K Number
K203532
Device Name
BI-MENTUM™ ALTRX® Dual Mobility Liner
Manufacturer
Date Cleared
2021-04-28

(147 days)

Product Code
Regulation Number
888.3353
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
BI-MENTUM™ ALTRX® Dual Mobility System is indicated for total hip replacement in the following conditions: - 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™ ALTRX® Dual Mobility Liners are designed to provide additional stability where there is an unstable joint and are for use in total hip arthroplasty that is intended to provide increased patient mobility and reduce pain by replacing the damaged hip joint articulation or a previously implanted prosthetic hip joint in patients where there is evidence of sufficient sound bone to seat and support the components. The BI-MENTUM™ ALTRX® Dual Mobility Liners are intended for single use only. BI-MENTUM™ ALTRX® Dual Mobility Liner 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 are if bone reconstruction so permits
Device Description
The BI-MENTUM™ ALTRX® Dual Mobility Liner is highly cross-linked ultra- high molecular weight polyethylene. The liner is mobile (free) in the metallic shell and retained on the prosthetic femoral head. The BI-MENTUM™ ALTRX® Dual Mobility Liner is compatible with all the stems listed on K181744 as well as all the BI-MENTUM™ cups cleared in K181744. The BI-MENTUM™ ALTRX® Dual Mobility Liner is also compatible with the PINNACLE® Dual Mobility Liner, cleared in K200854.
More Information

No
The document describes a mechanical implant (hip replacement liner) and its material properties and performance testing. There is no mention of software, algorithms, or data processing that would indicate the use of AI/ML.

Yes
The device is a total hip replacement system, which replaces damaged hip joints to reduce pain and improve mobility, directly treating a medical condition.

No
Explanation: The device is a total hip replacement system, indicated for conditions like osteoarthritis and femoral neck fracture, and is described as a replacement for damaged hip joint articulation. It is a therapeutic device, not a diagnostic one.

No

The device description clearly states it is a physical implant made of highly cross-linked ultra-high molecular weight polyethylene, intended for surgical implantation in the hip joint.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is for "total hip replacement" and is used to "replace the damaged hip joint articulation or a previously implanted prosthetic hip joint". This is a surgical implant, not a device used to examine specimens derived from the human body for the purpose of providing information for diagnosis, monitoring, or compatibility testing.
  • Device Description: The description details a physical implant made of "highly cross-linked ultra- high molecular weight polyethylene" that is inserted into the body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, performing tests on bodily fluids or tissues, or providing diagnostic information.

Therefore, the BI-MENTUM™ ALTRX® Dual Mobility System is a surgical implant, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The BI-MENTUM™ ALTRX® Dual Mobility Liner is indicated for total hip replacement in the following conditions: - 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™ ALTRX® Dual Mobility Liners are designed to provide additional stability where there is an unstable joint and are for use in total hip arthroplasty that is intended to provide increased patient mobility and reduce pain by replacing the damaged hip joint articulation or a previously implanted prosthetic hip joint in patients where there is evidence of sufficient sound bone to seat and support the components.
The BI-MENTUM™ ALTRX® Dual Mobility Liners are intended for single use only.

Product codes

LZO, MEH

Device Description

The BI-MENTUM™ ALTRX® Dual Mobility Liner is highly cross-linked ultra-high molecular weight polyethylene. The liner is mobile (free) in the metallic shell and retained on the prosthetic femoral head.
The BI-MENTUM™ ALTRX® Dual Mobility Liner is compatible with all the stems listed on K181744 as well as all the BI-MENTUM™ cups cleared in K181744. The BI-MENTUM™ ALTRX® Dual Mobility Liner is also compatible with the PINNACLE® Dual Mobility Liner, cleared in K200854.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Hip joint

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 following tests were performed on the BI-MENTUM™ ALTRX® Dual Mobility Liner to demonstrate of safety and efficacy with the predicate devices:

  • Verification of product compatibility
  • Standard walking wear testing (per ISO 14242-2)
  • Stem-Liner Range of Motion
  • Head assembly and retention force (per ASTM F1820-13)
  • Impingement testing (per ASTM F2582-20) after accelerated aging (per ASTM F2003-02)
  • Post impingement testing lever out testing (per ASTM F1820-13)
  • The proposed devices also meet the requirement of bacterial endotoxin testing
    No clinical tests were conducted to demonstrate substantial equivalence.

Key results: The subject BI-MENTUM™ ALTRX® Dual Mobility Liner is substantially equivalent to the predicate BI-MENTUM™ Dual Mobility System.

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

Not Found

Predicate Device(s)

K181744

Reference Device(s)

K072963, K132959

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

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April 28, 2021

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

Depuy Ireland UC Floriane Heinrich Regulatory Affairs Project Leader Loughbeg Ringaskiddy Co. Cork. Ireland

Re: K203532

Trade/Device Name: BI-MENTUM™ ALTRX® Dual Mobility Liner 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: April 1, 2021 Received: April 2, 2021

Dear Floriane Heinrich:

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,

Vesa Vuniqi 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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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K203532

Device Name

BI-MENTUM™ ALTRX® Dual Mobility Liner

Indications for Use (Describe)

BI-MENTUM™ ALTRX® Dual Mobility System is indicated for total hip replacement in the following conditions: - 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

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)

Submitter Information
NameDePuy Ireland UC
AddressLoughbeg
Ringaskiddy
Co. Cork, Ireland
Phone number+334 72792851
Establishment Registration
Number3015516266
Name of contact personFloriane Heinrich
Date preparedNovember 30, 2020
Name of device
Trade or proprietary
nameBI-MENTUM™ ALTRX® Dual Mobility Liner
Common or usual nameTotal hip prosthesis - Acetabular component
Classification nameHip joint metal/ceramic/polymer semi-constrained cemented or nonporous
uncemented prosthesis
ClassII
Classification panel87 Orthopedics
Regulation21 CFR 888.3353
Product Code(s)LZO, MEH
Legally marketed
device(s) to which
equivalence is claimedBI-MENTUM™ Dual Mobility System (K181744, cleared December 11, 2018)
Reference device: PINNACLE® ALTRX® insert (K072963, cleared January 8,
2008 and K132959, cleared March 10, 2014)
Reason for 510(k)
submissionLine extension - The subject device is dual mobility liner ALTRX® (ultra-high
molecular weight polyethylene) manufactured from DePuy.
Device descriptionThe BI-MENTUM™ ALTRX® Dual Mobility Liner is highly cross-linked ultra-
high molecular weight polyethylene. The liner is mobile (free) in the metallic
shell and retained on the prosthetic femoral head.
The BI-MENTUM™ ALTRX® Dual Mobility Liner is compatible with all the
stems listed on K181744 as well as all the BI-MENTUM™ cups cleared in
K181744. The BI-MENTUM™ ALTRX® Dual Mobility Liner is also
compatible with the PINNACLE® Dual Mobility Liner, cleared in K200854.
Intended use of the deviceBI-MENTUM™ ALTRX® Dual Mobility Liners are designed to provide
additional stability where there is an unstable joint and are for use in total hip
arthroplasty that is intended to provide increased patient mobility and reduce pain
by replacing the damaged hip joint articulation or a previously implanted prosthetic
hip joint in patients where there is evidence of sufficient sound bone to seat and
support the components.
The BI-MENTUM™ ALTRX® Dual Mobility Liners are intended for single use
only.
Indications for useBI-MENTUM™ ALTRX® Dual Mobility Liner 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 are if
    bone reconstruction so permits |

4

5

SUMMARY OF THE TECHNOLOGICAL CHARACTERISTICS OF THE DEVICE COMPARED TO THE PREDICATE DEVICE
CharacteristicsSubject Device:
BI-MENTUM™ ALTRX® Dual
Mobility LinerPredicate Device:
SERF BI-MENTUM™ Dual
Mobility System (K181744)Reference Device:
DePuy PINNACLE® ALTRX®
Acetabular Liners (K072963,
K132959)
Intended UseTotal Hip ArthroplastySameSame
Liner MaterialUHMWPE, GUR 1020UHMWPE, GUR 1050UHMWPE, GUR 1020
FixationUncementedSameSame
Dual MobilityYesYesNo
Dual Mobility
DesignMonobloc dual articulationMonobloc dual articulationN/A
Compatible
Acetabular Shell
Diameters41 - 69 mmSame44 - 76 mm
Internal Diameter
of Dual Mobility
Liner22.2 mm, 28 mmSame28, 32, 36, 40, 44 and 48 mm
Sterile MethodGas PlasmaGammaGas Plasma
Sterility Assurance
Level10-610-610-6
PackagingDouble PETG blister with Tyvek peel
lidVacuum-packed in bags and sealed in
blister packagingDouble PETG blister with Tyvek
peel lid
Shelf Life5 yearsSameSame
The subject BI-MENTUM™ ALTRX® Dual Mobility Liner has the same intended use and fixation as the predicate BI-MENTUM™ Dual
Mobility System (K181744). The subject device is intended for total hip arthroplasty; is a dual mobility construct and is available in the same
size range as the predicate device. The subject BI-MENTUM™ ALTRX® Dual Mobility Liner has the same intended use and the same materia
(UHMWPE GUR 1020) as the reference device DePuy PINNACLE® ALTRX® Acetabular Liners (K072963, K132959).

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PERFORMANCE DATA

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

The following tests were performed on the BI-MENTUM™ ALTRX® Dual Mobility Liner to demonstrate of safety and efficacy with the predicate devices:

  • . Verification of product compatibility
  • Standard walking wear testing (per ISO 14242-2) .
  • Stem-Liner Range of Motion .
  • Head assembly and retention force (per ASTM F1820-13) .
  • Impingement testing (per ASTM F2582-20) after accelerated aging (per ASTM F2003-02) .
  • Post impingement testing lever out testing (per ASTM F1820-13) .
  • The proposed devices also meet the requirement of bacterial endotoxin testing .

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

No clinical tests were conducted to demonstrate substantial equivalence.

CONCLUSIONS DRAWN FROM NON-CLINICAL AND CLINICAL DATA

The subject BI-MENTUM™ ALTRX® Dual Mobility Liner is substantially equivalent to the predicate BI-MENTUM™ Dual Mobility System.