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1. Metastatic tumor (i.e. osteosarcoma, chondrosarcoma, giant cell tumor or osteoma) where massive resection and transplantation are needed.

2. Severe knee joint damage resulting from trauma where massive resection and transplantation are needed.

3. Non-inflammatory degenerative joint disease such as avascular necrosis, osteoarthritis, or traumatic arthritis.

4. Revision of previously failed total joint arthroplasty, osteotomy, or arthrodesis.

5. Joint instability resulting from excessive bone resection

For Femoral component, Hinged/ Tibial baseplate, Hinged/ Cemented tibial stem/ Cemented Straight stem, RHS, non coated/ Cemented Curved stem, RHS, non coated/ Cemented Straight stem, RHS/ Cemented Curved stem, RHS/ Tibial Augment: These devices are single use implant and intended for cemented use only.

For Distal Femoral Component, RHS/ Proximal Tibial Component, RHS/ Tibial stem/ Segment Part, RHS/ Segment Part, RHS, Bridge: These devices are single use implant and PSC and intended for cementless use only.

"United" USTAR II System is used for patients who present large quantity of bone loss and deformity associated with previous failed arthroplasty, ligament deficiencies, tumor resection, or trauma and may require a further operation or reconstruction. The USTAR II System includes implanted arthroplasty components of both the USTAR II Knee System and USTAR II Hip System.

For the subject device, it's an extension line of 510(K) cleared device USTAR II System (K190100), which introduces two new variations:

1. Cemented curved stem, RHS, non-coated: diameter 17×200 mm
2. Tibial stem: stem length from 30mm to 150 mm by stem diameter from diameter 9 to diameter 24

The compatibility of cemented curved stem, RHS, non-coated and tibial stem is same as that of the 510(k) cleared USTAR II system (K190100).

Cemented Curved Stem, RHS, non-coated is an extension in terms of sizes to 510 (k) cleared device USTAR II system (K190100). Its design, materials, geometrical characteristic, locking mechanism, and manufacturing process are identical to that of the 510(k) cleared Cemented Curved Stem, RHS, non-coated.

Tibial stem's design, materials, geometrical characteristic, locking mechanism, and manufacturing process are identical to that of the 510(k) cleared Tibial Stem while the only difference lies in its specification

Please note: The provided FDA 510(k) clearance letter and summary describe a medical device (Stem Extension Line for the USTAR II System), which is an orthopedic implant. This document does not describe an AI/Software as a Medical Device (SaMD).

Therefore, the requested information about "acceptance criteria and the study that proves the device meets the acceptance criteria" in the context of an AI/SaMD, including details like "number of experts used to establish ground truth," "adjudication method," "MRMC study," "standalone performance," "training set size," and "ground truth establishment for training set," are not applicable to this type of device submission.

The provided text focuses on the mechanical and design equivalence of the new implant variations to a previously cleared predicate device. The "study" mentioned refers to non-clinical mechanical analyses.

Below is an interpretation of the requested points adapted to the context of this orthopedic implant:

Acceptance Criteria and Study for the Stem Extension Line (USTAR II System)

1. Table of Acceptance Criteria and Reported Device Performance

For this orthopedic implant, the acceptance criteria are based on established international standards for the mechanical performance of prosthetic components and demonstrate equivalence to the predicate device.

2. Sample size used for the test set and the data provenance

• Sample Size for Test Set: Not explicitly stated as a number of physical implants or test articles in the provided summary. For mechanical testing, typically a defined number of test samples are used per standard, but the specific quantity is not given here.
• Data Provenance: The studies are non-clinical mechanical analyses performed to international standards (ISO, ASTM). The origin of the "data" itself would be the laboratory where these mechanical tests were conducted. It's a prospective design verification process, not a retrospective or prospective clinical study with human data.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

• Not Applicable. This is a non-clinical, mechanical device clearance. "Ground truth" in the context of clinical interpretation or diagnosis by experts (e.g., radiologists) is not relevant here. Ground truth is established by standardized material properties, engineering specifications, and mechanical test results per the referenced ISO and ASTM standards. Experts involved would be engineers and material scientists responsible for the design, testing, and analysis, ensuring compliance with manufacturing and performance standards.

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

• Not Applicable. Adjudication methods like 2+1 or 3+1 typically refer to consensus readings or evaluations by multiple human experts in studies involving subjective interpretation (e.g., imaging, clinical outcomes). For mechanical testing, the results are quantitative and objective, measured against predefined acceptance criteria from engineering standards.

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

• Not Applicable. MRMC studies are specific to evaluating the clinical performance of diagnostic aids, particularly those involving human interpretation, and are commonly used for AI/ML in medical imaging. This submission concerns the mechanical safety and functionality of an orthopedic implant. No human reader involvement or AI assistance is relevant.

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

• Not Applicable. "Standalone performance" refers to the performance of an AI algorithm independent of human input. This device is a physical orthopedic implant, not an algorithm or software.

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

• The "ground truth" for this type of device is based on engineering standards and specifications. This includes:
  • Material properties: Verifying components meet specified material strengths and compositions.
  • Geometric tolerances: Ensuring dimensions align with design specifications.
  • Mechanical performance: Demonstrating the implant can withstand anticipated loads and stresses as defined by the ISO and ASTM test standards (e.g., fatigue life, static strength).
  • Equivalence to Predicate Device: The primary "ground truth" is that the new variations perform equivalently to or better than the already cleared predicate device under the same test conditions.

8. The sample size for the training set

• Not Applicable. This is not an AI/ML device where a "training set" of data is used to develop an algorithm. The "design" and "manufacturing process" are based on established engineering principles and prior validated designs (the predicate device).

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

• Not Applicable. As there is no "training set" in the context of an AI/ML algorithm for this physical device, there is no method for establishing its "ground truth." The design and manufacturing processes are validated through engineering analyses and quality control processes to meet the required specifications and standards.

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U2 Total Knee System - PF+ is indicated in knee arthroplasty for reduction or relief of pain and/or improved knee function in skeletally mature patients with severe knee pain and disability due to rheumatoid arthritis, osteoarthritis, primary and secondary traumatic arthritis, polyarthritis, collagen disorders, avascular necrosis of the femoral condyle or pseudogout, posttraumatic loss of joint configuration, particularly when there is patellofemoral joint surface erosion, dysfunction or prior patellectomy, moderate valgus, varus, or flexion deformities. This device may also be indicated in the salvage or previously failed surgical attempts or for knee in which satisfactory stability in flexion cannot be obtained at the time of surgery. Femoral Component, PF+, Tibial Baseplate, PF+, Tibial Extension Stem, Patella, Onset, E-XPE, PF+, and Patella, Asymmetric Onset, E-XPE, PF+ are indicated for both cemented and cementless use.

USTAR II Total Knee System

1. Metastatic tumor (i.e. osteosarcoma, chondrosarcoma, giant cell tumor or osteoma) where massive resection and transplantation are needed.
2. Severe knee joint damage resulting from trauma where massive resection and transplantation are needed.
3. Non-inflammatory degenerative joint disease such as avascular necrosis, osteoarthritis, or traumatic arthritis.
4. Revision of previously failed total joint arthroplasty, osteotomy, or arthrodesis.
5. Joint instability resulting from excessive bone resection.

For Femoral component, Hinged/ Tibial baseplate, Hinged/ Cemented tibial stem/ Cemented Straight stem, RHS, non coated/ Cemented Curved stem, RHS, non coated/ Cemented Straight stem, RHS/ Cemented Curved stem, RHS/ Tibial Augment: These devices are single use implant and intended for cemented use only.

For Distal Femoral Component, RHS/ Proximal Tibial Component, RHS/ Tibial stem/ Segment Part, RHS/ Segment Part, RHS, Bridge: These devices are single use implant and intended for cementless use only.

The subject PF+ Patella is a line extension of the U2 Total Knee System, and is compatible to the USTAR II System. The subject device, U2 Total Knee System–PF+ Patella; USTAR II System - PF+ Patella, is a Metal-Backed Patella, indicated for both cemented or cementless application. There are two variations available: (1) Patella, Onset, E-XPE, PF+, and (2) Patella, Asymmetric Onset, E-XPE, PF+. Patella, Onset, E-XPE, PF+ is a symmetric, dome-type metal-backed patella, and Patella, Asymmetric Onset, E-XPE, PF+ is an asymmetric, anatomic-type patella. Each type is available in five sizes. The body of PF+ patella is manufactured from Vitamin E blended highly cross-linked UHMWPE (ASTM F2695, ASTM F648/ISO5834-1), while the part of the metal back and the three pegs are produced by additive manufacturing according to the FDA guidance "Technical Considerations for Additive Manufactured Medical Devices - Guidance for Industry and Food and Drug Administration Staff", "Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone Cement", and "Guidance for Industry on the Testing of Metallic Plasma Sprayed Coatings on Orthopedic Implants to Support Reconsideration of Post market Surveillance Requirements." The metal back is made of Ti-6Al-4V alloy (ASTM 2924) and has a porous Ti structure on the bone side, peg side, and poly side. All types of PF+ Patella are compatibility with "United" U2 Total Knee System-Femoral components (K051640, K120507, K140073, K140075, K150829, and K150832), Femoral component, PSA (K082424), Femoral components, PF+ (K221705), and USTAR II System-Femoral components (K190100).

The provided text is a 510(k) Clearance Letter from the FDA for a total knee system. It details the device's name, regulation, a summary of its description, intended use, and a comparison to predicate devices, along with a list of non-clinical tests conducted.

However, the document specifically states "No clinical data is necessary." This means that the clearance was not based on a clinical study demonstrating the device's performance against detailed acceptance criteria in human patients with the format typically requested in your prompt (e.g., sensitivity, specificity, human-in-the-loop performance, ground truth establishment by experts, etc.).

Instead, the clearance is based on the substantial equivalence of the new device to existing legally marketed predicate devices, primarily through non-clinical testing and technological comparison.

Therefore, I cannot fulfill your request for a table of acceptance criteria and reported device performance from a clinical study, as no such study was presented or required for this 510(k) clearance.

The "acceptance criteria" for this device, as implied by the FDA clearance, revolve around demonstrating that its technological characteristics and non-clinical performance are substantially equivalent to already cleared devices.

Here's what I can extract from the document regarding the non-clinical tests that functionally served as part of the "proof" that the device meets some form of performance criteria:

Summary of Non-Clinical Tests (Implicit Acceptance Criteria & Performance):

Since no clinical study was conducted or referenced in this 510(k) clearance documentation, the following points of your request cannot be addressed from the provided text:

• Sample size used for the test set and data provenance: Not applicable, as no clinical test set was used. The non-clinical tests were performed on device prototypes or samples.
• Number of experts used to establish the ground truth... / qualifications of those experts: Not applicable. Ground truth for clinical performance was not established.
• Adjudication method for the test set: Not applicable.
• If a multi-reader multi-case (MRMC) comparative effectiveness study was done...: Not applicable.
• If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: Not applicable, as this is a physical medical device, not an AI algorithm.
• The type of ground truth used: For the non-clinical tests, the "ground truth" is defined by established engineering and material science standards and methodologies (e.g., ASTM standards for material properties, mechanical testing protocols).
• The sample size for the training set: Not applicable. This is a physical device, not an AI model requiring a training set.
• How the ground truth for the training set was established: Not applicable.

In essence, this 510(k) clearance is a regulatory determination of substantial equivalence based on non-clinical performance data and technological comparisons to predicate devices, not on a clinical trial demonstrating performance against specific diagnostic or treatment outcome acceptance criteria in humans.

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1. Non-inflammatory degenerative joint disease Including osteoarthritis and avascular necrosis.
2. Rheumatoid arthritis.
3. Correction of functional deformity.
4. Treatment of non-union, femoral neck fracture and trochanteric fractures of the proximal femur with head involvement, unmanageable using other techniques.
5. Revision of previously failed total hip arthroplasty.

This device is a single use implant and intended for cementless use only.

Resolve Modular Revision Hip Stem is a modular stem optimized for femoral primary or revision surgery. It consists of three main components:
(1) Resolve Proximal Component (two types: With Hole or No Hole, each available with HA/Ti plasma spray or Ti plasma spray coating)
(2) Resolve Distal Stem (four types: Taper Stem, Clothespin Stem, Clothespin With Hole Stem, and Interlocking Stems. Taper Stem is uncoated; others are available with HA/Ti plasma spray or Ti plasma spray coating. Clothespin With Hole Stem and Interlocking stem provide holes for additional Distal Interlocking Screw fixation.)
(3) Resolve Distal Interlocking Screw (used with Resolve Clothespin With Hole Stem and Interlocking stem)

Resolve Modular Revision Hip Stem can be used with "United" metallic femoral heads (K994078, K022520, K111546, K122504, K152439, K162957, K221675) or ceramic femoral heads (K103497, K112463, K122185).

All components are manufactured from Ti-6Al-4V alloy (ASTM F136). The coatings (HA/Ti plasma spray and Ti plasma spray) comply with ASTM F1580 and ASTM F1185, ISO 13779-6. Proximal components have standard and high offset designs.

Based on the provided FDA 510(k) Clearance Letter for the "Resolve Modular Revision Hip Stem," it's crucial to understand that this document pertains to a physical medical device (an orthopedic implant), not a software-based medical device or AI/ML algorithm.

Therefore, the concepts of "acceptance criteria for an AI/ML algorithm," "test set," "ground truth establishment," "expert adjudication," "MRMC studies," and "standalone performance" do not apply to the information contained within this 510(k) filing.

The 510(k) process for a physical device like this hip stem primarily focuses on demonstrating substantial equivalence to existing legally marketed predicate devices through:

• Indications for Use Comparison: Showing the device is intended for the same medical purposes.
• Technological Comparison: Demonstrating similar fundamental scientific principles, materials, design, and operating conditions.
• Non-Clinical (Bench) Testing: Conducting a series of engineering and materials tests to ensure the device meets specified mechanical and material performance standards, and that it is as safe and effective as the predicate devices.
• No Clinical Studies (unless specifically required): The letter explicitly states "No clinical studies were required or provided," which is common for devices demonstrating substantial equivalence through bench testing.

There is no "AI/ML algorithm" or "software performance" to describe acceptance criteria or study results for in this context.

Instead, I can extract and present the relevant information about the acceptance of this physical medical device based on the given 510(k) letter.

Acceptance Criteria and Study for the Resolve Modular Revision Hip Stem (Physical Device)

The "acceptance criteria" for a physical device in a 510(k) submission are not typically presented as a table of accuracy metrics. Instead, they are demonstrated by meeting various engineering and material standards, and by showing that the device performs similarly (or better) than the predicate devices in specified non-clinical tests. The "study" refers to the non-clinical (bench) testing performed.

1. Table of "Acceptance Criteria" (represented by tests aligned with regulatory standards) and "Reported Device Performance" (implied compliance or successful test outcomes):

Explanation of "Reported Device Performance": The document states: "Based on the design rationale of the Subject device, the following tests were conducted to evaluate the safety and effectiveness of the subject device, and the test results indicated that this device is safe and effective." This implies that the device successfully met the requirements and specifications of each listed test and standard, thus demonstrating its safety and effectiveness. Specific numerical performance values are not typically included in the summary letter itself but would be detailed in the full submission.

2. Sample Size and Data Provenance:

• Sample Size: Not explicitly stated for each test (e.g., number of stems tested for fatigue). These are typically engineering bench tests on a representative sample of device components or full devices.
• Data Provenance: The tests are non-clinical (bench tests), meaning they were conducted in a laboratory setting, not with human patient data. The manufacturer, United Orthopedic Corporation, is based in Taiwan.

3. Number of Experts and Qualifications for Ground Truth:

• This concept is not applicable as this is a physical device clearance based on non-clinical bench testing, not an AI/ML algorithm requiring expert review for ground truth establishment.

4. Adjudication Method:

• Not applicable for a physical device and non-clinical bench testing.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

• Not applicable. This is a clearance for a physical orthopedic implant. The letter explicitly states: "No clinical studies were required or provided." MRMC studies are typically performed for imaging-based AI/ML devices to assess human reader performance with and without AI assistance.

6. Standalone Performance (Algorithm Only):

• Not applicable as there is no algorithm. The performance documented is the standalone mechanical and material performance of the physical implant itself through a series of bench tests.

7. Type of Ground Truth Used:

• For the physical device, the "ground truth" for acceptance is based on established engineering standards (e.g., ISO, ASTM) and regulatory guidance (FDA guidance documents) for mechanical, material, and biological compatibility properties of orthopedic implants. Compliance with these predetermined, objective standards serves as the "ground truth" for safe and effective performance.

8. Sample Size for Training Set:

• Not applicable. This is not a "training set" in the context of AI/ML. The device's design and manufacturing processes are developed based on extensive engineering principles, materials science, and prior knowledge from predicate devices.

9. How Ground Truth for Training Set was Established:

• Not applicable. As there is no AI/ML training set, the concept of establishing ground truth for it does not apply. The "ground truth" for the device's design and material selection would be established through decades of orthopedic research, biomechanical principles, and clinical experience with similar implants.

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The device is indicated for use in hip arthroplasty in skeletally mature patients with the following conditions:

1. A severely painful and/or disabled joint from osteoarthritis, traumatic arthritis, rheumatoid arthritis, or congenital hip dysplasia.
2. Avascular necrosis of the femoral head.
3. Acute traumatic fracture of the femoral head or neck.
4. Failed previous hip surgery including joint reconstruction, internal fixation, arthrodesis, hemiarthroplasty, surface replacement or total hip replacement.
5. Certain cases of ankylosis.
   Conformity stem is for cementless use only.

The subject device is an extension line of 510(K) cleared device Conformity stem, cementless (K183312, K242249), which introduces four new variations: (1) Conformity stem, #0; (2) Conformity stem, collared, #0; (3) Conformity stem, coxa vara, 125° STD, collared, #0; and (4) Conformity stem, short neck, collared #0. The indications, design rationales, materials, manufacturing process, and sterilization method of the subject devices are identical to the 510(k) cleared Conformity Stem, cementless (K183312, K242249).
Conformity Stem can collocate with “United” metallic femoral heads (K994078, K022520, K111546, K122504, K152439, K162957, K221675) or ceramic femoral heads (K103497, K112463, K122185).

• Conformity stem, #0
  Conformity stem, #0 is an extension in terms of sizes to 510 (k) cleared device Conformity stem, #1-11 (K183312). The material, coating thickness, neck angle (135°), and neck length (35.5mm) design are identical to 510 (k) cleared device Conformity Stem, #1, #11 (K183312)The only differences in the items are the offset specifications and stem length.
• Conformity stem, collared, #0
• Conformity stem, collared, #0 is an extension in terms of sizes to 510 (k) cleared device Conformity stem, collared, #1-11 (K183312). The material, coating thickness, neck angle (135°), and neck length (35.5mm) design are identical to 510 (k) cleared device Conformity stem, collared, #1, #11 (K183312).The only differences in the items are the offset specifications and stem length.
• Conformity Stem, coxa vara, 125° STD, collared, #0
• Conformity Stem, coxa vara, 125° STD, collared, #0 is an extension in terms of sizes to 510 (k) cleared device Conformity stem, coxa vara 125° STD, collared, #1-7 (K242249). The material, coating thickness, neck angle (125°), and neck length (32.5mm) design are identical to 510 (k) cleared device Conformity stem, 125° STD, collared, #1, #7 (K242249). The only differences in the items are the offset specifications and stem length.
• Conformity Stem, short neck, collared #0
• Conformity Stem, short neck, collared #0 is an extension in terms of sizes to 510 (k) cleared device Conformity Stem, short neck, collared, #1-7 (K183312 and K242249). The material, coating thickness, neck angle (135°), and neck length (28.5mm) design are identical to 510 (k) cleared device Conformity Stem, short neck, collared, #1, #7 (K183312 and K242249). The only differences in the items are the offset specifications and stem length.

The provided text is a 510(k) summary for a medical device (hip stem extension line). It details the device's identity, intended use, and comparison to predicate devices, but it does not contain information about acceptance criteria or a study proving the device meets those criteria, especially not in the context of an AI/ML-driven device.

The document primarily focuses on demonstrating substantial equivalence to existing legally marketed devices based on:

1. Identical Indications for Use: The new device has the same indications as the predicate devices.
2. Similar Technological Characteristics: The material, principle of operation, regulation number, product code, risk class, intended users, fixation method, surface coating, locking mechanism, and sterilization method are the same as the predicate device.
3. Non-Clinical Performance Data: The submission includes tests like Range of Motion, Neck Fatigue Assessment, Stem Fatigue Test, Characterization of HA Plasma Spray Coating, and Usability Evaluation. These are standard engineering and material tests for orthopedic implants, not AI/ML performance metrics.

Therefore, I cannot extract the requested information regarding:

• A table of acceptance criteria and reported device performance (for AI/ML).
• Sample size and data provenance for a test set (for AI/ML).
• Number and qualifications of experts for ground truth (for AI/ML).
• Adjudication method (for AI/ML).
• MRMC comparative effectiveness study or human reader improvement with AI.
• Standalone algorithm performance.
• Type of ground truth (expert consensus, pathology, outcomes data, etc.) for AI/ML validation.
• Sample size for the training set (for AI/ML).
• How ground truth for the training set was established (for AI/ML).

The document is about a physical orthopedic implant and its substantial equivalence based on mechanical and material testing, not an AI/ML diagnostic or assistive device.

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This product is indicated for temporary use (maximum of 180 days) as a total knee replacement (TKR) in skeletally mature patients undergoing a two-stage procedure due to a septic process.

This product is not intended for use for more than 180 days, at which time it must be explanted and a permanent device implanted or another appropriate treatment performed (e.g., resection arthroplasty, fusion, etc.). During the implantation period, patients have to use traditional mobility assist devices (e.g. crutches, walkers, canes) for daily activities.
With pre-clinical validations of antibiotic elution, tibial spacer fatigue test, and knee spacer wear test, only Palacos MV+G bone cement may be used for preparing the spacers.

Cellbrick Knee Spacer is a temporary knee spacer product, it's suitable for the patients with mature skeleton and required to perform two-stage knee joint prosthesis procedure for infection control. It consists of three components, which are (1) Femoral Spacer, (2) Tibial Spacer, and (3) Canal Rod. The Femoral Spacers and the Tibial Spacers are designed with multiaperture features, which can act as carrier of antibiotic-loaded bone cement to release antibiotic at infection site. The Canal Rod is optional.

• Femoral Spacer
  The Femoral Spacer is made of UHMWPE (ASTM F648/ISO5834-2). The geometrical appearance of Femoral Spacer is designed and modified based on the 510(k) cleared cruciate-retaining femoral component (K140073). Their articular surface geometry and curvature is identical. In addition, the Femoral Spacer is designed with multiaperture feature. Such scaffold-like features can use as a carrier of antibiotic-loaded cement to release antibiotic at the infection site for infection control.
  The Femoral Spacer can be used for both of left and right knee because of the symmetric condyle design. Five femoral spacer sizes have been prepared for different anatomical demands with anteroposterior (AP) and mediolateral (ML) dimensions. The Femoral Spacer is designed “same/ one up" sizing options with the tibial spacers.
• Tibial Spacer
  The Tibial Spacer is made of UHMWPE (ASTM F648/ISO5834-2). The bearing surface's curvature and geometrical design of the tibial spacer is the same as the 510(k) cleared ultra-congruent tibial insert (K132752, K150829, and K222700). The Tibial Spacer is designed with multiaperture feature as well. This scaffold-like feature is used as a carrier of antibiotic-loaded cement to release antibiotic at the infection site for infection control.
  Five Tibial Spacer sizes have been prepared for different anatomical demands with anteroposterior (AP) and mediolateral (ML) dimensions.
• Canal Rod
  The canal rod is made of Ti-6Al-4V alloy (ASTM F136/ISO 5832-3). As a carrier, the rod provides the area for cement to attach so that to increase the surface area of cement. The canal rod is an optional device, it could be applied to patient with deeper infection problem, applying Canal Rod can make surgeon placing antibiotic-loaded cement into the deeper infection site. The Canal Rod is provided with one dimension: Ø 4(diameter) ×80mm (length).

The provided text is a 510(k) summary for the "Cellbrick Knee Spacer". It describes the device, its intended use, and compares it to predicate devices. However, the document does not contain any information about acceptance criteria or a study proving that an AI/ML device meets acceptance criteria.

The requested information (acceptance criteria table, sample sizes, expert qualifications, adjudication methods, MRMC studies, standalone performance, ground truth types, training set details) is all highly relevant to the evaluation of AI/ML-driven medical devices. Since the Cellbrick Knee Spacer is described as a physical implant (femoral spacer, tibial spacer, canal rod made of UHMWPE and Ti-6Al-4V alloy) and not a software or AI/ML product, the submission details focus on pre-clinical validations for physical properties like antibiotic elution, wear tests, fatigue tests, range of motion, constraint performance, and endotoxin testing.

Therefore, I cannot provide the requested information as it is not present in the provided document. The document describes a physical medical device clearance, not an AI/ML device validation.

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The device is indicated for use in hip arthroplasty in skeletally mature patients with the following conditions:

1. A severely painful and/or disabled joint from osteoarthritis, traumatic arthritis, rheumatoid arthritis, or congenital hip dysplasia.
2. Avascular necrosis of the femoral head.
3. Acute traumatic fracture of the femoral head or neck.
4. Failed previous hip surgery including joint reconstruction, internal fixation, arthrodesis, hemiarthroplasty, surface replacement or total hip replacement.
5. Certain cases of ankylosis.
   Conformity stem is for cementless use only.

The "United" Conformity Stem cementless type (K183312) is designed for cementless use in hip arthroplasty. The Conformity Stem cementless type is a proximal trapezoid and distal quadrangular stem with 12/14 neck taper, 135° and 125° neck angle. It is manufactured from Ti-6Al-4V alloy, which conforms to ASTM F136-13 and the distal part of each femoral stem is coated with hydroxyapatite (HA) (ASTM F1185-03) to provide biological fixation. The "United" Conformity Stem cementless is available in various sizes with collarless and collared types to accommodate various hip surgical requirements.
For the subject device, it's an extension line of the 510(K) cleared device Conformity Stem cementless type (K183312), which introduces two new variations: (1) Conformity stem, coxa vara, 125° STD, collared, #1-7; and (2) Conformity stem, short neck, #4-7. The indications, design rationales, materials, major manufacturing process, and sterilization method of the subject devices are identical to the 510(k) cleared Conformity Stem, cementless (K183312).
Conformity Stem can collocate with "United" metallic femoral heads (K994078, K022520, K111546, K122504, K152439, K162957, K221675) or ceramic femoral heads (K103497, K112463, K122185).

• Conformity stem, coxa vara, 125° STD, collared
  Conformity stem, coxa vara, 125° STD, collared is a new coxa vara type variation of 510(k) cleared Conformity stem, coxa vara (1110-52XX, K183312). The same as this 510(k) cleared device, it's also made of Ti-6Al-4V alloy (ASTM F136), and the distal part is coated with hydroxyapatite(HA) (ASTM F1185). In addition, the subject device is also a collared stem with a 125° neck angle. The only difference is the offset design. The subject device is standard offset, while the 510(k) cleared coxa vara collared stem (110-52XX) is high offset
• Conformity Stem, short neck, #4-7
  Conformity stem, short neck, #4-7 is an extension in terms of sizes to 510 (k) cleared device Conformity stem, short neck, #1-3 (K183312). The design, material, coating thickness, geometrical characteristics, neck angle (135°), and neck length (28.5mm) design are identical to 510 (k) cleared device Conformity Stem, short neck, #1-3 (K183312). The only different is the stem length sizes.

This is an FDA 510(k) clearance letter for a medical device called "Conformity Stem Extension Line." This document does not describe acceptance criteria for an AI/ML device or a study proving that an AI/ML device meets those criteria. Instead, it describes mechanical analyses performed on a physical orthopedic implant.

Therefore, I cannot extract the requested information regarding acceptance criteria and study details for an AI/ML device from this document. The document pertains to a hip joint prosthesis, which is a physical implant, not a software device.

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U2 Total Knee System - PF+ is indicated in knee arthroplasty for reduction or relief of pain and/or improved knee function in skeletally mature patients with severe knee pain and disability due to rheumatoid arthritis, primary and secondary traumatic arthritis, collagen disorders, avascular necrosis of the femoral condyle or pseudogout, posttraumatic loss of joint configuration, particularly when there is patellofemoral joint surface erosion, dysfunction or prior patellectomy, moderate valgus, varus, or flexion deformities. This device may also be indicated in the salvage or previously failed surgical attempts or for knee in which satisfactory stability in flexion cannot be obtained at the time of surgery. Femoral Component, PF+, Tibial Baseplate, PF+ and Tibial Extension Stem are indicated for both cemented and cementless use.

There are three components included in U2 Total Knee System- PF+ for this 510k, (1)Femoral Component, PF+, (2)Tibial Baseplate, PF+, and (3)Tibial Extension Stem. Both Femoral Component, PF+ and Tibial Baseplate, PF+ can collocate with U2 Total Knee System tibial insert and patellar component (K021657, K051640, K082469, K103733, K131864, K132752, K150829, K152430, K161705, and K210961). This system includes Cruciate Retained (CR) type and Posterior Stabilized (PS) type.

• Femoral Component, PF+
There are two types of Femoral Component, PF+ : Cruciate Retaining type and Posterior Stabilized type. Femoral Component, PF+ is manufactured from cast Co-Cr-Mo alloy conforming to ASTM F75. The inner surface is coated with Co-Cr-Mo beads and Co-Cr-Mo powder (ASTM F75) to provide a porous surface to achieve biological fixation.

• Tibial Baseplate, PF+
Tibial Baseplate, PF+ is manufactured from titanium alloy (ASTM F620) which is forged by titanium alloy bars (ASTM F136). The backside of the subject device is coated with Titanium powder (ASTM F1580).

• Tibial Extension Stem
Tibial Extension Stem is collocated with tibial baseplate. The subject device is made of titanium alloy conforming to ASTM F136.

The provided document (K221705) is a 510(k) summary for a medical device called the "U2 Total Knee System-PF+". This document is a premarket notification to the FDA to demonstrate that the device is substantially equivalent to legally marketed predicate devices.

It is crucial to understand that this document describes a mechanical orthopedic implant (knee replacement components), not an AI-powered or software-based medical device. Therefore, the concepts of acceptance criteria for AI performance, training and test sets for AI models, expert ground truth for imaging, MRMC studies, or standalone algorithm performance are not applicable to this submission.

The document discusses acceptance criteria and proof of meeting them, but these relate to the mechanical and material properties, biocompatibility, and sterilization of the knee implant components, not to the performance of an AI algorithm.

Therefore, I cannot provide the requested information for an AI-powered device based on this document.

However, I can extract information relevant to the device's performance, which is related to its mechanical and material integrity:

Information from the document relevant to the device's "performance" (mechanical/material):

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

The document broadly states that "the test results indicated that this device is safe and effective" and that "Verification activities on Subject devices demonstrated equivalent safety and effectiveness as compared to the predicate devices."

Specific acceptance criteria (e.g., "fatigue strength must exceed X N at Y cycles") and the exact reported values are not explicitly provided in a table format within this 510(k) summary. The summary typically refers to the fact that these tests were conducted and met the necessary standards for substantial equivalence.

However, the types of performance tests conducted are listed:

2. Sample sized used for the test set and the data provenance:

• Sample Size: Not explicitly stated for each mechanical test. For mechanical testing of components, samples typically refer to a number of physical units or prototypes tested, not patient data.
• Data Provenance: The tests are performed by the manufacturer, United Orthopedic Corporation (located in Hsinchu City, Taiwan). The testing is primarily laboratory-based mechanical and material characterization, not clinical data. Therefore, concepts like "country of origin of the data" or "retrospective/prospective" in the clinical sense are not applicable.

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 question is not applicable. This device is a mechanical implant, not an AI system interpreting medical images. "Ground truth" in this context would be defined by engineering specifications, material standards (e.g., ASTM F75, F136, F620, F1580), and validated test methodologies (e.g., fatigue testing standards). The "experts" involved would be materials scientists, mechanical engineers, and quality assurance professionals, whose qualifications are implicit in the adherence to recognized standards.

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

This question is not applicable. Mechanical tests have specific physical or chemical endpoints determined by validated methods and equipment, not human subjective interpretation requiring adjudication.

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:

This question is not applicable. MRMC studies are for assessing diagnostic accuracy of imaging or AI systems with human readers. This device is a mechanical implant.

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

This question is not applicable. This device is a mechanical implant.

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

The "ground truth" for this device's performance is established by:

• Adherence to international and national standards for materials (e.g., ASTM F75, F136, F620, F1580).
• Validated mechanical testing methodologies (e.g., fatigue testing, surface finish measurements).
• Biocompatibility standards (e.g., USP for endotoxin).
• Comparison to the established performance characteristics of predicate devices.

8. The sample size for the training set:

This question is not applicable. There is no AI model or "training set" for this mechanical device.

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

This question is not applicable.

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The device is used for reduction or relief of pain and/or improved hip function in skeletally mature patients with the following conditions:

1. Painful, disabling joint disease of the hip resulting from: degenerative arthritis, rheumatoid arthritis, post-traumatic arthritis or late stage avascular necrosis.
2. Revision of previous unsuccessful femoral head replacement, cup arthroplasty or other procedure.
3. Clinical management problems where arthrodesis or alternative reconstructive techniques are less likely to achieve satisfactory results.
4. Correction of functional deformity.
5. Treatment of nonunion femoral neck and trochanteric fracture of the proximal femur with head involvement that is unmanageable using other techniques.
   This device is a single use implant and intended for cementless use only.

The subject device, U-Motion II Acetabular System—Extension line, is an extension in terms of additional size to the previously cleared U-Motion II Acetabular System (K122185, K132455, K170089 and K172833). The subject device includes two components: U-Motion II Cup and U-Motion II XPE Cup liner. The indication, design rationale, material, major manufacture process and sterilization method of these two components are identical to the cleared U-Motion II Cup (K122185, K132455, K170089, and K172833) and U-Motion II XPE Cup Liner (K122185 and K170089), except for the dimension.
U-Motion II Cup
The cleared U-Motion II Cup is available from 44 through 80 mm outer diameter (O.D.) in 2 mm increments. The subject U-Motion II Cup is available in 48 mm O.D. and 54 mm O.D. and the compatible liner diameter is 36 mm and 40 mm, respectively, which is larger than the cleared cups. It is designed to only be compatible with the subject cup liner.
U-Motion II XPE Cup Liner
The cleared U-Motion II XPE Cup Liner is available in 28 mm, 32 mm, 36 mm, and 40 mm inner diameter (I.D.). The subject XPE Cup Liner is available in 36 mm I.D. and 40 mm I.D., and is compatible with the subject 48 mm O.D. cup. and 54 mm O.D. cup, respectively.

This document is a 510(k) premarket notification for the "U-Motion II Acetabular System-Extension line," a hip joint prosthesis. It outlines the device description, indications for use, technological characteristics, and performance analysis used to establish substantial equivalence to existing predicate devices.

Here's an analysis of the provided information, identifying what's present and what's missing, especially regarding the acceptance criteria and study details you requested:

1. Table of Acceptance Criteria and Reported Device Performance:

The document doesn't provide a specific table of acceptance criteria with quantitative thresholds for each test. Instead, it lists the types of tests conducted and states that "the test results indicated that this device is safe and effective."

2. Sample Size Used for the Test Set and Data Provenance:

• Sample Size: The document does not explicitly state the sample sizes used for each of the performance tests (Impingement analysis, Range of motion, Jumping distance analysis, Wear simulation test, Locking strength test, Cup deformation test, Cup fatigue test). These generally involve a certain number of specimens for mechanical testing.
• Data Provenance: The studies are described as "Verification activities on subject devices" and "tests were conducted to evaluate the safety and effectiveness of the subjected device." This indicates the studies were prospective in nature, specifically conducted for this submission. There's no explicit mention of the country of origin of the data, but the manufacturer (United Orthopedic Corporation) is located in Taiwan.

3. Number of Experts Used to Establish Ground Truth and Qualifications:

This information is not applicable as the device is a medical implant (hip prosthesis), and the studies described are mechanical performance tests, not analyses requiring ground truth established by medical experts (like in AI/diagnostic device studies).

4. Adjudication Method for the Test Set:

This information is not applicable for the same reason as point 3. Mechanical tests do not typically involve adjudication by experts.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

This information is not applicable. The device is a physical implant, not a diagnostic or AI-assisted system that would involve human readers interpreting cases. Therefore, no MRMC study or effect size comparing human readers with and without AI assistance was performed.

6. Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study:

This information is not applicable. The device is a physical implant, not an algorithm.

7. Type of Ground Truth Used:

This information is not applicable. As mentioned above, the tests are mechanical performance evaluations of a physical device, and the "ground truth" is defined by established engineering standards and biomechanical principles for joint prostheses.

8. Sample Size for the Training Set:

This information is not applicable. There is no "training set" as this is a physical medical device, not an AI/machine learning algorithm.

9. How the Ground Truth for the Training Set Was Established:

This information is not applicable for the same reason as point 8.

Summary of what's provided and what's missing for the requested information:

• Acceptance Criteria & Performance: A list of tests is provided, with a general statement of "safe and effective" results. However, specific quantitative acceptance criteria and the numerical results against these criteria are not detailed in this document.
• Sample Size (Test Set) & Data Provenance: Sample size is not explicitly stated. Data provenance is implied to be prospective mechanical testing, likely conducted in association with the Taiwanese manufacturer.
• Experts for Ground Truth & Qualifications: Not applicable (physical device, not diagnostic AI).
• Adjudication Method: Not applicable.
• MRMC Study: Not applicable.
• Standalone Study: Not applicable.
• Type of Ground Truth: Mechanical testing against established engineering/biomechanical standards.
• Training Set Sample Size: Not applicable.
• Training Set Ground Truth Establishment: Not applicable.

The document primarily focuses on establishing "substantial equivalence" of the new sizes of the U-Motion II Acetabular System to previously cleared versions and predicate devices based on identical intended use, materials, design rationale, and various mechanical performance tests. The detailed data and specific acceptance thresholds for these tests would typically be found in the full 510(k) submission, not necessarily summarized in this high-level FDA letter or 510(k) summary.

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The device is indicated for use in hip arthroplasty in patients with the following conditions:

1. A severely painful and/or disabled joint from osteoarthritis, traumatoid arthritis or congenital hip dysplasia.
2. Avascular necrosis of the femoral head.
3. Acute traumatic fracture of the femoral head or neck.
4. Failed previous hip surgery.
   This device is a single use implant and intended for cemented stem which is designed for cemented use only.
   In the USA: United U2 femoral head, 22mm delta ceramic head is only indicated for use with the hemi (bipolar) implant.

The Subject device is a size extension to the previously cleared U2 Femoral Head (K162957). The design, manufacturer, materials, manufacturing progress, sterilization of this subject are identical or similar to its primary and additional predicates.
Ceramic femoral head, delta, 22mm (Subject device) is manufactured from zirconia-toughened alumina ceramic is available in +1, +3 and +5 mm of neck length. This device is intended to articulate with U2 Bipolar Implant, 22mm I.D (K152439) and can be used in conjunction with United titanium Hip Stem. Hip Stem include HA/Ti Plasma Spray Stem (K003237), Ti porous coated Stem (K003237, K151316), Ti Press-fit Stem (K111546), Revision Hip Stem (K062978), UTS Stem (K172251), UTF Stem (K110245, K163193, K123550, K132207) and Conformity stem (K183312). The size extension does not affect the intended use or alter the fundamental scientific technology of the device.
Surgical procedures with the use of the subject device shall be performed with the support of orthopedic instrumentation, to facilitate their proper insertion and removal from the patient.

Here's an analysis of the provided text regarding acceptance criteria and the supporting study:

The provided text is a 510(k) summary for a medical device (United U2 femoral head, 22mm delta ceramic head) seeking substantial equivalence to predicate devices. It does not describe an AI medical device or a study involving human readers or a training/test set for an algorithm.

Therefore, most of the requested information regarding AI device performance, expert consensus, MRMC studies, and training/test set details cannot be extracted directly from this document.

However, I can extract the acceptance criteria and performance analysis conducted for this specific medical implant device.

Analysis of the Provided Document (Non-AI Medical Device)

The document describes the performance analysis for a ceramic femoral head (a medical implant) to demonstrate its substantial equivalence to previously cleared devices. The "acceptance criteria" here refer to the predefined standards for the engineering tests conducted on the physical device.

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

2. Sample size used for the test set and the data provenance

• Sample Size: Not explicitly stated. The document refers to "engineering analysis" and testing of "subject components," which typically involves a specific number of physical samples for mechanical tests.
• Data Provenance: Not applicable in the context of an AI device. For this physical implant, the "data" would be the results of the mechanical tests performed in a lab setting. No information about country of origin or retrospective/prospective nature is relevant here.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

• This is not applicable as the document describes mechanical testing of a physical implant, not an AI device requiring expert-established ground truth. The "ground truth" here is the physical performance measured against established ISO/ASTM standards.

4. Adjudication method for the test set

• This is not applicable as the document describes mechanical testing of a physical implant, not an AI device for diagnostic or prognostic purposes. The performance is adjudicated against the predefined limits in the engineering standards.

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

• No, an MRMC study was not done. This document is for a medical implant, not an AI device.

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

• Not applicable. This document is for a medical implant, not an AI device.

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

• For this physical medical implant, the "ground truth" implicitly refers to the established mechanical and material performance standards (ISO and ASTM). The device's performance is compared against the limits defined in these engineering standards.

8. The sample size for the training set

• Not applicable. This document is for a medical implant, not an AI device which requires a training set.

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

• Not applicable. This document is for a medical implant, not an AI device which requires a training set.

Summary for the AI context:

The provided document describes the regulatory clearance for a physical medical implant (femoral head), not an AI medical device. Therefore, the specific information requested about AI acceptance criteria, training/test sets, expert adjudication, and MRMC studies is not present in this text. The "acceptance criteria" discussed are engineering specifications for the mechanical performance of the physical implant, and the "study" is the mechanical engineering analysis and testing.

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For Tibial baseplate, CMA, #0
This device is indicated in knee arthroplasty for reduction or relief of pain and/or improved knee function in sketetally mature patients with severe knee pain and disability due to rheumatoid arthritis, primary and secondary traumatic arthritis, polyarthritis, collagen disorders, avascular necrosis of the femoral condyle or pseudogout, posttraumatic loss of joint configuration, particularly when there is patellofemoral joint surfaction or prior patellectorny, moderate valgus, varus, or flexion contraction. This device may also be indicated in the salvage or previously failed surgical attempts or for knee in which satisfactory stability in flexion cannot be obtained at the time of surgery. This device system is designed for cemented use only.

For Tibial insert, #0
The device is indicated in knee arthroplasty for reduction or relief of pain and/or improved knee function in sketally mature patients with severe knee pain and disability due to rheumatoid arthritis, primary and secondary traumatic arthritis, polyarthritis, collagen disorders, avascular necrosis of the femoral condyle or pseudogout, posttraumatic loss of joint configuration, particularly when there is patellofemoral erosion, dysfunction or prior patellectomy, moderate valgus, varus, or flexion deformities. This device may also be indicated in the salvage of previously failed surgical attempts if the knee can be satisfactorily balanced and stabilized at the time of surgery. This device is a single use implant and intended for cemented use only.

The U2 Total Knee System consists of Femoral components, patella components, Tibial baseplate components and Tibial inserts components which are designed to be used together to achieve total replacement of the knee joint. This system includes Cruciate Retained (CR) type, Ultracongruent (UC) type, and Posterior Stabilized (PS) type.

The U2 Total Knee System, Tibial baseplate, CMA, #0 (Subject device) is a size extension of the cleared "UNITED" U2 Total Knee System, Tibial baseplate, CMA, #1 to #7 (K131864). The materials, indications, sterilization of this subject are identical to the cleared "UNITED" U2 Total Knee System, Tibial baseplate, CMA, #1 to #7 (K131864).

The U2 Total Knee System, Tibial insert, #0 (Subject device) is a size extension of the cleared "UNITED" U2 Total Knee System, Tibial insert, #1 to #7 (K051640, K103733, K131864, K132752, K150829 and K161705). The materials, indications, sterilization of this subject are identical to the cleared "UNITED" U2 Total Knee System, Tibial insert, #1 to #7 (K051640, K103733, K131864, K132752, K150829 and K161705). The Subject Tibial insert, CR, #0 and Tibial insert, PS, #0 have a more concave sagittal plane design while comparing to the marketed predicate devices

Surgical procedures with the use of the Subject device shall be performed with the support of orthopedic instrumentation, to facilitate their proper insertion and removal from the patient. All the surgical instruments have been cleared as part of the predicate devices.

This is a medical device clearance, not an AI/ML device. Therefore, the questions regarding AI/ML device evaluations (sample size, experts, adjudication, MRMC, standalone performance, ground truth establishment for training set, etc.) are not applicable.

The document describes the acceptance criteria and study for a Tibial baseplate and Tibial insert, which are components of a knee replacement system. This is a traditional medical device, not an AI/ML powered device. Therefore, the concepts related to AI/ML device performance such as ground truth, expert adjudication, train/test sets, effect size of AI assistance, etc., are not relevant to this document.

However, I can extract the information provided regarding the device's performance analysis and acceptance criteria, based on the non-clinical tests conducted.

Here's the summary of the acceptance criteria and the study that proves the device meets them, based on the provided text:

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

The document does not explicitly list 'acceptance criteria' with numerical targets and then 'reported device performance' side-by-side in a table format. Instead, it states that "the following non-clinical tests were conducted to evaluate the safety and effectiveness of the subjected device, and the test results indicated that this device is safe and effective." This implies that the device met the internal acceptance criteria for each test.

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

The document does not specify the sample sizes (number of devices tested) for the non-clinical tests. It also does not provide information about data provenance as these are laboratory-based mechanical tests, not clinical data sets.

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)

Not applicable. This is a mechanical device, not an AI/ML device requiring expert ground truth for image interpretation or diagnosis.

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

Not applicable. This is a mechanical device. Adjudication methods are relevant for subjective interpretations, typically in clinical studies or AI/ML ground truth establishment.

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

Not applicable. This is a mechanical device, not an AI/ML device.

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

Not applicable. This is a mechanical device, not an AI/ML device.

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

Not applicable. For mechanical devices, "ground truth" is typically defined by engineering specifications, material properties, and mechanical test standards (e.g., ISO or ASTM standards) that define acceptable performance limits. The document states that the "non-clinical tests were conducted to evaluate the safety and effectiveness," implying adherence to established engineering and material science principles, but specific ground truth definition is not explicitly detailed in this summary.

8. The sample size for the training set

Not applicable. This is a mechanical device, not an AI/ML device that requires a training set.

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

Not applicable. This is a mechanical device, not an AI/ML device.

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