K Number
K241482
Device Name
Kinos Total Ankle System
Manufacturer
Date Cleared
2024-07-22

(59 days)

Product Code
Regulation Number
888.3110
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The r3 Tibial Implants of the Kinos Total Ankle System are indicated for revision total ankle arthroplasty. The Kinos Total Ankle System is intended for cement use only.
Device Description
The subject line extension to the Kinos Total Ankle System are implant and instrument components designed to preserve motion in patients with ankle arthritis or previously failed ankle surgery. The device is a fixed bearing and semi-constrained implant construct, intended for replacement of the articulating surfaces of the ankle that have been affected by a disease state or injury. The subject device provides limited mobility to a patient by restoring alignment of the articulating surfaces, reducing pain, and providing flexion-extension movement within the ankle joint. The tibial and talar implants are intended to be used with bone cement. The subject Kinos Total Ankle System consists of three implant components - a tibial implant affixed to the tibia, a bearing implant assembled to the tibial implant and a talar implant affixed to the talus. The tibial implant and bearing implant, assembled intraoperatively, function together and articulate with the talar implant to create a fixed bearing prosthesis, replacing the articulating surface of the tibiotalar joint. The extension includes tibial segments which are assembled intraoperatively to the tibial base plate to enhance tibial fixation height in the tibia.
More Information

No
The description focuses on the mechanical components and performance testing of a total ankle arthroplasty system, with no mention of AI or ML.

Yes
The device is an implantable system designed to replace articulating surfaces of the ankle to reduce pain and restore alignment and movement, indicating a therapeutic purpose for patients with ankle arthritis or failed ankle surgery.

No

Explanation: The device is an implantable medical device (Total Ankle System) used for revision total ankle arthroplasty, not for diagnosing a condition.

No

The device description clearly outlines physical implant and instrument components, which are hardware, not software.

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

Here's why:

  • Intended Use: The intended use is for "revision total ankle arthroplasty" and "replacement of the articulating surfaces of the ankle." This describes a surgical implant used in vivo (within the body) to treat a physical condition.
  • Device Description: The description details a "fixed bearing and semi-constrained implant construct" consisting of "tibial implant," "bearing implant," and "talar implant." These are physical components designed to be surgically implanted into the ankle joint.
  • Lack of IVD Characteristics: An IVD is a medical device used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. The provided information does not mention any testing of biological samples or diagnostic purposes.

Therefore, the Kinos Total Ankle System, as described, is a surgical implant, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The r3 Tibial Implants of the Kinos Total Ankle System are indicated for revision total ankle arthroplasty. The Kinos Total Ankle System is intended for cement use only. The r3 Tibial Implant components of the Kinos Total Ankle System are indicated for revision total ankle arthroplasty. The Kinos Total Ankle System is intended for cement use only.

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

HSN

Device Description

The subject line extension to the Kinos Total Ankle System are implant and instrument components designed to preserve motion in patients with ankle arthritis or previously failed ankle surgery. The device is a fixed bearing and semi-constrained implant construct, intended for replacement of the articulating surfaces of the ankle that have been affected by a disease state or injury. The subject device provides limited mobility to a patient by restoring alignment of the articulating surfaces, reducing pain, and providing flexion-extension movement within the ankle joint. The tibial and talar implants are intended to be used with bone cement. The subject Kinos Total Ankle System consists of three implant components - a tibial implant affixed to the tibia, a bearing implant assembled to the tibial implant and a talar implant affixed to the talus. The tibial implant and bearing implant, assembled intraoperatively, function together and articulate with the talar implant to create a fixed bearing prosthesis, replacing the articulating surface of the tibiotalar joint. The extension includes tibial segments which are assembled intraoperatively to the tibial base plate to enhance tibial fixation height in the tibia.

The additively manufactured r3 Tibial Implants subject of this 510(k), are compatible with:

  • All Kinos Axiom Total Ankle System Talar and Bearing Components and associated instrumentation cleared via K192778
  • All Kinos Axiom Total Ankle System r3 Talar and Vitamin E Bearing Components and associated instrumentation cleared via K240591

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Ankle

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 subject r3 Tibial Implant was subjected to the following performance testing and/or analyses to establish substantial equivalence in comparison to the predicate devices.

  • Tibial implant fatigue testing per ASTM F2665
  • Bone Stability Engineering Analysis
  • Tibial Stem Assembly and Disassembly Test per ASTM F2665
  • Stem Assembly Connecting Mechanism Testing per ASTM F2665
  • Porous Surface Characterization

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.

K232595

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.

K192778, K113828

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

§ 888.3110 Ankle joint metal/polymer semi-constrained cemented prosthesis.

(a)
Identification. An ankle joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle joint. The device limits translation and rotation in one or more planes via the geometry of its articulating surfaces and has no linkage across-the-joint. This generic type of device includes prostheses that have a talar resurfacing component made of alloys, such as cobalt-chromium-molybdenum, and a tibial 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.

0

Image /page/0/Picture/0 description: The image contains 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.

July 22, 2024

restor3d Anika Moorjani Regulatory Engineer 4001 NC 54 Highway Suite 3160 Durham, North Carolina 27709

Re: K241482

Trade/Device Name: Kinos Total Ankle System Regulation Number: 21 CFR 888.3110 Regulation Name: Ankle Joint Metal/Polymer Semi-Constrained Cemented Prosthesis Regulatory Class: Class II Product Code: HSN Dated: Mav 24, 2024 Received: May 24, 2024

Dear Anika Moorjani:

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 (the 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 available 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

1

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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.

Peter G.
Allen -S
Digitally signed by Peter
G. Allen -S
Date: 2024.07.22 16:36:20
-04'00'

For Lixin Liu, Ph.D. Assistant Director DHT6A: Division of Joint Arthroplasty Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 07/31/2026 See PRA Statement below.

Submission Number (if known)

K241482

Device Name

Kinos Total Ankle System

Indications for Use (Describe)

The r3 Tibial Implants of the Kinos Total Ankle System are indicated for revision total ankle arthroplasty. The Kinos Total Ankle System is intended for cement 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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

510(k) Summary

Date Prepared: July 19th, 2024

In accordance with 21 CFR 807.92 requirements, this information serves as a Summary of Substantial Equivalence for the Kinos Total Ankle System.

A. 510(k) Sponsor:

restor3d, inc. 4001 E. NC 54 Highway, Suite 3160 Durham, North Carolina, 27709

B. Primary Correspondent:

Knox Pittman Regulatory Engineer (404) 317-2436 (direct) knox.pittman@restor3d.com

C. Premarket Notification:

Trade Name:Kinos Total Ankle System
Common Name:Total Ankle Replacement
Classification Name:Ankle joint metal/polymer semi-constrained cemented prosthesis
Regulation Number:21 CFR 888.3110
Product Code:HSN
Classification:II
Review Panel:Orthopedic

D. Indications for Use:

The r3 Tibial Implant components of the Kinos Total Ankle System are indicated for revision total ankle arthroplasty. The Kinos Total Ankle System is intended for cement use only.

E. Predicate Devices:

4

510(k)Trade NameManufacturer
Primary Predicate Device
K232595Kinos Axiom Total Ankle
Systemrestor3d, Inc.
Reference Devices
K192778Kinos Axiom Total Ankle
Systemrestor3d, Inc.
Cleared under Kinos Medical
K113828DynaNailMedShape

The subject line extension to the Kinos Axiom Total Ankle System is substantially equivalent to the following devices:

F. Device Description:

The subject line extension to the Kinos Total Ankle System are implant and instrument components designed to preserve motion in patients with ankle arthritis or previously failed ankle surgery. The device is a fixed bearing and semi-constrained implant construct, intended for replacement of the articulating surfaces of the ankle that have been affected by a disease state or injury. The subject device provides limited mobility to a patient by restoring alignment of the articulating surfaces, reducing pain, and providing flexion-extension movement within the ankle joint. The tibial and talar implants are intended to be used with bone cement. The subject Kinos Total Ankle System consists of three implant components - a tibial implant affixed to the tibia, a bearing implant assembled to the tibial implant and a talar implant affixed to the talus. The tibial implant and bearing implant, assembled intraoperatively, function together and articulate with the talar implant to create a fixed bearing prosthesis, replacing the articulating surface of the tibiotalar joint. The extension includes tibial segments which are assembled intraoperatively to the tibial base plate to enhance tibial fixation height in the tibia.

The additively manufactured r3 Tibial Implants subject of this 510(k), are compatible with:

  • . All Kinos Axiom Total Ankle System Talar and Bearing Components and associated instrumentation cleared via K192778
  • All Kinos Axiom Total Ankle System r3 Talar and Vitamin E Bearing Components and associated instrumentation cleared via K240591

G. Performance Testing:

5

The subject r3 Tibial Implant was subjected to the following performance testing and/or analyses to establish substantial equivalence in comparison to the predicate devices.

  • Tibial implant fatigue testing per ASTM F2665 ●
  • Bone Stability Engineering Analysis ●
  • Tibial Stem Assembly and Disassembly Test per ASTM F2665 ●
  • Stem Assembly Connecting Mechanism Testing per ASTM F2665 ●
  • Porous Surface Characterization ●

H. Substantial Equivalence Comparison:

Substantial equivalence of the line extension r3 Tibial Implant to the primary predicate X-Stem Tibial Implant is based on the following

  • The line extension Tibial Implant and primary predicate X-Stem Tibial Implant have . the same intended use
  • The line extension Tibial Implant is indicated for a subset of the indications for use of . the primary predicate X-Stem Tibial Implant
  • . The line extension Tibial Implant and modular segments are manufactured from the same materials and undergo the same processes as the primary predicate X-Stem Tibial Implants. The line extension Tibial Lock screws are made from the same materials and undergo the same manufacturing processes as the reference predicate DynaNail headed cortical screws.
  • . Changes in technological characteristics are not shown to raise any new questions of safety or effectiveness

I. Conclusion:

Based on the comparison of the intended use, indications for use, and technological characteristics, the subject Kinos Total Ankle System is substantially equivalent to the predicate Kinos Axiom Total Ankle System. The minor changes in technological characteristics to offer additional options for implant extension do not raise any new or different questions of safety or effectiveness.