(449 days)
Biomet Comprehensive Reverse Shoulder products are in patients whose shoulder joint has a grossly deficient rotator cuff with severe arthropathy and/or previously failed shoulder joint replacement with a grossly deficient rotator cuff. The patient must be anatomically suited to receive the implants and a functional deltoid muscle is necessary.
The Comprehensive Reverse Shoulder is indicated for primary, fracture, or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency.
Glenoid components with Hydroxyapatite (HA) coating applied over the porous coating are indicated only for uncemented biological fixation applications. The Glenoid Baseplate components are intended for cementless application with the addition of screw fixation.
Interlok® finish humeral stems are intended for cemented use and the MacroBond® coated humeral stems are intended for press-fit or cemented applications. Humeral components with porous coating are indicated for either cemented or uncemented biological fixation applications.
Biomet Comprehensive Reverse Shoulder products are indicated for use in patients whose shoulder joint has a grossly deficient rotator cuff with severe arthropathy and/or previously failed shoulder joint replacement with a grossly deficient rotator cuff. The patient must be anatomically suited to receive the implants and a functional deltoid muscle is necessary.
The Comprehensive Reverse Shoulder is indicated for primary, fracture, or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency.
Titanium glenospheres are intents with Cobalt Alloy material sensitivity. The wear of these devices has not been tested but, based on pin on disk testing, the wear rate is inferior to that of cobalt alloy glenospheres. A Cobalt Alloy glenosphere is the recommended component for reverse shoulder arthroplasty patients without material sensitivity to cobalt alloy.
Glenoid components with Hydroxyapatite (HA) coating applied over the porous coating are indicated only for uncemented biological fixation applications. The Glenoid Baseplate components are intended for cementless application with the addition of screw fixation.
Interlok® finish humeral stems are intended for cemented use and the MacroBond® coated humeral stems are intended for press-fit or cemented applications. Humeral components with porous coating are indicated for either cemented or uncemented biological fixation applications.
- Non-inflammatory degenerative joint disease including osteoarthritis and avascular necrosis.
- Rheumatoid arthritis.
- Correction of functional deformity.
- Fractures of the proximal humerus, where other methods of treatment are deemed inadequate.
- Difficult clinical management problems, including cuff arthropathy, where other methods of treatment may not be suitable or may be inadequate.
Optional use in revision: in some medical conditions (e.g. revision when healthy and good bone stock exists), the surgeon may opt to use primary implants in a revision procedure.
Humeral components with a porous coated surface coating are indicated for either cemented biological fixation applications.
The Comprehensive® 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.
The Comprehensive Humeral Positioning Sleeves are for cemented use only and are intended for use with the Comprehensive Fracture Stem.
The Versa-Dial Humeral Head Prosthesis is intended for use only with the Comprehensive Shoulder Stems (Fracture, Primary and Revision), and the glenoid components of the Comprehensive Shoulder System.
The Titanium Versa-Dial Humeral Head Prosthesis is indicated for patients with suspected cobalt alloy sensitivity. The wear properties of Titanium alloys are inferior to that of cobalt alloy. A Titanium humeral head is not recommended for patients who lack suspected material sensitivity to cobalt alloy*
*The Titanium Versa-Dial Humeral Head Prosthesis is not for sale in Canada
Anatomic Applications
- Non-inflammatory degenerative joint disease including osteoarthritis and avascular necrosis.
- Rheumatoid arthritis.
- Revision where other devices or treatments have failed.
- Correction of functional deformity.
- Fractures of the proximal humerus, where other methods of treatment are deemed inadequate.
- Difficult clinical management problems, including cuff arthropathy, where other methods of treatment may be suitable or may be inadequate.
Reverse Applications
The Comprehensive Reverse Shoulder is indicated for use in patients whose shoulder joint has a grossly deficient rotator cuff with severe arthropathy and/or previously failed shoulder joint replacement with a grossly deficient rotator cuff. The patient must be anatomically and structurally suited to receive the implants and a functional deltoid muscle is necessary.
Comprehensive Convertible Glenoid Baseplate components are intended for cementless applications with the addition of screw fixation.
Interlok® finish humeral stems are intended for cemented use and the MacroBond® coated humeral stems are intended for press-fit or cemented application. Huments with porous coated surface coating are indicated for either cemented or uncemented biological fixation applications.
Biomet Comprehensive Reverse Shoulder products are in patients whose shoulder joint has a grossly deficient rotator cuff with severe arthropathy failed shoulder joint replacement with a grossly deficient rotator cuff. The patient must be anatomically and structurally suited to receive the implants and a functional deltoid muscle is necessary.
The Comprehensive Reverse Shoulder is indicated for primary, fracture, or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency.
Titanium glenospheres are intended for patients with Cobalt Alloy material sensitivity. The wear of these devices has not been tested but, based on pin on disk testing, the wear rate is inferior to that of cobalt alloy glenospheres. A Cobalt Alloy glenosphere is the recommended component for reverse shoulder arthroplasty patients without material sensitivity to cobalt alloy.
Glenoid components with Hydroxyapatite (HA) coating applied over the porous coating are indicated only for uncemented biological fixations. The Glenoid Baseplate components are intended for cementless application with the addition of screw fixation.
Interlok® finish humeral stems are intended for cemented use and the MacroBond® coated humeral stems are intended for press-fit or cemented applications. Humeral components with porous coated surface coating are indicated for either cemented or uncemented biological fixation applications.
Comprehensive Shoulder System consists of partial and total shoulder replacement components use in cemented and uncemented applications. The devices are modular components consisting of humeral stems, modular heads and glenoid components for anatomic and humeral tray and glenosphere components for reverse configuration. The purpose of the current submission is to add MR Conditional labeling.
Here's an analysis of the provided information, addressing your questions about acceptance criteria and study details.
Important Note: The provided document is a 510(k) FDA clearance letter, which focuses on demonstrating substantial equivalence to predicate devices rather than establishing novel performance criteria through extensive clinical trials. Therefore, much of the information you've requested regarding specific acceptance criteria, performance metrics, ground truth, and human reader studies is not present in this type of document because it is not required for a 510(k) submission for this type of device (implants). The "acceptance criteria" here implicitly refer to the device not posing new questions of safety or effectiveness compared to its predicates and meeting established standards for its material properties and MR compatibility.
Acceptance Criteria and Reported Device Performance
Given that this is a 510(k) for a shoulder replacement system seeking to add "MR Conditional" labeling, the "acceptance criteria" are related to established safety and performance standards for implants, particularly concerning their interaction with Magnetic Resonance (MR) environments. The performance data provided is entirely non-clinical and related to MR compatibility.
Table of Acceptance Criteria and Reported Device Performance
Acceptance Criteria (Implicit) | Reported Device Performance (Non-Clinical Tests) |
---|---|
Material Properties & Design: Similar to predicate devices, ensuring established biocompatibility, mechanical strength, and functional design. | - Intended Use: Identical to predicate. |
- Indications for Use: Identical to predicate.
- Materials: Identical to predicate.
- Design Features: Identical to predicate.
- Sterilization: Identical to predicate. |
| MR Compatibility: The device should not pose an unacceptable risk or generate excessive artifacts in an MR environment and should meet established standards for MR Conditional labeling. | - ASTM F2503-20 (Labeling): Evaluation completed (implies compliance for labeling). - ASTM F2119-07R13 (Artifact): Evaluation completed (implies acceptable artifact levels).
- ASTM F2213-17 (Torque): Evaluation completed (implies acceptable torque in MR environment).
- ASTM F2052-21 (Displacement Force): Evaluation completed (implies acceptable displacement force in MR environment).
- ASTM F2182-19E02 (RF-heating): Evaluation completed (implies acceptable RF-heating).
- Preliminary Phantom Evaluation: Completed. |
Study Details
As this is a 510(k) for a medical implant and not an AI/software device, many of the requested categories related to diagnostic performance or human reading studies are not applicable.
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Sample Size Used for the Test Set and Data Provenance:
- Test Set Sample Size: Not applicable in the context of diagnostic data. For the non-clinical MR compatibility tests, the "sample size" would refer to the number of device components tested according to the referenced ASTM standards. This specific number is not provided in the summary but would be detailed in the full test reports.
- Data Provenance: Not applicable for diagnostic data. The MR compatibility tests are conducted in a controlled laboratory setting (likely in the US, where the company is based), not on patient data.
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Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications:
- Not applicable. Ground truth, in the AI/diagnostic context, refers to definitively established diagnoses or classifications. For an implant, "ground truth" relates to material science and engineering principles verified by standard testing methods and accredited labs.
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Adjudication Method for the Test Set:
- Not applicable. Adjudication methods are used to resolve discrepancies among expert opinions in diagnostic studies.
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Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:
- No, a MRMC comparative effectiveness study was not done. This type of study is relevant for diagnostic imaging AI systems, not for physical implants.
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Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study:
- No, a standalone performance study in the AI sense was not done. The "performance" here is for the physical device's interaction with an MR field, which isn't an "algorithm-only" performance.
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Type of Ground Truth Used:
- For the core claims of equivalence (materials, design, etc.), the "ground truth" is established engineering and scientific principles, validated by testing against relevant ASTM standards and by comparison to the predicate devices. For MR compatibility specifically, the ground truth is defined by the objective measurements obtained through the standard ASTM test procedures (e.g., measured temperature rise, displacement force, artifact size) and compared against the limits established by those standards to determine "MR Conditional" status.
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Sample Size for the Training Set:
- Not applicable. There is no training set mentioned, as this is not an AI/machine learning device.
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How the Ground Truth for the Training Set Was Established:
- Not applicable, as there is no training set.
§ 888.3660 Shoulder joint metal/polymer semi-constrained cemented prosthesis.
(a)
Identification. A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a shoulder 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 have a humeral resurfacing component made of alloys, such as cobalt-chromium-molybdenum, and a glenoid resurfacing 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. The special controls for this device are:(1) FDA's:
(i) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Devices—Part I: Evaluation and Testing,’ ”
(ii) “510(k) Sterility Review Guidance of 2/12/90 (K90-1),”
(iii) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone Cement,”
(iv) “Guidance Document for the Preparation of Premarket Notification (510(k)) Application for Orthopedic Devices,” and
(v) “Guidance Document for Testing Non-articulating, ‘Mechanically Locked’ Modular Implant Components,”
(2) International Organization for Standardization's (ISO):
(i) ISO 5832-3:1996 “Implants for Surgery—Metallic Materials—Part 3: Wrought Titanium 6-aluminum 4-vandium Alloy,”
(ii) ISO 5832-4:1996 “Implants for Surgery—Metallic Materials—Part 4: Cobalt-chromium-molybdenum casting alloy,”
(iii) ISO 5832-12:1996 “Implants for Surgery—Metallic Materials—Part 12: Wrought Cobalt-chromium-molybdenum alloy,”
(iv) ISO 5833:1992 “Implants for Surgery—Acrylic Resin Cements,”
(v) ISO 5834-2:1998 “Implants for Surgery—Ultra-high Molecular Weight Polyethylene—Part 2: Moulded Forms,”
(vi) ISO 6018:1987 “Orthopaedic Implants—General Requirements for Marking, Packaging, and Labeling,” and
(vii) ISO 9001:1994 “Quality Systems—Model for Quality Assurance in Design/Development, Production, Installation, and Servicing,” and
(3) American Society for Testing and Materials':
(i) F 75-92 “Specification for Cast Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implant Material,”
(ii) F 648-98 “Specification for Ultra-High-Molecular-Weight Polyethylene Powder and Fabricated Form for Surgical Implants,”
(iii) F 799-96 “Specification for Cobalt-28 Chromium-6 Molybdenum Alloy Forgings for Surgical Implants,”
(iv) F 1044-95 “Test Method for Shear Testing of Porous Metal Coatings,”
(v) F 1108-97 “Specification for Titanium-6 Aluminum-4 Vanadium Alloy Castings for Surgical Implants,”
(vi) F 1147-95 “Test Method for Tension Testing of Porous Metal,”
(vii) F 1378-97 “Standard Specification for Shoulder Prosthesis,” and
(viii) F 1537-94 “Specification for Wrought Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implants.”