K Number
K193549
Device Name
SIGMA High Performance (HP) Partial Knee System
Manufacturer
Date Cleared
2020-04-16

(118 days)

Product Code
Regulation Number
888.3530
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
INDICATIONS The SIGMA High Performance Partial Knee System is indicated for single compartmental knee replacement in skeletally mature individuals with osteoarthritis, post-traumatic arthritis of the tibiofemoral surfaces or a history of gout or pseudogout. All components are intended for CEMENTED USE ONLY.
Device Description
The DePuy SIGMA® High Performance Partial Knee System is a single compartmental knee prosthesis, composed of individually packaged femoral and tibial components designed to be used in various combinations to replace the natural articular surfaces of the knee joint. The unicompartmental femoral components are Co-Cr-Mo metal implants, available with or without a porous coating. The metal backed tibial components are Co-Cr-Mo and polyethylene and are available without a porous coating. The all-polyethylene unicompartmental tibial component manufactured from polyethylene. The unicompartmental femoral components are designed for individuals who require a higher than normal degree of flexion (up to 155°).
More Information

No
The 510(k) summary describes a mechanical knee implant and does not mention any software, algorithms, or AI/ML capabilities. The performance studies are focused on mechanical and material properties.

Yes
This device is a knee replacement system intended for single compartmental knee replacement, which explicitly falls under the definition of a therapeutic device designed to treat a medical condition (osteoarthritis, post-traumatic arthritis, gout, or pseudogout).

No
Explanation: The device described is a knee replacement system (prosthesis) used for treatment, not for diagnosing a condition. Its indications for use describe the conditions it treats, not conditions it helps to identify.

No

The device description clearly states it is a knee prosthesis composed of physical components (femoral and tibial components made of metal and polyethylene), indicating it is a hardware medical device.

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

Here's why:

  • Intended Use: The intended use is for "single compartmental knee replacement" in individuals with specific knee conditions. This is a surgical procedure involving the implantation of a medical device, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device is described as a "single compartmental knee prosthesis," composed of "femoral and tibial components." These are physical implants designed to replace parts of the knee joint.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens (like blood, urine, or tissue) outside of the body to provide information for diagnosis, monitoring, or screening.

The device is clearly a surgical implant used for treatment, not a diagnostic tool.

N/A

Intended Use / Indications for Use

The SIGMA High Performance Partial Knee System is indicated for single compartment in skeletally mature individuals with osteoarthritis, post-traumatic arthritis of the tibiofemoral articular surfaces or a history of gout or pseudogout. All components are intended for CEMENTED USE ONLY.

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

HRY, OIY

Device Description

The DePuy SIGMA® High Performance Partial Knee System is a single compartmental knee prosthesis, composed of individually packaged femoral and tibial components designed to be used in various combinations to replace the natural articular surfaces of the knee joint.

The unicompartmental femoral components are Co-Cr-Mo metal implants, available with or without a porous coating. The metal backed tibial components are Co-Cr-Mo and polyethylene and are available without a porous coating. The all-polyethylene unicompartmental tibial component manufactured from polyethylene.

The unicompartmental femoral components are designed for individuals who require a higher than normal degree of flexion (up to 155°).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Knee joint

Indicated Patient Age Range

Skeletally mature individuals

Intended User / Care Setting

Prescription Use

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 following tests were performed (per FDA's Class II Special Controls Guidance Document: Knee Joint Patellofenerotibial Metal/Polyner Porous-Coated Uncenented Prosheses; Guidance for Industry and FDA) on the SIGMA High Performance (HP) Patial Knee AOX Insert to demonstrate substantial equivalence of safety and efficacy with the predicate device:

  • Biocompatibility .
  • UHMWPE Material Property Characterization .
  • Range of Motion/Constraint ●
  • Contact Area/Stress ●
  • Wear Testing ●
  • Pull-Off .

The proposed devices also meet the requirement of bacterial endotoxin testing as specified in ANSI AAMI ST-72:2011.

Clinical testing was not necessary to demonstrate substantial equivalence.

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.

K070849, K070267, K061648

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.

K101433

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

§ 888.3530 Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis.

(a)
Identification. A knee joint femorotibial metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace part of a knee 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 includes prostheses that consist of a femoral component made of alloys, such as cobalt-chromium-molybdenum, and a tibial component made of ultra-high molecular weight polyethylene and is limited to those prostheses intended for use with bone cement (§ 888.3027).(b)
Classification. Class II.

0

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April 16, 2020

DePuy Ireland UC % Brad Osborne Regulatory Affairs Specialist II DePuv Synthes. Inc. 700 Orthopaedic Drive Warsaw. Indiana 46582

Re: K193549

Trade/Device Name: SIGMA High Performance (HP) Partial Knee System Regulation Number: 21 CFR 888.3530 Regulation Name: Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis Regulatory Class: Class II Product Codes: HRY, OIY Dated: February 17, 2020 Received: February 18, 2020

Dear Brad Osborne:

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

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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,

for Ting Song, Ph.D., R.A.C. Acting Assistant Director DHT6A: Division of Joint Arthroplasty Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K193549

Device Name

SIGMA High Performance (HP) Partial Knee System

Indications for Use (Describe)

INDICATIONS

The SIGMA High Performance Partial Knee System is indicated for single compartment in sketally mature individuals with osteoarthritis, post-traumatic arthritis of the tibiofemoral articular surfaces or a history of gout or pseudogout. All components 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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510(K) SUMMARY

(As required by 21 CFR 807.92 and 21 CFR 807.93)

Submitter Information
NameDePuy Ireland UC
AddressLoughbeg, Ringaskiddy
Co. Cork Munster, Ireland
Phone number574-371-4724
Fax number574-371-4987
Establishment Registration Number1818910
Name of contact personBrad Osborne
Date prepared4/16/2020
Name of device
Trade or proprietary nameSIGMA High Performance (HP) Partial Knee System
Common or usual nameProsthesis, Knee, Femorotibial, Semi-Constrained, Cemented, Metal/Polymer
Classification nameKnee joint femorotibial metal/polymer semi-constrained cemented prosthesis
ClassII
Classification panel87 Orthopedics
RegulationPrimary: 21 CFR 888.3530
Secondary: 21 CFR 888.3560
Product Code(s)Primary: HRY
Secondary: OIY
Legally marketed device(s) to which
equivalence is claimedK070849 DEPUY GCK (SIGMA HP Partial) FEMORAL AND TIBIAL COMPONENTS
K070267 DEPUY GCK (SIGMA HP Partial) TIBIAL COMPONENTS
K061648 DEPUY GRADUATED COMPARTMENTAL KNEE (GCK) (SIGMA HP Partial)
K101433 DEPUY ATTUNE KNEE SYSTEM
Reason for 510(k) submissionThis submission describes additional inserts compatible with the previously cleared SIGMA High
Performance (HP) Partial Knee System (previously referred to as DePuy Graduated Compartmental Knee or
GCK) and includes a labeling update to the existing IFU.
Device descriptionThe DePuy SIGMA® High Performance Partial Knee System is a single compartmental knee prosthesis,
composed of individually packaged femoral and tibial components designed to be used in various
combinations to replace the natural articular surfaces of the knee joint.

The unicompartmental femoral components are Co-Cr-Mo metal implants, available with or without a
porous coating. The metal backed tibial components are Co-Cr-Mo and polyethylene and are available
without a porous coating. The all-polyethylene unicompartmental tibial component manufactured from
polyethylene.

The unicompartmental femoral components are designed for individuals who require a higher than normal
degree of flexion (up to 155°). |
| Intended use of the device | The DePuy SIGMA HP Partial Knee System is intended to provide increased patient mobility and reduced
pain by replacing the damaged knee joint articulation in patients where there is evidence of sufficient sound
bone to seat and support the components. |
| Indications for use | INDICATIONS
The SIGMA High Performance Partial Knee System is indicated for single compartmental knee
replacement in skeletally mature individuals with osteoarthritis, post-traumatic arthritis of the
tibiofemoral surfaces or a history of gout or pseudogout. All components are intended for
CEMENTED USE ONLY. |

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5

SUMMARY OF THE TECHNOLOGICAL CHARACTERISTICS OF THE DEVICE COMPARED TO THE PREDICATE DEVICE
CharacteristicsSubject Device:Predicate Device:AOX Reference Device:
SIGMA HP Uni AOX InsertSIGMA HP Partial Knee XLK Insert
(K061648, K070267, K070849)DePuy ATTUNE Knee System AOX Insert
(K101433)
Intended UseUnicondylar Knee ArthroplastyUnicondylar or Partial Knee ArthroplastyTotal Knee Arthroplasty
Properties
MaterialAOX UHMWPEXLK UHMWPEAOX UHMWPE
FixationCementedCementedCemented
SizesTibial Inserts: 6 Sizes, 7mm-11mm thickness in 1mm incrementsFemoral & Tibial Components: 6 Sizes
Tibial Inserts: 6 Sizes, 7mm-11mm thickness in 1mm incrementsCR Fixed Bearing Tibial Inserts
Sizes 1-10 with 5, 6, 7, 8, 10, 12,
14, 16mm options for each
PS Fixed Bearing Tibial Inserts
Sizes 1-10 with 5, 6, 7, 8, 10, 12,
14, 16 mm options for each
ModularityMetal femoral component and
either an all polyethylene tibial
component or metal tibial
component with polyethylene
insertMetal femoral component and either an
all polyethylene tibial component or
metal tibial component with polyethylene
insertN/A
Packaging Description
ComponentInner foil pouch laminated out
of foil/LLDPE/Polyester
materials and vacuumed,
packaged inside a Tyvek/blister
tray with a foam protectorDouble PETG Blister/TyvekInner foil pouches
and outer rigid
blister trays with Tyvek lids

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Sterility
Sterile MethodGamma IrradiationGas Plasma SterilizationGamma Irradiation
Sterility Assurance Level$10^{-6}$$10^{-6}$$10^{-6}$
Shelf Life5 Years5 Years5 Years
Purpose of Submission
This submission adds an AOX material option to the existing legally marketed SIGMA High Performance (HP) Partial Knee System (K070267,
K070849, K061648). The SIGMA HP Partial AOX insert is equivalent to the primary predicate SIGMA HP Partial XLK Insert (K070267) in intended
use, geometry, design, fixation, and compatibility. The AOX material is similar to the AOX UHMWPE material used in the manufacture of the legally
marketed ATTUNE® Primary Knee System. All three poly materials conform to ASTM-F648. This submission also includes a labeling update to the
existing SIGMA HP Partial Knee System IFU.

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PERFORMANCE DATA

SUMMARY OF NON-CLINICAL TESTS CONDUCTED FOR DETERMINATION OF SUBSTANTIAL EQUIVALENCE

The following tests were performed (per FDA's Class II Special Controls Guidance Document: Knee Joint Patellofenerotibial Metal/Polyner Porous-Coated Uncenented Prosheses; Guidance for Industry and FDA) on the SIGMA High Performance (HP) Patial Knee AOX Insert to demonstrate substantial equivalence of safety and efficacy with the predicate device:

  • Biocompatibility .
  • UHMWPE Material Property Characterization .
  • Range of Motion/Constraint ●
  • Contact Area/Stress ●
  • Wear Testing ●
  • Pull-Off .

The proposed devices also meet the requirement of bacterial endotoxin testing as specified in ANSI AAMI ST-72:2011.

SUMMARY OF CLINICAL TESTS CONDUCTED FOR DETERMINATION OF SUBSTANTIAL EQUIVALENCE AND/OR OF CLINICAL INFORMATION

Clinical testing was not necessary to demonstrate substantial equivalence.

CONCLUSIONS DRAWN FROM NON-CLINICAL AND CLINICAL DATA

The subject DePuy SIGMA High Performance Partial Kneets are substantially equivalent to the predicate SIGMA High Performance Partial Knee System.