K Number
K193135
Device Name
TSolution One Total Knee Application
Date Cleared
2019-12-11

(29 days)

Product Code
Regulation Number
882.4560
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan. The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA). The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made. The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes. The TSolution One® Total Knee Application is compatible with the following Knee Implant Systems: - · Zimmer Persona™ Knee System - · Corin Unity Knee System - Aesculap Columbus Knee System - · DJO Surgical® EMPOWR 3D Knee® System
Device Description
The TSolution One® Total Knee Application is a three-dimensional, graphical, preoperative planning workstation and implementation tool for treatment of patients who require total joint arthroplasty. The device is intended as an alternative to manual template planning and preparation of the bone with patients requiring primary total knee arthroplasty (TKA). The TSolution One® Total Knee Application consists of TPLAN and TCAT. TPLAN is a three-dimensional (3D) preoperative planning workstation that aids a surgeon in planning the position and orientation of the implant components relative to 3D models of the patient's anatomy. TCAT consists of an electromechanical arm, an arm base including control electronics and computer, a display monitor, operating software, pendant control, and tools and accessories, for the implementation of the preoperative plan. TCAT and TPLAN when used according to the instructions for use, make submillimeter precision bone preparation possible before and during TKA surgical procedures.
More Information

Not Found

No
The summary describes a robotic surgical system for total knee arthroplasty that uses preoperative planning software and a robotic arm for precise bone preparation. There is no mention of AI or ML in the intended use, device description, or performance studies. The system appears to be based on pre-programmed plans and image-guided execution rather than adaptive or learning algorithms.

No.
The document explicitly states that the device is intended for preoperative planning and to provide orientation and reference information during intraoperative procedures, assisting with bone preparation and implant positioning, rather than directly treating a disease or condition.

No

Explanation: The device uses diagnostic images for planning and provides intraoperative guidance; it does not itself diagnose a disease or condition.

No

The device description explicitly states that the TSolution One® Total Knee Application consists of both TPLAN (preoperative planning software) and TCAT, which includes an electromechanical arm, arm base with control electronics and computer, display monitor, operating software, pendant control, and tools and accessories. This clearly indicates the presence of significant hardware components beyond just software.

Based on the provided information, the TSolution One® Total Knee Application is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • IVD Definition: In Vitro Diagnostics are devices intended for use in the collection, preparation, and examination of specimens taken from the human body (such as blood, urine, or tissue) to provide information for the diagnosis, treatment, or prevention of disease.
  • TSolution One® Function: The TSolution One® Total Knee Application is a surgical planning and robotic assistance system. Its primary function is to assist the surgeon with preoperative planning using diagnostic images (CT scans) and to provide guidance and precise bone preparation during the surgical procedure itself. It does not analyze biological specimens from the patient.

The device's intended use, description, and the type of input data (CT scans of the anatomy) all point to it being a surgical planning and execution tool, not a diagnostic device that analyzes biological samples.

N/A

Intended Use / Indications for Use

The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan.

The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA).

The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made.

The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes.

The TSolution One® Total Knee Application is compatible with the following Knee Implant Systems:

  • · Zimmer Persona™ Knee System
  • · Corin Unity Knee System
  • Aesculap Columbus Knee System
  • · DJO Surgical® EMPOWR 3D Knee® System

Product codes

OLO

Device Description

The TSolution One® Total Knee Application is a three-dimensional, graphical, preoperative planning workstation and implementation tool for treatment of patients who require total joint arthroplasty. The device is intended as an alternative to manual template planning and preparation of the bone with patients requiring primary total knee arthroplasty (TKA).

The TSolution One® Total Knee Application consists of TPLAN and TCAT. TPLAN is a three-dimensional (3D) preoperative planning workstation that aids a surgeon in planning the position and orientation of the implant components relative to 3D models of the patient's anatomy. TCAT consists of an electromechanical arm, an arm base including control electronics and computer, a display monitor, operating software, pendant control, and tools and accessories, for the implementation of the preoperative plan. TCAT and TPLAN when used according to the instructions for use, make submillimeter precision bone preparation possible before and during TKA surgical procedures.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

CT Scan

Anatomical Site

distal femur and proximal tibia

Indicated Patient Age Range

Not Found

Intended User / Care Setting

physician, surgeon, orthopedic procedures

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)

Performance testing to verify the cutting accuracy of the subject device was conducted following similar test methods and acceptance criteria to those used for the predicate device. This testing demonstrated that the TSolution One® Total Knee Application met all test criteria and specifications. Validation testing, with methods and acceptance criteria similar to that used for the predicate device, was conducted using simulated surgical testing in a cadaver model and all test criteria were met.

  • Cutting Accuracy Verification: Passed
  • Cadaver Lab Validation Testing: Passed
  • Software Testing: Passed

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K191369

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 882.4560 Stereotaxic instrument.

(a)
Identification. A stereotaxic instrument is a device consisting of a rigid frame with a calibrated guide mechanism for precisely positioning probes or other devices within a patient's brain, spinal cord, or other part of the nervous system.(b)
Classification. Class II (performance standards).

0

December 11, 2019

Image /page/0/Picture/1 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA acronym with the full name of the agency on the right. The FDA part of the logo is in blue, with the acronym in a square and the full name written out to the right of the square.

Think Surgical, Inc. Meliha Mulalic Director, Regulatory Affairs and Quality Assurance 47201 Lakeview Blvd Fremont, California 94538

Re: K193135

Trade/Device Name: TSolution One Total Knee Application Regulation Number: 21 CFR 882.4560 Regulation Name: Stereotaxic Instrument Regulatory Class: Class II Product Code: OLO Dated: November 11, 2019 Received: November 12, 2019

Dear Meliha Mulalic:

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

1

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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Shumaya Ali, M.P.H. Assistant Director DHT6C: Division of Restorative, Repair and Trauma Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K193135

Device Name TSolution One® Total Knee Application

Indications for Use (Describe)

The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan.

The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA).

The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made.

The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes.

The TSolution One® Total Knee Application is compatible with the following Knee Implant Systems:

  • · Zimmer Persona™ Knee System
  • · Corin Unity Knee System
  • Aesculap Columbus Knee System
  • · DJO Surgical® EMPOWR 3D Knee® System

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 shows the logo for Think Surgical. The logo consists of the word "THINK" in a bold, sans-serif font, with a blue triangle replacing the "I". Below the word "THINK" is the word "SURGICAL" in a smaller, sans-serif font. The logo is simple and modern, and the blue triangle adds a touch of color and visual interest.

SECTION 6

K193135

510(k) SUMMARY

Applicant Information:

Owner Name:THINK Surgical, Inc.
Address:47201 Lakeview Blvd., Fremont, CA 94538
Phone number:510-249-2337
Fax number:510-249-2396
Establishment Registration Number:3000719653
Contact Person:Meliha Mulalic
Date Prepared:11 November 2019

Device Information:

Device Classification:Class II
Trade Name:TSolution® One Total Knee Application
Common name:Orthopedic Stereotaxic Instrument
Classification name:Stereotaxic Instrument
Regulation number:882.4560
Product Code:OLO

Predicate Device:

The TSolution® One Total Knee Application is substantially equivalent in intended use, fundamental scientific technology and performance to TSolution One® Total Knee Application cleared via K191369.

Device Modification:

The following changes have been made to the TSolution® One Total Knee Application:

  • Compatible implants Addition of the Corin Unity Knee System, Aesculap . Columbus Knee System and DJO Surgical® EMPOWR 3D Knee® System.
  • . Labeling - Implant compatibility has been modified in the Indications for Use.

Device Description:

The TSolution One® Total Knee Application is a three-dimensional, graphical, preoperative planning workstation and implementation tool for treatment of patients who require total joint arthroplasty. The device is intended as an alternative to manual template planning and preparation of the bone with patients requiring primary total knee arthroplasty (TKA).

Page 1 of 4.

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Image /page/4/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in bold, sans-serif font, with a blue triangle replacing the "I". Below the word "THINK" is the word "SURGICAL" in a smaller, sans-serif font. The logo is simple and modern, and the blue triangle adds a touch of color and visual interest.

TSolution One® Total Knee Application Special 510(k) Submission

The TSolution One® Total Knee Application consists of TPLAN and TCAT. TPLAN is a three-dimensional (3D) preoperative planning workstation that aids a surgeon in planning the position and orientation of the implant components relative to 3D models of the patient's anatomy. TCAT consists of an electromechanical arm, an arm base including control electronics and computer, a display monitor, operating software, pendant control, and tools and accessories, for the implementation of the preoperative plan. TCAT and TPLAN when used according to the instructions for use, make submillimeter precision bone preparation possible before and during TKA surgical procedures.

Intended Use / Indications for Use:

The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan.

The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA).

The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made.

The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes.

The TSolution One® Total Knee Application is compatible with the following Knee Implant Systems:

  • Zimmer Persona™ Knee System
  • Corin Unity Knee System ●
  • Aesculap Columbus Knee System .
  • DJO Surgical® EMPOWR 3D Knee® System .

Substantial Equivalence:

Both the TSolution One® Total Knee Application, and the predicate device have the same intended use. Both are intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with presurgical planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan. The difference between the new device and the predicate is that the new device provides additional compatible total knee implant systems to those previously cleared.

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Image /page/5/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in large, bold, gray letters, with a blue triangle in place of the "I". Below the word "THINK" is the word "SURGICAL" in smaller, gray letters.

The indications for use of the new device adds three new total knee implant systems that are compatible with the TSolution One® Total Knee Application.

Performance testing to verify the cutting accuracy of the subject device was conducted following similar test methods and acceptance criteria to those used for the predicate device. This testing demonstrated that the TSolution One® Total Knee Application met all test criteria and specifications. Validation testing, with methods and acceptance criteria similar to that used for the predicate device, was conducted using simulated surgical testing in a cadaver model and all test criteria were met.

Substantial equivalence in technological characteristic and performance of the TSolution One® Total Knee Application to the predicate device is outlined in the table below:

| Product | TSolution One Total Knee
Application | TSolution One Total Knee
Application | Conclusion |
|------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------|
| 510(k) number | Subject Device | K191369 | |
| Manufacturer | THINK Surgical Inc | THINK Surgical Inc | SAME |
| Technological
Characteristics | | | |
| -Patient Imaging | CT Scan | CT Scan | SAME |
| -User Controls | Keyboard, mouse, Pendant
with mechanically latched
Stop Button | Keyboard, mouse, Pendant
with mechanically latched
Stop Button | SAME |
| -Preoperative
planning
workstation | TPLAN three-dimensional
preoperative planning
workstation | TPLAN three-dimensional
preoperative planning
workstation | SAME |
| -Pre-surgical Plan | CT images used to create
a 3D model of the bone,
library of FDA cleared
components used to
develop optimal implant
size and location | CT images used to create a
3D model of the bone,
library of FDA cleared
components used to
develop optimal implant
size and location | SAME |
| -Surgical Plan
Data | High level operative plan
based on preoperative plan
with predetermined control
file developed to control the
robotic arm. | High level operative plan
based on preoperative plan
with predetermined control
file developed to control the
robotic arm. | SAME |
| -Surgical
Exposure | Similar to traditional
surgical exposure for the
anatomic site | Similar to traditional
surgical exposure for the
anatomic site | SAME |
| Electromechanical
arm to implement
pre-surgical plan | TCAT electromechanical
arm system implements
pre-surgical plan | TCAT electromechanical
arm system implements
pre-surgical plan | SAME |
| -Patient/Robot
Registration | Pinless point to surface
registration with
mechanical tracking.
Percutaneous probe thin
enough to make contact via
direct puncture through
skin | Pinless point to surface
registration with
mechanical tracking.
Percutaneous probe thin
enough to make contact via
direct puncture through
skin | SAME |

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Image /page/6/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in bold, sans-serif font, with the "I" replaced by a blue, elongated triangle pointing downwards. Below the word "THINK" is the word "SURGICAL" in a smaller, sans-serif font.

TSolution One® Total Knee Application Special 510(k) Submission

| Product | TSolution One Total Knee
Application | TSolution One Total Knee
Application | Conclusion |
|------------------------------------|-----------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------|------------|
| 510(k) number | Subject Device | K191369 | |
| Manufacturer | THINK Surgical Inc | THINK Surgical Inc | |
| -Bone Motion
Recovery | Two bone motion recovery
markers are used to
recover registration after
bone motion. | Two bone motion recovery
markers are used to
recover registration after
bone motion. | SAME |
| Performance
Testing | | | |
| -Cutting Accuracy
Verification | Passed | Passed | SAME |
| -Cadaver Lab
Validation Testing | Passed | Passed | SAME |
| -Software Testing | Passed | Passed | SAME |

Conclusion

The TSolution One® Total Knee Application is equivalent to the predicate, TSolution One® Total Knee Application, in the following ways: it has the same intended use, the same technological characteristics and operating principles, incorporates the same design and materials. Performance testing has demonstrated that the characteristics of the TSolution One® Total Knee Application are equivalent to the predicate device, and that the device is as safe and effective as the predicate device and does not raise any new questions of safety and effectiveness; therefore, a determination of Substantial Equivalence is supported.