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K Number
K241143
Device Name
Materialise Shoulder System™, Materialise Shoulder Guide and Models, SurgiCase Shoulder Planner
Manufacturer
Materialise N.V.
Date Cleared
2024-05-22

(27 days)

Product Code
QHE,KWS,PHX
Regulation Number
888.3660
Type
Special
Panel
OR
Reference & Predicate Devices
K052472,K120174,K062250,K183077,K203694,K092122,K202716,K212737,K212933,K221467,K051075,K111629,K092873,K080402,K162024,K213387,K100448,K112438,K142413,K152047,K130050,K161189,K173717,K181999,K220847,K230572,K100858,K110598,K113254,K143256,K130642,K133349,K142139,K220792,K222427,K233408
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Hardware:
The Materialise Shoulder Guide and Models are intended to be used as a surgical instrument to assist in the intraoperative positioning of glenoid components used with total and reverse shoulder arthroplasty by referencing anatomic landmarks of the shoulder that are identifiable on preoperative CT-imaging scans.
The Materialise Shoulder Guide and Models are single use only.
The Materialise Shoulder Guide and Models can be used in conjunction with the following total and reverse shoulder implants systems and their respective compatible components:

Software:
SurgiCase Shoulder Planner is intended to be used as a pre-surgical planner for simulation of surgical interventions for shoulder orthopedic surgery. The software is used to assist in the positioning of shoulder components. SurgiCase Shoulder Planner allows the surgeon to visualize, measure, reconstruct, annotate and edit pre-surgical plan data. The software leads to the generation of a surgery report along with a pre-surgical plan data file which can be used as input data to design the Materialise Shoulder Guide and Models.

Device Description

Materialise Shoulder System™ is a patient-specific medical device that is designed to be used to assist the surgeon in the placement of shoulder components during total anatomic and reverse shoulder replacement surgery. This can be done by generating a pre-surgical shoulder plan and, if requested by the surgeon, by manufacturing a patient-specific glenoid guide and models to transfer the glenoid plan to surgery. The device is a system composed of the following:

  • a software component, branded as SurgiCase Shoulder Planner. This software is a planning tool used to generate a pre-surgical plan for a specific patient.
  • Materialise Shoulder Guide and Models, which are a patient-specific guide and models that are based on a pre-surgical plan. This pre-surgical plan is generated using the software component. Patient-specific glenoid guide and models will be manufactured if the surgeon requests patient-specific guides to transfer the glenoid plan to surgery. The Materialise Shoulder Guide is designed and manufactured to fit the anatomy of a specific patient. A bone model of the scapula is delivered with the Materialise Shoulder Guide. A graft model can be delivered with the Materialise Shoulder Guide. The graft model visualizes the graft-space between implant and bone, based on the pre-operative planning of the surgeon. The graft model serves as a visual reference for the surgeon in the OR.
AI/ML Overview

The provided text describes a 510(k) submission for the Materialise Shoulder System™, Materialise Shoulder Guide and Models, and SurgiCase Shoulder Planner. It indicates that this is a special 510(k) submission, meaning it's for a modification to a previously cleared device. Therefore, much of the performance data refers back to the predicate device and prior clearances.

Here's an analysis of the acceptance criteria and supporting study information based on the provided text:

1. A table of acceptance criteria and the reported device performance

The document does not explicitly state quantitative acceptance criteria or a direct table showing "acceptance criteria vs. reported device performance" for this specific 510(k) submission. Instead, for this special 510(k), the performance data mainly focuses on demonstrating that the changes (addition of new implant components to the software and hardware compatibility) do not raise new questions of safety and effectiveness compared to the predicate device.

The "performance data (non-clinical)" section highlights that:

  • Hardware: Previous testing for biocompatibility, cleaning, debris, dimensional stability, and packaging is applicable. Accuracy and performance of the system were "adequate to perform as intended." Previous simulated surgeries and cadaver testing on earlier cleared devices are considered applicable.
  • Software: Software verification and validation were performed "against defined requirements" and "against user needs," following FDA guidance.

Since this is a special 510(k) for an incremental change (adding compatibility with specific new implants), it's implied that the acceptance criteria are met if these additions do not negatively impact the established safety and effectiveness of the existing device, and the software development process meets regulatory standards.

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

  • Hardware (previous testing cited): The document mentions "previous simulated surgeries using rapid prototyped bone models" and "previous cadaver testing on previously cleared devices K153602 and K131559." It does not specify the sample size for these previous studies (e.g., number of bone models or cadavers) or their provenance (country of origin), nor does it state if they were retrospective or prospective.
  • Software (verification and validation): The document states "Software verification and validation were performed," but does not specify a separate "test set" in the context of clinical data or specific performance metrics with sample sizes for this particular submission. The V&V activities would involve testing against requirements and user needs, which could include various test cases and scenarios, but these are not quantified here as a "test set" size.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

This information is not provided in the document. The studies cited for hardware ("simulated surgeries" and "cadaver testing") and software ("verification and validation") do not detail the involvement of experts in establishing ground truth, their number, or specific qualifications. The software's function is to assist surgeons in planning, implying surgeon input in its use, but not explicitly in establishing a ground truth for a test set described in this submission.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This information is not provided in the document.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

The document does not mention any MRMC comparative effectiveness studies. The device (SurgiCase Shoulder Planner software component and Materialise Shoulder Guide and Models hardware component) is designed to assist surgeons in planning and component positioning, but the provided text does not contain data on whether human readers/surgeons improve with or without this specific AI assistance or effect sizes.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

The document states that the SurgiCase Shoulder Planner is "intended to be used as a pre-surgical planner for simulation of surgical interventions for shoulder orthopedic surgery. The software is used to assist in the positioning of shoulder components." It also mentions, "SurgiCase Shoulder Planner allows the surgeon to visualize, measure, reconstruct, annotate and edit pre-surgical plan data." This indicates that the software is a human-in-the-loop device, where the surgeon is actively involved in the planning process and responsible for approving the plan. Therefore, a standalone (algorithm only) performance assessment, without human input, is unlikely to be the primary method of evaluation described or required for this type of device. The document does not provide such standalone performance data.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The document does not explicitly state the type of ground truth used for any specific test set related to this submission. For the hardware (guides and models), the "accuracy and performance" implies a comparison to a known standard or ideal, perhaps derived from anatomical models or surgical goals. For the software, "verification against defined requirements, and validation against user needs" suggests that the ground truth for V&V would be the successful adherence to these requirements and user expectations, which could involve internal expert review or adherence to pre-defined medical/engineering specifications. However, specific types of ground truth like pathology or long-term outcomes data are not mentioned.

8. The sample size for the training set

This information is not provided in the document. As the submission is for a special 510(k) updating compatibility, it's possible that the core algorithms were developed and trained previously, and details of their original training are not part of this specific submission. The focus here is on the impact of the changes to the device.

9. How the ground truth for the training set was established

This information is not provided in the document. Similar to the training set size, the specifics of how the ground truth was established for the original training of any underlying algorithms are not included in this special 510(k).

§ 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.”