K Number
K220896
Device Name
Legion Inserts with JRNY Lock
Date Cleared
2022-04-26

(29 days)

Product Code
Regulation Number
888.3560
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Total Knee components are indicated for rheumatoid arthritis, osteoarthritis, osteoarthritis, or degenerative arthritis; failed osteotomies, unicoment, or total knee replacement. Posterior stabilized knee systems are designed for use in patients in primary and revision surgery. where the anterior cruciate ligaments are incompetent and the collateral ligaments remain intact. Constrained knee systems are designed for use in patients in primary and revision surgery, where the posterior cruciate ligament and one or both of the collateral ligaments (i.e. medial collateral and/or lateral collateral ligament) are incompetent. The Smith & Nephew LEGION Inserts with JRNY Lock are single use devices.
Device Description
The subject devices of this Special 510(k) are the LEGION Inserts with JRNY Lock. The subject LEGION Inserts with JRNY Lock are tibia insert components, and a line extension of the LEGION Articular Inserts cleared under premarket notification K071071 (S.E. 09/16/2007). The subject devices were modified by incorporating the identical JOURNEY II locking mechanism from the LEGION CR High Flex and CR Deep Dish Inserts with JRNY Lock, cleared under premarket notifications K200407 (S.E. 3/13/2020) respectively. The subject LEGION Inserts with JRNY Lock have a size range of 1-2, 3-4, 5-6, 7-8 with thicknesses of 9, 10, 11, 12, 13, 15, 18, 21, 25, 30mm, and come in cruciate-retaining standard (CR STD), posterior-stabilizing standard (PS STD), posterior-stabilizing high flexion (PS HF) and posterior-stabilizing Constrained (PS Constrained) varieties. The subject LEGION PS Constrained, LEGION PS STD, and LEGION CR STD Inserts with JRNY Lock are manufactured from Ultra-High Molecular Weight Polyethylene (UHMWPE) and the subject LEGION PS HF Inserts with JRNY Lock are manufactured from 7.5MRad Crosslinked Polyethylene (XLPE) conforming to ASTM F648 (FDA Recognition Number 8-569) and ISO 5834-2 (FDA Recognition Number 8-514).
More Information

No
The document describes a mechanical knee implant component and its materials, with no mention of software, algorithms, or data processing that would indicate AI/ML.

Yes
The device is a knee implant component indicated for conditions like rheumatoid arthritis and osteoarthritis, which are health-related conditions that the device is designed to treat or alleviate.

No
This device is a total knee replacement component (tibia insert) used for surgical implantation, not for diagnosing medical conditions. Its purpose is to replace parts of a damaged knee joint, not to identify diseases or conditions.

No

The device description clearly states that the device is a physical component (tibia insert) made of Ultra-High Molecular Weight Polyethylene (UHMWPE) or Crosslinked Polyethylene (XLPE). It is a hardware device, not software.

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

Here's why:

  • Intended Use: The intended use clearly describes the device as a component for total knee replacement surgery, addressing conditions like arthritis and failed previous surgeries. This is a surgical implant, not a diagnostic test performed on samples from the body.
  • Device Description: The description details the physical components (tibia inserts), materials (UHMWPE, XLPE), and sizes. This aligns with a medical device intended for implantation.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.), detecting specific analytes, or providing diagnostic information about a patient's condition based on laboratory testing.

The device is a surgical implant used to treat a condition, not a tool for diagnosing a condition.

N/A

Intended Use / Indications for Use

Total Knee components are indicated for rheumatoid arthritis; post-traumatic arthritis, osteoarthritis, or degenerative arthritis; failed osteotomies, unicompartmental replacement, or total knee replacement. Posterior stabilized knee systems are designed for use in patients in primary and revision surgery, where the anterior and posterior cruciate ligaments are incompetent and the collateral ligaments remain intact. Constrained knee systems are designed for use in patients in primary and revision surgery, where the posterior cruciate ligament and one or both of the collateral ligaments (i.e. medial collateral and/or lateral ligament) are incompetent.

The Smith & Nephew LEGION Inserts with JRNY Lock are single use devices.

Product codes

JWH, MBH

Device Description

The subject devices of this Special 510(k) are the LEGION Inserts with JRNY Lock. The subject LEGION Inserts with JRNY Lock are tibia insert components, and a line extension of the LEGION Articular Inserts cleared under premarket notification K071071 (S.E. 09/16/2007). The subject devices were modified by incorporating the identical JOURNEY II locking mechanism from the LEGION CR High Flex and CR Deep Dish Inserts with JRNY Lock, cleared under premarket notifications K200407 (S.E. 3/13/2020) respectively.

The subject LEGION Inserts with JRNY Lock have a size range of 1-2, 3-4, 5-6, 7-8 with thicknesses of 9, 10, 11, 12, 13, 15, 18, 21, 25, 30mm, and come in cruciate-retaining standard (CR STD), posterior-stabilizing standard (PS STD), posterior-stabilizing high flexion (PS HF) and posterior-stabilizing Constrained (PS Constrained) varieties.

The subject LEGION PS Constrained, LEGION PS STD, and LEGION CR STD Inserts with JRNY Lock are manufactured from Ultra-High Molecular Weight Polyethylene (UHMWPE) and the subject LEGION PS HF Inserts with JRNY Lock are manufactured from 7.5MRad Crosslinked Polyethylene (XLPE) conforming to ASTM F648 (FDA Recognition Number 8-569) and ISO 5834-2 (FDA Recognition Number 8-514).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Knee

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

A review of the leveraged mechanical data indicates that the subject LEGION Inserts with JRNY Lock are substantially equivalent to one or more of the previously cleared predicate devices listed in Table 5.1 above. The following characteristics and performance testing were reviewed to determine the substantial equivalence: Range of Motion and Constraint, Tibiofemoral Contact Area Analysis, Component Interlock Strength Testing.
Bacterial endotoxin testing was completed and met the acceptable endotoxin limits as stated in the FDA Guidance, "Submission and Review of Sterility Information in Premarket Notification (510(k)) Submissions for Devices Labeled as Sterile," "Pyrogen and Endotoxins Testing: Questions and Answers," and ANSI/AAMI ST72 (FDA Recognition Number 14-541).

Key Metrics

Not Found

Predicate Device(s)

K071071, K962137

Reference Device(s)

K200407

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 888.3560 Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis.

(a)
Identification. A knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace 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 have a femoral component made of alloys, such as cobalt-chromium-molybdenum, and a tibial component or components and a retropatellar resurfacing component made of ultra-high molecular weight polyethylene. This generic type of device is limited to those prostheses intended for use with bone cement (§ 888.3027).(b)
Classification. Class II.

0

April 26, 2022

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 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.

Smith & Nephew, Inc. Madison Padgett Regulatory Affairs Specialist 7135 Goodlett Farms Parkway Cordova, Tennessee 38016

Re: K220896

Trade/Device Name: Legion Inserts with JRNY Lock Regulation Number: 21 CFR 888.3560 Regulation Name: Knee Joint Patellofemorotibial Polymer Semi-Constrained Cemented Prosthesis Regulatory Class: Class II Product Code: JWH, MBH Dated: March 25, 2022 Received: March 28, 2022

Dear Madison Padgett:

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,

Ting Song, Ph.D. 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) K220896

Device Name LEGION Inserts with JRNY Lock

Total Knee components are indicated for theumatoid arthritis, osteoarthritis, osteoarthritis, or degenerative arthritis; failed osteotomies, unicoment, or total knee replacement. Posterior stabilized knee systems are designed for use in patients in primary and revision surgery. where the anterior cruciate ligaments are incompetent and the collateral ligaments remain intact. Constrained knee systems are designed for use in patients in primary and revision surgery, where the posterior cruciate ligament and one or both of the collateral ligaments (i.e. medial collateral and/or lateral collateral ligament) are incompetent.

The Smith & Nephew LEGION Inserts with JRNY Lock are single use devices.

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

| 510(k) Summary Submitted by: | Smith & Nephew, Inc.
Orthopaedic Division
7135 Goodlett Farms Parkway
Cordova, Tennessee 38016 |
|----------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Date of Summary: | March 25, 2022 |
| Primary Contact Person: | Madison Padgett, Regulatory Affairs Specialist II
Phone: (901) 456-8789 |
| Secondary Contact Person | Michelle Huettner, Director, Regulatory Affairs
Phone: (765) 426-6070 |
| Name of Device: | LEGION Inserts with JRNY Lock |
| Common Name: | Tibial Articular Insert Components |
| Device Classification Name and
Reference: | 21 CFR 888.3560 Knee joint patellofemorotibial
polymer/metal/polymer semi-constrained
cemented prosthesis
21 CFR 888.3565 Knee joint patellofemorotibial
metal/polymer porous-coated uncemented
prothesis |
| Device Class: | Class II |
| Panel Code: | Orthopaedics/87 |
| Product Code: | JWH - Prosthesis, Knee, Patellofemorotibial, Semi-Constrained, Cemented, Polymer/Metal/Polymer
MBH - Prosthesis, Knee, Patello/Femorotibial, Semi-Constrained, Uncemented, Porous, Coated, Polymer/Metal/Polymer |

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Predicate Device:

Primary Predicate – K071071 – Crosslinked Polyethylene Articular Inserts (S.E. 9/19/2007) JWH, MBH Secondary Predicate – K962137 – GENESIS II Constrained System (S.E. 8/2/1996) JWH Reference Predicate – K200407 – LEGION Inserts with JRNY Lock (S.E. 3/13/2020) JWH

5

Device Description

The subject devices of this Special 510(k) are the LEGION Inserts with JRNY Lock. The subject LEGION Inserts with JRNY Lock are tibia insert components, and a line extension of the LEGION Articular Inserts cleared under premarket notification K071071 (S.E. 09/16/2007). The subject devices were modified by incorporating the identical JOURNEY II locking mechanism from the LEGION CR High Flex and CR Deep Dish Inserts with JRNY Lock, cleared under premarket notifications K200407 (S.E. 3/13/2020) respectively.

The subject LEGION Inserts with JRNY Lock have a size range of 1-2, 3-4, 5-6, 7-8 with thicknesses of 9, 10, 11, 12, 13, 15, 18, 21, 25, 30mm, and come in cruciate-retaining standard (CR STD), posterior-stabilizing standard (PS STD), posterior-stabilizing high flexion (PS HF) and posterior-stabilizing Constrained (PS Constrained) varieties.

The subject LEGION PS Constrained, LEGION PS STD, and LEGION CR STD Inserts with JRNY Lock are manufactured from Ultra-High Molecular Weight Polyethylene (UHMWPE) and the subject LEGION PS HF Inserts with JRNY Lock are manufactured from 7.5MRad Crosslinked Polyethylene (XLPE) conforming to ASTM F648 (FDA Recognition Number 8-569) and ISO 5834-2 (FDA Recognition Number 8-514).

Indication for Use:

Total Knee components are indicated for rheumatoid arthritis; post-traumatic arthritis, osteoarthritis, or degenerative arthritis; failed osteotomies, unicompartmental replacement, or total knee replacement. Posterior stabilized knee systems are designed for use in patients in primary and revision surgery, where the anterior and posterior cruciate ligaments are incompetent and the collateral ligaments remain intact. Constrained knee systems are designed for use in patients in primary and revision surgery, where the posterior cruciate ligament and one or both of the collateral ligaments (i.e. medial collateral and/or lateral ligament) are incompetent.

The Smith & Nephew LEGION Inserts with JRNY Lock are single use devices.

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Technological Characteristics

The subject devices were modified by incorporating the identical locking mechanism cleared under premarket notification K200407 (S.E. 03/13/2020) to the primary predicate LEGION Articular Inserts cleared under K071071 (S.E. 09/16/2007). A review of the technological characteristics indicates that the subject LEGION Inserts with JRNY Lock are equivalent to existing, legally marketed predicate devices with regards to mechanical performance and that there are no new issues related to the safety and effectiveness of the subject devices. A review of this testing has demonstrated that there are no new issues related to the safety and effectiveness of the subject devices. Clinical data was not needed to support the safety and effectiveness of the subject devices.

Substantial Equivalence Information

The subject devices are substantially equivalent to the predicate devices listed in the following table in function, intended use, indications for use, design, and material composition.

| Manufacturer | Submission Name | Submission
Number | Clearance
Date |
|-------------------------|--------------------------------------------------------|----------------------|-------------------|
| Smith & Nephew,
Inc. | Crosslinked Polyethylene
Articular Inserts (LEGION) | K071071 | 09/16/2007 |
| Smith & Nephew,
Inc. | GENESIS II Constrained
System | K962137 | 08/02/1996 |
| Smith & Nephew,
Inc. | LEGION Inserts with
JRNY Lock | K200407 | 03/13/2020 |

Table 5.1: Substantially Equivalent Predicates

Performance Testing:

A review of the leveraged mechanical data indicates that the subject LEGION Inserts with JRNY Lock are substantially equivalent to one or more of the previously cleared predicate devices listed in Table 5.1 above. The following characteristics and performance testing were reviewed to determine the substantial equivalence.

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  • . Range of Motion and Constraint
  • . Tibiofemoral Contact Area Analysis
  • Component Interlock Strength Testing .

Bacterial endotoxin testing was completed and met the acceptable endotoxin limits as stated in the FDA Guidance, "Submission and Review of Sterility Information in Premarket Notification (510(k)) Submissions for Devices Labeled as Sterile," "Pyrogen and Endotoxins Testing: Questions and Answers," and ANSI/AAMI ST72 (FDA Recognition Number 14-541).

Conclusion

As previously noted, this Special 510(k) Premarket Notification is being submitted to request clearance for the LEGION Inserts with JRNY Lock. Based on the similarities to the predicate devices and rationale to support substantial equivalence, the subject devices are substantially equivalent to the commercially available predicate devices listed in Table 5.1.