Components of the Signature Orthopaedics hip replacement range are intended to replace a hip joint where bone stock is sufficient to support the implant. When a surgeon has selected prosthetic replacement as the preferred treatment, the devices are indicated for:

· Non-inflammatory degenerative ioint disease including osteoarthritis or avascular necrosis

· Inflammatory joint disease including rheumatoid arthritis
· Correction of functional deformity including congenital hip dysplasia
· Traumatic injury involving the hip joint including traumatic arthritis or femoral head or neck fracture

· Failed previous hip surgery including internal fixation or joint fusion, reconstruction, hemiarthroplasty, surface replacement, or total replacement

Signature Orthopaedics' World Cup components are intended for cementless fixation only.

Device Description

The primary purpose of this Special 510(k) Device Modification to devices cleared as part of the World Cup System (K201278 and K241690) is to notify the FDA of additional geometrical variants of the World liner available in crosslinked UHMWPE (XLPE) and Vitamin-E Stabilized, 100kGy crosslinked UHMWPE (Vit-E HXLPE) material options.

The World Liners are compatible with World Acetabular Cups and are available in neutral, and hooded, lateralised, high wall, face changing and eccentric variants. The liners are designed to sit within an acetabular shell and articulate with a femoral head.

AI/ML Overview

The provided document is an FDA 510(k) clearance letter for a medical device called "World Liner," which is a component of a hip replacement system. It primarily details the regulatory clearance process, the device's indications for use, and a comparison to predicate devices, emphasizing that the new "World Liner" variants are substantially equivalent to previously cleared versions.

However, this document does not contain any information about acceptance criteria, specific study designs (like MRMC or standalone performance studies), sample sizes for test or training sets, expert qualifications, or ground truth establishment methods as would be expected for an AI/ML-based device submission.

The "Performance Testing" section is extremely brief and only mentions "Engineering evaluations" and "Range of Motion assessment per ISO 21535." These are typical for mechanical devices to demonstrate physical performance and compatibility, not for evaluating the performance of an AI/ML algorithm.

Therefore, I cannot fulfill your request for:

A table of acceptance criteria and reported device performance: This information is not present.
Sample sizes used for the test set and data provenance: Not mentioned.
Number of experts used to establish ground truth and qualifications: Not mentioned, as there is no apparent AI/ML ground truth evaluation.
Adjudication method: Not mentioned.
MRMC comparative effectiveness study details: Not mentioned.
Standalone performance details: Not mentioned.
Type of ground truth used: Not mentioned.
Sample size for the training set: Not mentioned.
How ground truth for the training set was established: Not mentioned.

This document is for a mechanical medical device (hip liner), not an AI/ML-driven device. As such, the type of performance data and evaluation criteria you are asking about (which are relevant for AI/ML) are not applicable or present in this context.

Summary

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November 25, 2024

Signature Orthopaedics Pty Ltd Declan Brazil Managing Director 7 Sirius Road Lane Cove West, NSW 2066 Australia

Re: K243162

Trade/Device Name: World 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: MEH, LPH Dated: October 31, 2024 Received: October 31, 2024

Dear Declan Brazil:

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.

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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" (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 QS 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.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

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 medical devices and radiation-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-regulatory

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assistance/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,

Limin Sun -S

Limin Sun, 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

Submission Number (if known)

K243162

Device Name

World Liner

Indications for Use (Describe)

· Non-inflammatory degenerative ioint disease including osteoarthritis or avascular necrosis

· Inflammatory joint disease including rheumatoid arthritis
· Correction of functional deformity including congenital hip dysplasia
· Traumatic injury involving the hip joint including traumatic arthritis or femoral head or neck fracture

· Failed previous hip surgery including internal fixation or joint fusion, reconstruction, hemiarthroplasty, surface replacement, or total replacement

Signature Orthopaedics' World Cup components are intended for cementless fixation 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)

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510(k) SUMMARY

Manufacturer:	Signature Orthopaedics Pty Ltd7 Sirius RoadLane Cove, NSW 2066Australia
Device TradeName:	World Liner
Common Name:	Prosthesis, Hip, Semi-Constrained, Uncemented, Metal/Polymer,Non-Porous, Calcium Phosphate
Contact:	Dr. Declan BrazilManaging Director, Signature Orthopaedics Pty Ltd
Prepared By:	Signature Orthopaedics Pty Ltd7 Sirius RoadLane Cove, NSW 2066AustraliaPhone: +61 (2) 9428 5181Fax: +61 (2) 8456 6065
Date Prepared:	November 20th, 2024
Classification:	Class II per 21 CFR 888.3353: Hip joint metal/ceramic/polymersemi-constrained cemented or nonporous uncemented prosthesis(MEH)Class II per 21 CFR 888.3358: Hip joint metal/polymer/metalsemi-constrained porous-coated uncemented prosthesis (LPH)
Predicate Device:	Substantial equivalence to the following device is claimed,• Signature Orthopaedics World Liner (K201278) - PrimaryPredicate• Signature Orthopaedics World Liner (K241690) -Additional Predicate

Device Description:

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Indications for Use:

Non-inflammatory degenerative joint disease including osteoarthritis or avascular necrosis
Inflammatory joint disease including rheumatoid arthritis
Correction of functional deformity including congenital hip dysplasia ●
Traumatic injury involving the hip joint including traumatic arthritis or femoral ● head or neck fracture
. Failed previous hip surgery including internal fixation or joint fusion, reconstruction, hemiarthroplasty, surface replacement, or total replacement

Signature Orthopaedics' World Cup components are intended for cementless fixation only.

Intended Use:

The intended use for the World Liner is identical to their previously cleared predicate devices (K201278 and K241690).

Components of the Signature Orthopaedics hip replacement range are intended to replace a hip joint where bone stock is sufficient to support the implant.

Comparison of Technological Characteristics:

The World Hip liner described in this Special 510(k) Device Modification are similar to the primary predicate and reference devices cleared in K201278 and K241690, respectively. The technological characteristics that remain the same for the subject device systems are as follows:

Clinical Indications for Use, Intended Use and Surgical Techniques for the Vit-E HXLPE Variants and the previously cleared UHMWPE components are identical.
The manufacturing process of the XLPE and Vit-E HXLPE Variants in questions . have the same manufacturing processes as the previously cleared systems. This includes cleaning and passivation, packaging, transportation, and sterilization.
The liner variants have similar geometry and fundamental design as the previously cleared predicate devices. All interconnections between components are the same.
. All implants are provided sterile with SAL of 106 as seen in the predicate systems.

The differences between the subject and primary predicate devices are as follows:

. Addition of lateralised, high wall, face changing and eccentric liner geometrical variants available in XLPE and Vit-E HXLPE material options.

Performance Testing:

Engineering evaluations were conducted to verify that the performance of World ● Hip system with additional variants are equal to and/or better than the predicate devices and therefore adequate for anticipated in-vivo use.
. Range of Motion assessment per ISO 21535

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Substantial Equivalence:

The results of the V&V testing, associated engineering review, risk analysis and design control activities demonstrated substantial equivalence of the subject device system to the primary predicate cited herein.

Regulation Number and Section

§ 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.