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510(k) Data Aggregation
(90 days)
DePuy Knee Prosthesis System Universal Stem Extensions and Universal Femoral Metaphyseal Sleeves; DePuy
Sigma PS Femoral Components; DePuy Sigma Cruciate Retaining (C/R) Porocoat Femoral Components; S-ROM
ATTUNE™ Revision Knee System: Candidates for total knee replacement include patients with A severely painful and/or severely disabled joint resulting from osteoarthritis, post-traumatic arthritis, or rheumatod arthritis Moderate valgus, varus, or flexion deformities Avascular necrosis of the femoral condyle A previous unsuccessful knee replacement, osteotomy, or other knee procedure ATTUNE Revision Knee System implants are designed for use in total knee arthroplasty for patients with: Absence or loss of both cruciate ligaments Moderate varus-valgus or flexion instability that requires a bearing surface with increased constraint in the clinical judgment of the surgeon Bone loss that requires supplemental fixation in the clinical judgment of the surgeon The porous-coated metaphyseal sleeves are intended for either cementless applications. ANY NON POROUS-COATED COMPONENTS ARE INTENDED FOR CEMENTED USE ONLY.
DePuy Knee Prosthesis System Universal Stem Extensions and Universal Femoral Metaphyseal Sleeves: The DePuy Universal Femoral Metaphyseal Sleeve and Universal Stem components are intended for use with the PFC, PFC Sigma, Sigma TC3 Revision Knee, or S-ROM knee prosthesis in total knee replacement surgery for patients suffering from severe pain and disability due to permanent structural damage resulting from rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, collagen disorders, pseudogout, trauma or failed prior surgical intervention. These devices are for cemented use only. The DePuy Universal Femoral Metaphyseal Sleeve and Universal Stem components are also intended for use with the DePuy LPS prosthesis for replacement of the mid-shaft portion of the femur, proximal, distal femur, and proximal tibia, especially in cases that require extensive resection and replacement. Specific diagnostic indications for use include: Malignant tumors (e.g., osteosarcomas, gian cell tumors, bone tumors) requiring extensive resection and replacement; patient conditions of noninflammatory degenerative join disease (NIDD), e.g. avascular necrosis, osteoarthritis, and inflammatory joint disease (IJD), e.g. rheumatoid arthritis, requiring extensive resection and replacement; revision for failed previous prosthesis cases requiring extensive resection and replacement. The LPS prosthesis is also intended for use in bone loss post-infection, where the surgeon has elected to excise the bone and replacement is required. The Universal Stem and the Universal Metaphyseal Sleeve components are intended for cemented use only.
DePuy Sigma PS Femoral Components and DePuy Sigma Cruciate Retaining (C/R) Porocoat Femoral Components: Candidates for total knee replacement include patients with a severely disabled joint resulting from osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, or a failed previous implant. Total knee replacement may be considered for younger patients if, in the surgeon, an unequivocal indication for total knee replacement outweighs the risks associated with the age of the patient, and if limited demands regarding activity and knee joint loading can be assured. This includes severely crippled patients with multiple joint involvement for whom a gain in knee mobility may lead to significant improvement in the quality of their lives. THE SIGMA C/R POROCOAT® FEMORAL COMPONENTS ARE INTENDED FOR CEMENTED OR CEMENTLESS USE AS THE FEMORAL COMPONENT OF A TOTAL KNEE REPLACEMENT SYSTEM. THE SIGMA PS FEMORAL COMPONENTS ARE INTENDED FOR CEMENTED USE AS THE FEMORAL COMPONENTS OF A TOTAL KNEE REPLACEMENT SYSTEM.
S-ROM™ NOILESTM Rotating Hinge Knee: The S-ROM NOILES Rotating Hinge Knee is indicated in cases for cement use in patients who have reached skeletal maturity and for whom the surgeon has decided to resect both cruciate ligaments due to the following conditions: 1. Severe instability, gross deformity and/or bone loss. 2. Failure of a previous knee reconstruction procedure. 3. Trauma or tumor resection. 4. Absent or markedly insufficient collateral ligaments.
DePuy P.F.C. TM SIGMA™ Total Knee Prosthesis and DePuy SIGMA™ Total Knee Prosthesis: The DePuy SIGMA™ and P.F.C. ™SIGMA™ Total Knee Prosthesis are intended for use in total knee replacement surgery for patients suffering from severe pain and disability due to permanent structural damage resulting from rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, collagen disorders, pseudogout, trauma or failed prior surgical intervention. The DePuy SIGMA™ and P.F.C. ™SIGMA™ Total Knee Prosthesis are intended for cement use only.
ATTUNE™ Revision Knee System: A Total Knee Prosthesis is composed of individually packaged femoral, tibial and patellar components designed to replace the natural articular surface of the knee joint. The femoral component is a metal implant without a porous coating. The tibial component consists of a metal tibial base without porous coating, and a locking polyethylene insert. Some metal components have modular stems, porous and non porous-coated sleeves and/or modular augments. The patella component is an all polyethylene design Total knee arthroplasty may include supplemental fixation through stems, sleeves, and/or modular augments where bone loss requires said fixation in the opinion of the surgeon. Total knee arthroplasty may also include more constrained bearing surfaces where necessary to provide stability where musculoligamentous supporting structures are insufficient.
DePuy Knee Prosthesis System Universal Stem Extensions and Universal Femoral Metaphyseal Sleeves: A Total Knee Prosthesis System is composed of individually packaged femoral, tibial and patellar components designed to replace the natural articular surface of the knee joint. The femoral component is a metal implant, with or without a porous coating. The tibial component may be an all polyethylene component or comprised of a metal tibial tray with or without porous coating, and a polyethylene insert and locking components. Some metal components have modular stems, sleeves and/or modular wedges. The patella component may be of an all polyethylene design or may be a metal backed polyethylene component. The wobble bit is an instrument used to aid implant assembly.
DePuy Sigma PS Femoral Components and DePuy Sigma Cruciate Retaining (C/R) Porocoat Femoral Components: A SIGMA™ Total Knee System is composed of individually packaged femoral, tibial and patellar components designed to replace the natural articular surface of the knee joint. The femoral component is a metal implant, with or without a porous coating. The tibial component may be an all polyethylene component or comprised of a metal tibial tray with or without porous coating, and a polyethylene insert and locking components. Some metal components have modular stems, sleeves and/or modular wedges or augments. The patella component is an all polyethylene design.
S-ROM™ NOILESTM Rotating Hinge Knee System: The S-ROM NOILES Rotating Hinge Knee System is a tricompartmental total knee replacement for both primary and revision cases. The S-ROM NOILES Rotating Hinge Knee System includes the femoral component with hinge pin, the tibial plateau assembly, and the distal femoral augmentation blocks. Replacement bumpers for the femoral component assembly and replacement hinge bearings for the tibial plateau assembly are also available.
DePuy P.F.C. TM SIGMA™ Total Knee Prosthesis and DePuy SIGMA™ Total Knee Prosthesis: The DePuy SIGMA™ and P.F.C.™ SIGMA® Total Knee Prosthesis is a total knee prosthesis composed of individually packaged femoral, tibial base, tibial insert and patellar components designed to replace the natural articular surface of the knee joint or after a failed previous implant. Some femoral and tibial components can be used with modular stems, porous and non-porous coated sleeves and/or modular augments when supplemental fixation is required in the judgement of the surgeon. The natural patella may or may not be resurfaced.
The provided text describes several knee prosthesis systems from DePuy, specifically outlining their intended use, indications for use, and a summary of non-clinical tests conducted to demonstrate substantial equivalence to previously marketed predicate devices.
1. Table of Acceptance Criteria and Reported Device Performance:
The devices in this application (ATTUNE™ Revision Knee System, DePuy Knee Prosthesis System Universal Stem Extensions and Universal Femoral Metaphyseal Sleeves, DePuy Sigma PS Femoral Components, DePuy Sigma Cruciate Retaining (C/R) Porocoat Femoral Components, S-ROM™ NOILES™ Rotating Hinge Knee System, DePuy P.F.C.™ SIGMA™ Total Knee Prosthesis, DePuy SIGMA™ Total Knee Prosthesis) are being submitted with a modification to labeling to include updated MRI compatibility information and modernized/standardized language in the Instructions for Use (IFU) and labels. There are no changes in design, manufacturing, principle of operation, indication, or intended use of the devices themselves. Therefore, the "acceptance criteria" and "reported device performance" in this context relate to Magnetic Resonance (MR) Safety standards.
Acceptance Criteria (Standard) | Reported Device Performance (Summary from Non-Clinical Testing) |
---|---|
ASTM F2503-23: Standard practice for marking medical devices and other items for safety in the magnetic resonance environment | Testing performed to determine MR Safety, including marking devices for the MR environment. |
ASTM F2182-19E2: Standard Test Method for Measurement of Radio Frequency Induced Heating On or Near Passive Implants during Magnetic Resonance | Testing performed to determine MR Safety, specifically measuring radio frequency induced heating. |
ASTM F2052-21: Standard Test Method for Measurement of Magnetically Induced Displacement Force on Medical Devices in the Magnetic Resonance Environment | Testing performed to determine MR Safety, specifically measuring magnetically induced displacement force. |
ASTM F2213-17: Standard Test Method for Measurement of Magnetically Induced Torque on Medical Devices in the Magnetic Resonance Environment | Testing performed to determine MR Safety, specifically measuring magnetically induced torque. |
ASTM F2119-07: Standard Test Method for Evaluation of MR Image Artifacts from Passive Implants | Testing performed to determine MR Safety, specifically evaluating MR image artifacts. |
ANSI/AAMI ST 72:2019: Bacterial endotoxin testing | The proposed devices also meet the requirement of bacterial endotoxin testing as specified in ANSI/AAMI ST 72:2019. |
2. Sample size used for the test set and the data provenance:
The document explicitly states: "No clinical tests were conducted to demonstrate substantial equivalence." The "tests" mentioned are non-clinical (bench testing) and refer to compliance with ASTM standards for MR safety and ANSI/AAMI for bacterial endotoxin. The document does not provide specific sample sizes for these non-clinical tests or their data provenance (e.g., country of origin, retrospective/prospective). It merely states that the tests were performed according to the specified standards.
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 "No clinical tests were conducted." The ground truth for this submission is established through compliance with recognized industry standards for MR safety and bacterial endotoxin testing, not through expert-reviewed clinical data.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:
This is not applicable as "No clinical tests were conducted." The assessment is based on the results of non-clinical, standard laboratory tests.
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 is not applicable. The submission is for knee joint prostheses and concerns MR safety labeling, not an AI-assisted diagnostic or treatment system.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
This is not applicable. The submission does not involve an algorithm or AI.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):
The "ground truth" for this submission is the compliance with established international and national standards for medical device safety, specifically:
- ASTM standards for Magnetic Resonance (MR) Environment safety (F2503-23, F2182-19E2, F2052-21, F2213-17, F2119-07).
- ANSI/AAMI ST 72:2019 for bacterial endotoxin testing.
8. The sample size for the training set:
This is not applicable as "No clinical tests were conducted." There is no "training set" in the context of this submission, which relies on non-clinical engineering and biological safety testing against established standards.
9. How the ground truth for the training set was established:
This is not applicable, as explained in point 8.
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(38 days)
DEPUY SIGMA PS FEMORAL COMPONENTS
The Sigma PS Femoral Components are intended for cemented use as the femoral components of a Total Knee Replacement system.
Candidates for total knee replacement include elderly patients with a severely painful and/or severely disabled joint resulting from osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, or a failed previous implant. Total knee replacement may be considered for younger patients if, in the opinion of the surgeon, an unequivocal indication for total knee replacement outweighs the risks associated with the age of the patient, and if limited demands regarding activity and knee joint loading can be assured. This includes severely crippled patients with multiple joint involvement for whom a gain in knee mobility may lead to significant improvement in their quality of life.
The Sigma PS Femoral Components are part of the Sigma Total Knee Replacement System. They are Co-Cr-Mo alloy cruciate substituting femoral components with an asymmetric trochlear groove, available in sizes 1.5 to 6, in right and left versions. The Sigma PS Femoral Components are available with or without lugs (pegs) on the fixation surface. The femoral components incorporate an intercondylar box and bolt hole, which allow the attachment of optional femoral stems for additional stability. The Sigma PS Femoral Components (without lugs) allow for the attachment of modular augments on the distal and posterior fixation surfaces. Fixation of the femoral component to the femur is achieved using bone cement.
The provided document is a 510(k) premarket notification for a medical device, specifically the DePuy Sigma PS Femoral Components, a part of a Total Knee Replacement system. This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device rather than fulfilling specific performance-based acceptance criteria through a clinical study or extensive performance testing as would be seen in a PMA (Premarket Approval) application.
Therefore, many of the typical elements of a study that prove a device meets acceptance criteria (like sample size for test sets, ground truth establishment, MRMC studies, standalone performance, etc.) are not applicable in this context. The basis for substantial equivalence is primarily focused on design, materials, manufacturing, and preclinical testing (dimensional comparisons, fatigue testing, and patellofemoral contact area analysis), rather than clinical performance metrics in humans.
Here's a breakdown based on the information available:
1. Table of acceptance criteria and the reported device performance
Acceptance Criteria (Related to Substantial Equivalence Basis) | Reported Device Performance / Assessment |
---|---|
Indications for Use Alignment: Intended for cemented use as femoral components of a Total Knee Replacement system, for conditions like osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, or failed previous implants. | The device's intended use and indications for use are identical or highly similar to the predicate devices (Darwin Knee System (K950010) and PFC Sigma Knee System (K971189)). |
Design Similarity: Cruciate substituting femoral components with asymmetric trochlear groove, available in sizes 1.5-6, with/without lugs, Co-Cr-Mo alloy, intercondylar box and bolt hole for optional stems, modular augments allowed. | The device is described as a "modification of the Sigma Femoral Components that were previously cleared." The design features (Co-Cr-Mo alloy, cruciate substituting, asymmetric trochlear groove, sizes, right/left, with/without lugs, intercondylar box/bolt hole) are the same as or minor modifications of the predicate devices. |
Material Similarity: Co-Cr-Mo alloy. | The device uses Co-Cr-Mo alloy, which is the same as the predicate devices. |
Method of Manufacture Similarity. | The submission asserts similarity in the method of manufacture as a basis for substantial equivalence. No specific details about the manufacturing process or acceptance criteria for manufacturing are provided in this summary. |
Performance - Dimensional Comparisons. | Dimensional comparisons were conducted to demonstrate similarity to the predicate devices, though specific criteria or results are not detailed in this summary. This is a common preclinical assessment for orthopedic implants to ensure fit and function within expected parameters. |
Performance - Fatigue Testing. | Fatigue testing was conducted to assess the mechanical durability and longevity of the device, implying that the device met acceptable standards for this type of implant. Specific acceptance criteria (e.g., cycles to failure, load levels) or results are not detailed in this summary, but the conclusion is that it supports substantial equivalence. |
Performance - Patellofemoral Contact Area Analysis. | Patellofemoral contact area analysis was performed. This is crucial for knee implants to ensure proper articulation and minimize wear and stress on the patella. The results of this analysis contributed to the determination of substantial equivalence, implying acceptable contact mechanics. Specific criteria or results are not detailed in this summary. |
Study Details (Not applicable for a 510(k) "substantial equivalence" claim based on design and preclinical testing):
This submission is a 510(k), which demonstrates "substantial equivalence" to a predicate device rather than showing de novo safety and effectiveness through clinical trials with specific performance endpoints. Therefore, many of the typical elements requested in the prompt for a clinical study are not present or relevant:
- 2. Sample size used for the test set and the data provenance: Not applicable. The "test set" here refers to preclinical tests (dimensional, fatigue, patellofemoral contact). No human clinical test set is described.
- 3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for preclinical engineering tests is based on established engineering principles and standards, not expert consensus in the clinical sense.
- 4. Adjudication method for the test set: Not applicable.
- 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 not an AI/diagnostic device.
- 6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not applicable. This is not an AI/algorithm device.
- 7. The type of ground truth used (expert consensus, pathology, outcomes data, etc): For preclinical tests, the "ground truth" is derived from established engineering test methods and standards (e.g., ISO, ASTM for fatigue testing).
- 8. The sample size for the training set: Not applicable. There is no training set in the context of device development for a 510(k) clearance based on substantial equivalence through design and preclinical testing.
- 9. How the ground truth for the training set was established: Not applicable.
In summary: The "study" described in the 510(k) is a comparison to predicate devices and involves preclinical engineering assessments (dimensional comparisons, fatigue testing, patellofemoral contact area analysis) to demonstrate that the modified device performs similarly and is as safe and effective as the previously cleared devices. It is not a clinical trial with human subjects, nor does it involve AI/reader performance metrics.
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