K Number
K161620
Device Name
Anatomical Shoulder Domelock Dome centric
Manufacturer
Date Cleared
2016-11-01

(141 days)

Product Code
Regulation Number
888.3690
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Hemi or Total Arthroplasty Application of the Anatomical Shoulder Humeral Stems and Domelock System The Anatomical Shoulder Humeral Stems and Domelock System are indicated for - · Advanced wear and tear of the shoulder joint resulting from degenerative, posttraumatic or rheumatoid arthritis. - · Avascular necrosis. - · Conditions consequent to earlier operations. - · Omarthrosis. - · Rheumatoid arthritis. - · Revision of shoulder prosthesis. The Humeral Stems Cemented are intended for cemented use and the Humeral Stems Uncemented are intended for uncemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented and the Biomet all-polyethylene Keeled Glenoid are intended for cemented use only. The Biomet Modular Hybrid Glenoid is intended to be implanted with bone cement. The optional porous titanium peg may be inserted without bone cement. The optional polyethylene peg should be inserted with bone cement. Reverse Application of the Anatomical Shoulder System · The Anatomical Shoulder Inverse System is indicated for primary, fracture or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency. · The patient's joint must be anatomically suited to receive the selected implants and a functional deltoid muscle is necessary to use the device. The Humeral Stems Cemented are intented use and the Humeral Stems Uncemented are intended for uncemented use. When used with the Anatomical Shoulder Glenoid Fixation, it is intended for uncemented use and requires two screws for fixation. Fracture Application of the Anatomical Shoulder Fracture System The Anatomical Shoulder Fracture System is intended for use in prosthetic replacement of the proximal humerus and the glenoid articular surface of the scapula during total-, hemi and fracture shoulder arthroplasty in treatment of the following: - · Complex 3- and 4-part fractures of the proximal humerus with subluxation of the head fragment - · Complex 3- and 4-part fractures of the proximal humerus with loosening of the spongiosa in the bead fragment - · Complex 3- and 4-part fractures of the proximal humerus with additional cross split of the head fragment - · Fracture instability after osteosynthesis of 3- and 4-part fragments of the proximal humerus - · Posttraumatic necrosis of the humeral head - · Posttraumatic arthrosis after humeral head fracture The Humeral Fracture Stems are intended for either cemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented are intended for cemented use only.
Device Description
The Anatomical Shoulder System is a modular shoulder prosthesis designed to be used in primary o revision, total or hemi shoulder arthroplasty. Anatomical Shoulder Humeral Stems are available as either cemented or uncemented designs. Cemented stems are available in longer designs to support revision cases. All Humeral Stems possess a female oval taper geometry, which is the basis for all modularity with compatible mating components. The Anatomical Shoulder Domelock System consists of a Humeral Head which is connected to the Anatomical Shoulder humeral stems using an adjustable Domelock Dome centric including an Expansion Ball and Expansion-pin. The Domelock Dome is used to set the orientation of the Domelock Humeral Heads. The male oval cone taper of the Domelock expansion ball component is compatible with all Humeral Stems of the Anatomical Shoulder System. The assembled humeral component may be used alone for hemiarthroplasty or combined with the glenoid component of the Anatomical Shoulder System or with the Biomet Modular Hybrid or all-polyethylene Keeled Glenoid for total arthroplasty.
More Information

No
The 510(k) summary describes a modular shoulder prosthesis system and its components. There is no mention of AI, ML, image processing, or any software-driven analytical capabilities that would suggest the use of such technologies. The performance studies focus on functional relationship and finite element analysis, which are standard engineering assessments for mechanical devices.

Yes
The device is a modular shoulder prosthesis intended for total or hemi shoulder arthroplasty, which is a medical procedure to replace damaged joint components with artificial implants to relieve pain and restore function. This clearly falls under the definition of a therapeutic device.

No

The device is a modular shoulder prosthesis intended for surgical replacement in cases of advanced shoulder joint wear, necrosis, or fractures. It is an implantable medical device used for treatment, not for diagnosing a condition.

No

The device description clearly describes physical implants (humeral stems, humeral heads, glenoid components) used in shoulder arthroplasty, which are hardware components.

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

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Description and Intended Use: The description clearly states that this device is a modular shoulder prosthesis designed for surgical implantation to replace parts of the shoulder joint. The intended uses are related to treating various conditions affecting the shoulder joint through surgery.
  • Lack of Specimen Analysis: There is no mention of the device being used to analyze any biological specimens from the patient. Its function is purely mechanical and structural within the body.

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

N/A

Intended Use / Indications for Use

Hemi or Total Arthroplasty Application of the Anatomical Shoulder Humeral Stems and Domelock System
The Anatomical Shoulder Humeral Stems and Domelock System are indicated for

  • · Advanced wear and tear of the shoulder joint resulting from degenerative, posttraumatic or rheumatoid arthritis.
  • · Avascular necrosis.
  • · Conditions consequent to earlier operations.
  • · Omarthrosis.
  • · Rheumatoid arthritis.
  • · Revision of shoulder prosthesis.

The Humeral Stems Cemented are intended for cemented use and the Humeral Stems Uncemented are intended for uncemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented and the Biomet all-polyethylene Keeled Glenoid are intended for cemented use only. The Biomet Modular Hybrid Glenoid is intended to be implanted with bone cement. The optional porous titanium peg may be inserted without bone cement. The optional polyethylene peg should be inserted with bone cement.

Reverse Application of the Anatomical Shoulder System
· The Anatomical Shoulder Inverse System is indicated for primary, fracture or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency.
· The patient's joint must be anatomically suited to receive the selected implants and a functional deltoid muscle is necessary to use the device.

The Humeral Stems Cemented are intented use and the Humeral Stems Uncemented are intended for uncemented use. When used with the Anatomical Shoulder Glenoid Fixation, it is intended for uncemented use and requires two screws for fixation.

Fracture Application of the Anatomical Shoulder Fracture System

The Anatomical Shoulder Fracture System is intended for use in prosthetic replacement of the proximal humerus and the glenoid articular surface of the scapula during total-, hemi and fracture shoulder arthroplasty in treatment of the following:

  • · Complex 3- and 4-part fractures of the proximal humerus with subluxation of the head fragment
  • · Complex 3- and 4-part fractures of the proximal humerus with loosening of the spongiosa in the bead fragment
  • · Complex 3- and 4-part fractures of the proximal humerus with additional cross split of the head fragment
  • · Fracture instability after osteosynthesis of 3- and 4-part fragments of the proximal humerus
  • · Posttraumatic necrosis of the humeral head
  • · Posttraumatic arthrosis after humeral head fracture

The Humeral Fracture Stems are intended for either cemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented are intended for cemented use only. Type of Use (Select one or both, as applicable)

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

HSD, KWS, KWT, PHX

Device Description

The Anatomical Shoulder System is a modular shoulder prosthesis designed to be used in primary o revision, total or hemi shoulder arthroplasty.
Anatomical Shoulder Humeral Stems are available as either cemented or uncemented designs. Cemented stems are available in longer designs to support revision cases. All Humeral Stems possess a female oval taper geometry, which is the basis for all modularity with compatible mating components.
The Anatomical Shoulder Domelock System consists of a Humeral Head which is connected to the Anatomical Shoulder humeral stems using an adjustable Domelock Dome centric including an Expansion Ball and Expansion-pin. The Domelock Dome is used to set the orientation of the Domelock Humeral Heads. The male oval cone taper of the Domelock expansion ball component is compatible with all Humeral Stems of the Anatomical Shoulder System.
The assembled humeral component may be used alone for hemiarthroplasty or combined with the glenoid component of the Anatomical Shoulder System or with the Biomet Modular Hybrid or all-polyethylene Keeled Glenoid for total arthroplasty.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Shoulder joint, proximal humerus, scapula

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)

The results of non-clinical analyses demonstrate that the devices are safe and effective and substantially equivalent to the predicate devices. Performance analyses included:

  1. Functional relationship analysis
  2. Finite Element Analysis for fatigue strength.

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.

Anatomical ShoulderTM Domelock® Dome centric which is part of the Anatomical ShoulderTM System Anatomical ShoulderTM Domelock® Shoulder™ Fracture System, K142403

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.

K160085

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

§ 888.3690 Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

(a)
Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as cobalt-chromium-molybdenum. It has an intramedullary stem and is intended to be implanted to replace the articular surface of the proximal end of the humerus and to be fixed without bone cement (§ 888.3027). This device is not intended for biological fixation.(b)
Classification. Class II.

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Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized graphic of three human profiles facing right, stacked on top of each other. The profiles are connected and form a single, abstract shape. The graphic is positioned to the right of a circular text element that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA".

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

Zimmer GmbH Annemie Rehor Kausch Senior Specialist Regulatory Affairs Sulzerallee 8 Winterthur. 8404 CH

Re: K161620 Trade/Device Name: Anatomical Shoulder Domelock Dome Centric Regulation Number: 21 CFR 888.3690 Regulation Name: Shoulder Joint Humeral (Hemi-Shoulder) Metallic Uncemented Prosthesis Regulatory Class: Class II Product Code: HSD, KWS, KWS, KWT, PHX Dated: September 29, 2016 Received: September 30, 2016

Dear Annemie Rehor Kausch:

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. Iisting 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 of medical devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

1

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 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" (21 CFR 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/Resourcesfor You/Industry/default.htm.

Sincerely,

Mark N. Melkerson -S

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

Enclosure

2

Indications for Use

Form Approved: OMBN1620, Rayge T of 1 Expiration Date: January 31, 2017 See PRA Statement below.

510(k) Number (if known) n/a

Device Name Anatomical Shoulder™ System Anatomical Shoulder™ Domelock® Anatomical Shoulder™ Fracture System

Indications for Use (Describe)

Hemi or Total Arthroplasty Application of the Anatomical Shoulder Humeral Stems and Domelock System

The Anatomical Shoulder Humeral Stems and Domelock System are indicated for

  • · Advanced wear and tear of the shoulder joint resulting from degenerative, posttraumatic or rheumatoid arthritis.
  • · Avascular necrosis.
  • · Conditions consequent to earlier operations.
  • · Omarthrosis.
  • · Rheumatoid arthritis.
  • · Revision of shoulder prosthesis.

The Humeral Stems Cemented are intended for cemented use and the Humeral Stems Uncemented are intended for uncemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented and the Biomet all-polyethylene Keeled Glenoid are intended for cemented use only. The Biomet Modular Hybrid Glenoid is intended to be implanted with bone cement. The optional porous titanium peg may be inserted without bone cement. The optional polyethylene peg should be inserted with bone cement.

Reverse Application of the Anatomical Shoulder System

· The Anatomical Shoulder Inverse System is indicated for primary, fracture or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency.

· The patient's joint must be anatomically suited to receive the selected implants and a functional deltoid muscle is necessary to use the device.

The Humeral Stems Cemented are intented use and the Humeral Stems Uncemented are intended for uncemented use. When used with the Anatomical Shoulder Glenoid Fixation, it is intended for uncemented use and requires two screws for fixation.

Fracture Application of the Anatomical Shoulder Fracture System

The Anatomical Shoulder Fracture System is intended for use in prosthetic replacement of the proximal humerus and the glenoid articular surface of the scapula during total-, hemi and fracture shoulder arthroplasty in treatment of the following:

  • · Complex 3- and 4-part fractures of the proximal humerus with subluxation of the head fragment
  • · Complex 3- and 4-part fractures of the proximal humerus with loosening of the spongiosa in the bead fragment
  • · Complex 3- and 4-part fractures of the proximal humerus with additional cross split of the head fragment
  • · Fracture instability after osteosynthesis of 3- and 4-part fragments of the proximal humerus
  • · Posttraumatic necrosis of the humeral head
  • · Posttraumatic arthrosis after humeral head fracture

The Humeral Fracture Stems are intended for either cemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented are intended for cemented use only. 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)

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Image /page/3/Picture/0 description: The image contains the logo for Zimmer Biomet. The logo features a stylized blue letter Z inside of a blue circle. Below the circle is the word "zimmer" in a lowercase, sans-serif font, also in blue.

Zimmer GmbH
Sulzerallee 8
8404 Winterthur
Switzerland

510(k) Summary

| Sponsor: | Zimmer GmbH
Sulzerallee 8, P.O. Box
8404 Winterthur, Switzerland |
|----------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Annemie Rehor Kausch
Senior Specialist, Regulatory Affairs
Telephone: +41 58 854 82 61
Fax: + 41 52 244 86 58 |
| Date: | June, 10th 2016 |
| Trade Name: | Anatomical ShoulderTM Domelock® Dome centric
which is part of the Anatomical ShoulderTM System
and Anatomical ShoulderTM Domelock® System |
| Classification Product Code / | HSD - Prosthesis, Shoulder, Hemi-, Humeral,
Metallic Uncemented
KWS - Prosthesis, Shoulder, Semi-Constrained,
Metal/Polymer Cemented
KWT - Prosthesis, Shoulder, Non-Constrained,
Metal/Polymer Cemented
PHX – Shoulder Prosthesis, Reverse Configuration |
| Device Classification Name: | Shoulder Prosthesis |
| Regulation Number / Description: | 21 CFR § 888.3690 – Shoulder joint humeral
(hemishoulder) metallic uncemented prosthesis
21 CFR § 888.3660 – Shoulder joint metal/polymer
semi-constrained cemented prosthesis
21 CFR § 888.3650 – Shoulder joint metal/polymer
non-constrained cemented prosthesis |
| Predicate Device: | Anatomical ShoulderTM Domelock® Dome centric
which is part of the Anatomical ShoulderTM System
Anatomical ShoulderTM Domelock® |

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| | Shoulder™ Fracture System, K142403, cleared
November 24, 2014.
Update of the IFU for this system for compatibility
with Biomet glenoids has been cleared by K160085
on March 8, 2016 |
|---------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Device Description: | The Anatomical Shoulder System is a modular
shoulder prosthesis designed to be used in primary o
revision, total or hemi shoulder arthroplasty. |
| | Anatomical Shoulder Humeral Stems are available as
either cemented or uncemented designs. Cemented
stems are available in longer designs to support
revision cases. All Humeral Stems possess a female
oval taper geometry, which is the basis for all
modularity with compatible mating components. |
| | The Anatomical Shoulder Domelock System consists
of a Humeral Head which is connected to the
Anatomical Shoulder humeral stems using an
adjustable Domelock Dome centric including an
Expansion Ball and Expansion-pin. The Domelock
Dome is used to set the orientation of the Domelock
Humeral Heads. The male oval cone taper of the
Domelock expansion ball component is compatible
with all Humeral Stems of the Anatomical Shoulder
System. |
| | The assembled humeral component may be used
alone for hemiarthroplasty or combined with the
glenoid component of the Anatomical Shoulder
System or with the Biomet Modular Hybrid or all-
polyethylene Keeled Glenoid for total arthroplasty. |
| Intended Use of the AS System: | The Anatomical Shoulder Domelock System is
intended for long-term implantation into the human
shoulder joint in primary or revision, total or hemi
shoulder arthroplasty. The system is intended to
relieve pain and restore function in patients with
adequate bone stock to support the prosthesis. |
| Indications for Use of the AS System: | Hemi or Total Arthroplasty Application of the
Anatomical Shoulder Humeral Stems and Domelock
System
The Anatomical Shoulder Humeral Stems and
Domelock System are indicated for |

5

  • · Advanced wear and tear of the shoulder ioint resulting from degenerative, posttraumatic or rheumatoid arthritis.
  • Avascular necrosis.
  • · Conditions consequent to earlier operations.
  • Omarthrosis.
  • · Rheumatoid arthritis.
  • · Revision of shoulder prosthesis.

The Humeral Stems Cemented are intended for cemented use and the Humeral Stems Uncemented are intended for uncemented use. When used in a total shoulder application, the Anatomical Shoulder Pegged and Keeled Glenoids Cemented and the Biomet all-polyethylene Keeled Glenoid are intended for cemented use only. The Biomet Modular Hybrid Glenoid is intended to be implanted with bone cement. The optional porous titanium peg may be inserted without bone cement. The optional polyethylene peg should be inserted with bone cement.

Reverse Application of the Anatomical Shoulder System

· The Anatomical Shoulder Inverse/Reverse System is indicated for primary, fracture or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency.

· The patient's joint must be anatomically and structurally suited to receive the selected implants and a functional deltoid muscle is necessary to use the device.

The Humeral Stems Cemented are intended for cemented use and the Humeral Stems Uncemented are intended for uncemented use. When used with the Anatomical Shoulder Glenoid Fixation, it is intended for uncemented use and requires two screws for fixation.

Fracture Application of the Anatomical Shoulder Fracture System

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| | The Anatomical Shoulder Fracture System is intended
for use in prosthetic replacement of the proximal
humerus and the glenoid articular surface of the
scapula during total-, hemi and fracture shoulder
arthroplasty in treatment of the following:
• Complex 3- and 4-part fractures of the proximal
humerus with subluxation of the head fragment
• Complex 3- and 4-part fractures of the proximal
humerus with loosening of the spongiosa in the head
fragment
• Complex 3- and 4-part fractures of the proximal
humerus with additional cross split of the head
fragment
• Fracture instability after osteosynthesis of 3- and 4-
part fracture fragments of the proximal humerus
• Posttraumatic necrosis of the humeral head
• Posttraumatic arthrosis after humeral head fracture
The Humeral Fracture Stems are intended for either
cemented or uncemented use. When used in a total
shoulder application, the Anatomical Shoulder
Pegged and Keeled Glenoids Cemented are intended
for cemented use only. |
|------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Comparison to Predicate Device: | Three modifications to the Anatomical Shoulder
Domelock Dome centric are proposed:

  1. The oval taper of the expansion ball is splitted
    into a 9.3 mm long oval taper and a 2.2 mm long
    oval cylinder to avoid interference with the rasps
    during trialing.
  2. The thickness of a laser mark line which is used
    for correct alignement of expansion ball and stem
    is increased for improved readability.
  3. The inner diameter of the Dome is increased by
    0.01 mm to improve ease of trialing. |
    | | The indications for use/intended use are unchanged.
    The materials remain the same and the fundamental
    technology is unchanged. |
    | Performance Data (Nonclinical
    and Clinical) | The results of non-clinical analyses demonstrate that
    the devices are safe and effective and substantially
    equivalent to the predicate devices. Performance
    analyses included:
  1. Functional relationship analysis
  2. Finite Element Analysis for fatigue strength. |

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Clinical Performance and Conclusions: Clinical data and conclusions were not needed to demonstrate
substantial equivalence.