameCFR	KRR – Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis, CFR 888.3540
	HSX – Prosthesis, Knee, Femorotibial, Non-Constrained,Cemented, Metal Polymer CFR 888.3520
Predicate Device	K073120: ACCIN Patellofemoral System
	K063782, K060670: ACCIN UNI-Knee System
	K090763: Mako Restoris MCK
	K052917: Stryker Compartmental Knee System
Purpose of Submission	This traditional 510(k) premarket notification issubmitted to obtain FDA clearance for use of the ArthrexiBalance UKA system in conjunction with the ArthrexiBalance PFJ System to create the Arthrex iBalanceBiCompartmental Arthroplasty System
Device Description	The Arthrex iBalance BiCompartmental ArthroplastySystem is comprised of a unicompartmental implantsystem (Arthrex iBalance UKA) and a patellofemoralimplant system (Arthrex iBalance PFJ). The ArthrexiBalance UKA and Arthrex iBalance PFJ systems may be
	used in conjunction to create a bicompartmental
	patellofemorotibial replacement for the medial or lateral
	side of the knee.
Intended Use	When used concurrently, the Arthrex iBalance UKA and PFJ systems create the Arthrex iBalanceBiCompartmental Arthroplasty System. The Arthrex iBalance BiCompartmental Arthroplasty System isintended to be used as a multi-compartmental knee arthroplasty in patients with:
	Moderately disabling joint disease of the knee•resulting from painful osteoarthritis or post traumatic arthritis;
	Correction of functional deformities;•
	Revision of previous unsuccessful partial knee•replacement or other procedure.
	The BiCompartmental Arthroplasty System is notintended to be used as a dual-condyle or tri-compartmental knee.These components are single use only and are intended for implantation with bone cement
Substantial Equivalence Summary	The iBalance BiCompartmental Arthroplasty system is
	substantially equivalent to the predicate devices in which the basic features and intended uses are the same. Anydifferences between the iBalance BiCompartmental Arthroplasty system and the predicates are consideredminor and do not raise questions concerning safety and effectiveness.
	The proposed devices are substantially equivalent to the predicate devices in regards to its intended use, design,size ranges, and materials.
	The submitted biomechanical testing data demonstrated the system worked well and the two systems did notimpinge on one another. No further instrumentation beyond the existing devices cleared with the originalsystems was required to perform the procedure. Mechanical data is unchanged from the originalclearances; no further mechanical testing is necessary to demonstrate that the iBalance BiCompartmentalArthroplasty System is adequate for its intended use. Clinical data and conclusions are not needed for this
	device.Based on the indication for use, technological
characteristics, and the comparison to the predicate
devices, Arthrex, Inc. has determined that the iBalance
BiCompartmental Arthroplasty system is substantially
equivalent to currently marketed predicate devices.

2.1 510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

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Regulation Number and Section

§ 888.3540 Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis.

(a)
Identification. A knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis is a two-part device intended to be implanted to replace part of a knee joint in the treatment of primary patellofemoral arthritis or chondromalacia. 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 a component made of alloys, such as cobalt-chromium-molybdenum or austenitic steel, for resurfacing the intercondylar groove (femoral sulcus) on the anterior aspect of the distal femur, and a patellar component made of ultra-high molecular weight polyethylene. This generic type of device is limited to those devices intended for use with bone cement (§ 888.3027). The patellar component is designed to be implanted only with its femoral component.(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)) Applications for Orthopedic Devices,” and
(v) “Guidance Document for Testing Non-articulating, ‘Mechanically Locked’ Modular Implant Components,” and
(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,”
(vii) ISO 7207-2:1998 “Implants for Surgery—Components for Partial and Total Knee Joint Prostheses—Part 2: Articulating Surfaces Made of Metal, Ceramic and Plastic Materials,” and
(viii) 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 “Titanium-6 Aluminum-4 Vanadium Alloy Castings for Surgical Implants,”
(vi) F 1147-95 “Test Method for Tension Testing of Porous Metal Coatings,”
(vii) F 1537-94 “Specification for Wrought Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implants,” and
(viii) F 1672-95 “Specification for Resurfacing Patellar Prosthesis.”