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The Kinemax® Superstabilizer (K904208), Kinematic® II Modular Condylar and Stabilizer Inserts (K871349), PCA® Modular Inserts (K894403), Kinematio® Rotating Hinge Knee (K792089), Duracon® Unicompartmental Knee (K 926231), and the Modular Replacement Metal Encapsulated Components (K952970) are intended to be used with the PCA®, Duracon®, or Kinemax® family of femoral components, tibial baseplates, and patellar components in primary or revision cemented total knee arthroplasty.

This submission describes additional UHMWPE Knee components that can be sterilized by the Duration® Stabilized process previously cleared in submission K936292, as an alternate to standard air irradiated gamma sterilization. Corresponding wear claims, previously cleared in submission K 965173 and listed below, are also applicable to these additional components. This submission includes the Kinemax® Superstabilizer (K904208), the Kinematic® II Modular Condylar and Stabilizer Inserts (K871349), the PCA Modular Inserts(K894403), the Kinematic® Rotating Hinge Knee (K792089), the Duracon® Unicompartmental Knee (K926231), and the Modular Replacement Metal Encapsulated Components (K952970). These components are intended to be used with the PCA®, Duracon®, or Kinemax® family of femoral components, tibial baseplates, and patellar components in primary or revision cemented total knee arthroplasty.

This 510(k) summary describes the Duraction® Stabilized UHMWPE Knee Components and their wear claims. The submission details three in vitro wear tests comparing the Duraction® Stabilized UHMWPE with conventionally gamma sterilized UHMWPE.

1. Table of Acceptance Criteria and Reported Device Performance

Note: The document does not explicitly state "acceptance criteria" but rather presents the results as "wear claims" based on the performed in vitro tests. The implied acceptance criterion for each test is a demonstrated reduction in volumetric wear compared to the conventionally gamma sterilized UHMWPE.

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

The document describes material-level testing rather than patient or imaging data.

• Sample Size:
  • Ring-on-Block Test: "A block of Howmedica's Duration® Stabilized UHMWPE" and "the same block of Howmedica's conventionally gamma sterilized UHMWPE." (Implies n=1 for each material type for the block test, though likely multiple replicates were used within the block).
  • Pin-on-Disk Tests (both non-aged and aged): "A 9mm thick circular disk of Howmedica's Duration® Stabilized UHMWPE" and "the same circular disk of Howmedica's conventionally gamma sterilized UHMWPE." (Implies n=1 for each material type for the disk test, though likely multiple replicates were used).
• Data Provenance: The tests are described as "in vitro tests" and "independent laboratory test(s)." The country of origin of the data is not specified, but the manufacturer is Howmedica Inc. in the USA. The data is prospective for these specific tests as they were conducted to support the submission.

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 materials science engineering test, not a medical device performance assessment based on expert interpretation (e.g., radiology reads). The "ground truth" is measured volumetric wear.

4. Adjudication Method for the Test Set

Not applicable. This is a direct measurement of material wear, not a consensus-based assessment.

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 an in vitro materials test, not a clinical study involving human readers or AI.

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

Not applicable. This refers to the performance of the UHMWPE material itself, not an algorithm.

7. The Type of Ground Truth Used

The ground truth used for these tests is measured volumetric wear of the material samples under controlled in vitro laboratory conditions.

8. The Sample Size for the Training Set

Not applicable. This is not a machine learning or AI device that requires a training set. The "training" in this context would refer to the development and optimization of the UHMWPE material and sterilization process, which is not detailed in terms of sample sizes for individual material property tests.

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

Not applicable. (See point 8). The "ground truth" for material development would involve various material characterization techniques and performance testing during the R&D phase, but this specific 510(k) focuses on the final wear claims derived from the described in vitro tests.

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The Duracon®, P.C.A.® and Kinemax® Plus Tibial Inserts, All Plastic Tibial Components and Patellar Components (proviously cleared in K915512, K923573, K910235, K922048, K932070, K913188, K872735, K871772 and K921640) are intended to be used with Duracon®, P.C.A.® or Kinemax® femoral components, tibial baseplates and patellar components in primary or revision cemented total knee arthroplasty.

This submission includes wear testing data on UHMWPE Knee Components sterilized by the method previously cleared in 510(k) submission K936292. This data is provided to substantiate claims of improved wear due to the processing of the devices. The submission includes Duracon®, P.C.A.® and Kinemax® Plus Tibial Inserts, All Plastic Tibial Components and Patellar Components which are intended to be used with Duracon®, P.C.A.® or Kinemax® Plus femoral components, tibial baseplates and patellar components in primary or revision cemented total knee arthroplasty.

This submission details the wear testing of Howmedica's Duration™ Stabilized UHMWPE Knee Components to substantiate claims of improved wear. The study compares the wear performance of the stabilized UHMWPE against conventionally gamma sterilized UHMWPE in various in vitro wear tests.

Here is an analysis of the provided information:

1. Table of Acceptance Criteria and Reported Device Performance

Note: The submission does not explicitly state pre-defined acceptance criteria in numerical terms (e.g., "must show at least X% reduction"). Instead, the reported device performance is the claim being substantiated, implying that any measured reduction in wear would be considered a positive outcome. The FDA's substantial equivalence determination suggests acceptance of these claims.

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

• Sample Size: The document refers to "a block" and "a 9mm thick circular disk" for the unaged tests, and "a 9 mm thick circular disk" for the aged test, both for the Duration™ Stabilized UHMWPE and the conventionally gamma sterilized UHMWPE for comparison. This phrasing suggests a sample size of one test article for each condition (stabilized vs. conventional, unaged vs. aged) for each type of test. However, wear testing typically involves multiple samples to ensure reproducibility and statistical significance. The limited detail provided here implies either a single sample per comparison or a simplified reporting of the outcome from multiple samples.
• Data Provenance: The tests were conducted as "in vitro tests" in an "independent laboratory test." The country of origin is not specified but is presumably the USA, given the FDA 510(k) submission. The data is prospective in the sense that these were controlled experiments specifically designed to test the wear properties.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

Not applicable. This study involves in vitro mechanical wear testing, not a clinical study or diagnostic device assessment where expert opinion would establish ground truth. The "ground truth" for wear is established by the measured weight loss or volume displacement during the mechanical tests.

4. Adjudication Method for the Test Set

Not applicable. This is an in vitro mechanical test, not a clinical review requiring adjudication. The measurements of wear are objective.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

No, an MRMC comparative effectiveness study was not done. This study is an in vitro mechanical wear test of materials, not a diagnostic imaging study involving human readers.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) was done

Yes, in a way. The tests performed are standalone in the sense that they are material property tests performed in a lab setting, independent of human interaction once initiated. There is no "algorithm" in the context of AI, but the measurements of wear are objective outcomes of the material's performance under simulated conditions.

7. The Type of Ground Truth Used

The ground truth used is measured volumetric wear. This is an objective measurement obtained through laboratory testing (reciprocating ring-on-block wear test and reciprocating pin-on-disk wear evaluations) using established scientific methods (weight loss to calculate volume change, or direct volume measurement if applicable).

8. The Sample Size for the Training Set

Not applicable. This study does not involve a "training set" in the context of machine learning or AI algorithms. It is an in vitro study of material properties.

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

Not applicable, as there is no training set for an AI algorithm in this context.

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