K Number
K181744
Manufacturer
Date Cleared
2018-12-11

(162 days)

Product Code
Regulation Number
888.3353
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

BI-MENTUM™ Dual Mobility System is indicated for total hip replacement, which includes:

  • Osteoarthritis
  • Femoral neck fracture
  • Dislocation risk
  • Osteonecrosis of the femoral head
  • Revision procedures where other treatments or devices have failed and if bone reconstruction so permits
    BI-MENTUM™ PressFit Cup, BI-MENTUM™ Plus Cup and BI-MENTUM™ Revision Cup are intended for press-fit use and BI-MENTUMTM Cemented Cup is indicated for cemented use.
Device Description

The BI-MENTUM™ dual mobility system is composed of a metallic shell fixed in the acetabulum and a polyethylene liner.
Cemented metallic shell: BI-MENTUM™ Cemented Cup: the cemented metallic shell is made of stainless steel according to ISO 5832- 1. The outer surface is sandblasted and presents macro-volumes to augment contact between the implant and the cement. The inner surface is highly polished.
Cementless metallic shell: The cementless metallic shell is made of stainless steel according to ISO 5832-1 and is coated with a CP titanium and hydroxyapatite plasma spray (double layer coating) on the outer surface and is highly polished on the inner surface.
Three cementless metal-backs are available:

  • BI-MENTUM™ PressFit Cup: this version is available without the pegs and screw, and is a press fit only.
  • BI-MENTUM™ Plus Cup: it has 3 fixation points (2 divergent pegs towards the pubis and ischium and 1 cortical screw through a flange towards the ilium).
  • BI-MENTUM™ Revision Cup: it has 5 fixation points (2 divergent pegs towards the pubis and ischium, cortical screws through 2 flanges towards the ilium and 1 foramen hook).
    Liner: The liner is made of Ultra-High-Molecular-Weight Polyethylene according to ISO 5834-2. The liner is mobile (free) in the metallic shell and retained on the prosthetic femoral head. Liners can be used with Ø22,2 or 28 mm prosthetic femoral heads.
    Pegs and cortical screws: When applicable, primary fixation can be reinforced by impacted pegs and self-tapping cortical screws made of stainless steel according to ISO 5832-1.
AI/ML Overview

The provided text details the 510(k) summary for the BI-MENTUM™ dual mobility system, claiming substantial equivalence to a previously cleared device, the NOVAE® Dual Mobility Acetabular Cup (K111572). The document outlines non-clinical testing performed to support this claim.

Here's an analysis of the acceptance criteria and study information:

1. Table of Acceptance Criteria and Reported Device Performance

TestAcceptance CriteriaReported Device Performance
Head Insertion On ForceNot explicitly stated in the provided text, but implied as "acceptance criteria was met".Acceptance criteria was met.
Head Pull-Out TestingNot explicitly stated in the provided text, but implied as "acceptance criteria was met".Acceptance criteria was met.
Range of Motion AnalysisNot explicitly stated in the provided text, but implied as "acceptance criteria was met".Acceptance criteria was met.
Wear AnalysisNot explicitly stated in the provided text, but implied as "acceptance criteria was met".Acceptance criteria was met.

Note: The specific numerical or qualitative acceptance criteria for these tests are not provided in the submitted text. The document only states that the acceptance criteria were met.

2. Sample Size Used for the Test Set and Data Provenance

The provided text only mentions "new cup/head + stem assembly were validated" and lists non-clinical tests. It does not specify sample sizes for these tests, nor does it provide information on data provenance (e.g., country of origin, retrospective or prospective) as these were non-clinical, in-vitro tests, not studies involving patient data.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

Not applicable. The tests performed were non-clinical mechanical and wear studies, not studies requiring expert interpretation of medical images or patient data for ground truth establishment.

4. Adjudication Method for the Test Set

Not applicable, as no expert-based ground truth establishment or adjudication was involved in these non-clinical tests.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No. The document explicitly states: "No clinical studies were performed." Therefore, no MRMC comparative effectiveness study was conducted. The evaluation was based on non-clinical testing and substantial equivalence to a predicate device.

6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) Was Done

No. This device is a physical medical implant (hip prosthesis components), not an algorithm or AI system. Therefore, the concept of "standalone performance" for an algorithm is not applicable.

7. The Type of Ground Truth Used

For the non-clinical tests, the "ground truth" would be the established engineering and biomechanical standards and specifications for hip prostheses. This would involve:

  • Physical measurements and material properties: Conforming to ISO standards like ISO 5832-1 (stainless steel), ISO 5834-2 (UHMWPE).
  • Biomechanical performance metrics: Such as those for head insertion/pull-out force, range of motion, and wear, as defined by relevant ISO standards or industry best practices for similar devices.

8. The Sample Size for the Training Set

Not applicable. This device is a physical medical implant, not an AI/ML algorithm that requires a training set.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no training set for a physical implant device.

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December 11, 2018

Image /page/0/Picture/1 description: The image shows the logos of the Department of Health and Human Services and the Food and Drug Administration (FDA). The Department of Health and Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

Serf % Catherine Gloster Founder and Principal Consultant Gloster Biomedical International 577 N Hope Avenue Santa Barbara. California 93110

Re: K181744

Trade/Device Name: BI-MENTUM™ dual mobility system Regulation Number: 21 CFR 888.3353 Regulation Name: Hip Joint Metal/Ceramic/Polymer Semi-Constrained Cemented Or Nonporous Uncemented Prosthesis Regulatory Class: Class II Product Code: LZO, MEH Dated: October 17, 2018 Received: October 22, 2018

Dear Catherine Gloster:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

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801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.htm); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice

(https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Daniel S. Ramsey -S 2018.12.11 12:15:09 -05'00'

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

Enclosure

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Indications for Use

510(k) Number (if known) K181744

Device Name

BI-MENTUM™ Dual Mobility System

Indications for Use (Describe)

BI-MENTUM™ Dual Mobility System is indicated for total hip replacement, which includes:

  • Osteoarthritis

  • Femoral neck fracture

  • Dislocation risk

  • Osteonecrosis of the femoral head

  • Revision procedures where other treatments or devices have failed and if bone reconstruction so permits

BI-MENTUM™ PressFit Cup, BI-MENTUM™ Plus Cup and BI-MENTUM™ Revision Cup are intended for press-fit use and BI-MENTUMTM Cemented Cup is indicated for cemented use.

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

X Prescription Use (Part 21 CFR 801 Subpart D)

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

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510(k) Summary

Date: June 27th, 2018

Company name and address:SERF85 avenue des Bruyères69153 Décines CedexFRANCEPhone: +33 4 72 05 60 10Fax: +33 4 72 02 19 18
Contact person:Jean-Luc AURELLEGeneral Manager
Date prepared:June 27th, 2018
Trade name:BI-MENTUMTM dual mobility system
Common name:Total hip prosthesis - Acetabular component

Hip joint metal/ceramic/polymer semi-constrained cemented or Classification name: nonporous uncemented prosthesis (21 CFR 888.3353, Product Code LZO/MEH)

Device description

The BI-MENTUM™ dual mobility system is composed of a metallic shell fixed in the acetabulum and a polyethylene liner.

Cemented metallic shell

  • BI-MENTUM™ Cemented Cup: the cemented metallic shell is made of stainless steel according to ISO 5832- 1. The outer surface is sandblasted and presents macro-volumes to augment contact between the implant and the cement. The inner surface is highly polished.

Cementless metallic shell

The cementless metallic shell is made of stainless steel according to ISO 5832-1 and is coated with a CP titanium and hydroxyapatite plasma spray (double layer coating) on the outer surface and is highly polished on the inner surface.

Three cementless metal-backs are available:

  • BI-MENTUM™ PressFit Cup: this version is available without the pegs and screw, and is a press fit only.

  • BI-MENTUM™ Plus Cup: it has 3 fixation points (2 divergent pegs towards the pubis and ischium and 1 cortical screw through a flange towards the ilium).

  • BI-MENTUM™ Revision Cup: it has 5 fixation points (2 divergent pegs towards the pubis and ischium, cortical screws through 2 flanges towards the ilium and 1 foramen hook).

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Liner

The liner is made of Ultra-High-Molecular-Weight Polyethylene according to ISO 5834-2. The liner is mobile (free) in the metallic shell and retained on the prosthetic femoral head. Liners can be used with Ø22,2 or 28 mm prosthetic femoral heads.

Pegs and cortical screws

When applicable, primary fixation can be reinforced by impacted pegs and self-tapping cortical screws made of stainless steel according to ISO 5832-1.

Substantial equivalence claimed to predicate devices

BI-MENTUM™ dual mobility system is the same product as NOVAE® Dual Mobility Acetabular Cup cleared in 2011 (K111572, SERF).

There is no change in the design of the acetabular cup, no change in the fundamental scientific technology of the device. Newly validated cup/head + stem assembly are substantially equivalent to the NOVAE® Dual Mobility Acetabular Cup yet validated assembly (K111572, SERF) in terms of mechanical safety and performances.

DeviceBI-MENTUM™ dual mobility systemNOVAE® Dual Mobility Acetabular Cup
510(k) number/K111572
Intended use
Total hip replacementYesYes
Cemented/CementlessYes/YesYes/Yes
Primary/RevisionYes/YesYes/Yes
Design
Dual mobilityYesYes
Metal-back and a mobile linerYesYes
ScrewsCorticalCortical
PegsGroovedGrooved
Liner is retained on the headYesYes
Materials
Metal-backStainless steel (ISO 5832-1)Stainless steel (ISO 5832-1)
Metal-back coatingCommercially pure titaniumand hydroxyapatiteCommercially pure titaniumand hydroxyapatite
LinerLiner: UHMWPE (ISO 5834-2)Liner: UHMWPE (ISO 5834-2)
Screws and PegsStainless steel (ISO 5832-1)Stainless steel (ISO 5832-1)

Intended use

BI-MENTUM™ dual mobility system is indicated for total hip replacement, which includes:

  • . Osteoarthritis
  • . Femoral neck fracture
  • Dislocation risk .
  • Osteonecrosis of the femoral head .
  • . Revision procedures where other treatments or devices have failed and if bone reconstruction so permits

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BI-MENTUM™ PressFit Cup, BI-MENTUM™ Plus Cup and BI-MENTUM™ Revision Cup are intended for press-fit use and BI-MENTUM™ Cemented Cup is indicated for cemented use.

Non-clinical Test Summary

BI-MENTUM™ dual mobility system is the same product as NOVAE® Dual Mobility Acetabular Cup cleared in 2011 (K111572, SERF). There is no change in the design of the acetabular cup, no change in the fundamental scientific technology of the device. However new cup/head + stem assembly were validated.

The following tests were conducted:

  • Head insertion on force and Head Pull-Out testing (acceptance criteria was met) .
  • Range of motion analysis (acceptance criteria was met) .
  • . Wear Analysis (acceptance criteria was met)

Clinical Test Summary

No clinical studies were performed

Conclusions Nonclinical and Clinical

BI-MENTUM™ dual mobility system is substantially equivalent to the predicate devices in terms of indications for use, design, material, function and performances.

§ 888.3353 Hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis.

(a)
Identification. A hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis is a device intended to be implanted to replace a hip joint. This device limits translation and rotation in one or more planes via the geometry of its articulating surfaces. It has no linkage across-the-joint. The two-part femoral component consists of a femoral stem made of alloys to be fixed in the intramedullary canal of the femur by impaction with or without use of bone cement. The proximal end of the femoral stem is tapered with a surface that ensures positive locking with the spherical ceramic (aluminium oxide, A12 03 ) head of the femoral component. The acetabular component is made of ultra-high molecular weight polyethylene or ultra-high molecular weight polyethylene reinforced with nonporous metal alloys, and used with or without bone cement.(b)
Classification. Class II.