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EXULT Knee Replacement System is indicated for the treatment of diseases as follows:

• Painful, disabling joint disease of the knee resulting from non-inflammatory degenerative joint disease (including osteoarthritis, traumatic arthritis or avascular necrosis) or rheumatoid arthritis;
• Post-traumatic loss of knee joint configuration and function;
• Moderate varus, valgus, or flexion deformity in which the ligamentous structures can be returned to adequate function and stability;
• Correction or revision of unsuccessful osteotomy, arthrodesis, or failure of previous arthroplasty procedure.

The EXULT Knee Replacement System is intended for cemented use only.

The purpose of this submission is to introduce EXULT Tibial Insert UCR (Ultra Congruent & Cruciate Retaining) which is a line extension to the EXULT Knee Replacement System.

The EXULT Tibial Insert UCR is a modification to the PCL (Posterior Cruciate Ligament) notch of the EXULT Tibial Insert UC (K242046). This change allows the EXULT Tibial Insert UC to be used by surgeons who do not resect the PCL when implanting an EXULT Tibial Insert UC. Tibial Insert is used at both right and left knee. It is only used in combination with the same Femoral component and Tibial baseplate of the predicate device.

The provided FDA 510(k) clearance letter for the EXULT Knee Replacement System (K250889) does not contain any information about an AI/ML-driven medical device, nor does it include details about a study that assesses AI/ML performance against acceptance criteria.

This document pertains to a medical device (a knee replacement system) that is a physical implant made of materials like UHMWPE. The "acceptance criteria" and "study that proves the device meets the acceptance criteria" in this context refer to engineering and biomechanical tests to ensure the mechanical integrity, wear characteristics, range of motion, and other physical properties of the knee implant.

Therefore, I cannot fulfill your request to describe the acceptance criteria and study for an AI/ML device based on this input. The provided text does not contain any of the required information regarding AI/ML performance, sample sizes for AI/ML test sets, expert ground truth adjudication, MRMC studies, standalone AI performance, or training set details.

The "Non-Clinical Testing" section on Page 7 lists the following mechanical/physical tests:

• Contact area/pressure per ASTM F2083
• Interlocking test per ASTM F1814
• Wear of articular surface per ISO 14243-2/3
• Range of Motion analysis per ISO 21536
• Constraint analysis per ASTM F1223
• Endurance and deformation under high flexion per ASTM F2777

These are standard tests for orthopedic implants and are not related to AI/ML performance. The "Clinical Testing" section explicitly states: "Clinical data was not needed to support the safety and effectiveness of the subject device." This further confirms that no clinical study involving human readers or AI assistance was conducted for this device.

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EXULT Knee Replacement System is intended for the treatment of diseases as follows:

• Painful, disabling joint disease of the knee resulting from non-inflammatory degenerative joint disease (including osteoarthritis, traumatic arthritis or avascular necrosis) or rheumatoid arthritis.
• Post-traumatic loss of knee joint configuration and function.
• . Moderate varus, valgus, or flexion deformity in which the ligamentous structures can be returned to adequate function and stability.
• . Correction or revision of unsuccessful osteotomy, arthrodesis, or failure of previous arthroplasty procedure

EXULT Knee Replacement System is intended for cemented application only.

The purpose of the submission is a line extension of the EXULT Tibial Insert (CPS-type) to the EXULT Knee Replacement System (K192507). The CPS-type Tibial Inserts are designed based on the design of the other previously cleared Tibial Inserts of the EXULT Knee Replacement System (PS-type, CR-type and UC-type). The CPS-type, which is constrained posterior stabilized, has a thicker and wider post which provides additional constraint as compared to the PS-type insert. The CPS-type Tibial Insert matches with Femoral Components of one-size up and down. The CPS-type Tibial Insert is symmetrical and used in both the right and left knee. It is only used in combination with the Femoral component/Tibial baseplate of the predicate device (K192507).

The provided text does not contain information about acceptance criteria and a study that proves a device meets those criteria for software or AI/ML-driven medical device performance.

The document is a 510(k) premarket notification for the EXULT Knee Replacement System, a physical orthopedic device. It discusses the device's indications for use, technological characteristics, and non-clinical testing performed to establish substantial equivalence to predicate devices (other knee replacement systems).

The "Non-Clinical Testing" section lists various engineering tests (wear testing, fatigue testing, constraint testing, range of motion, surface roughness, disassembly) and references ISO and ASTM standards. These are traditional mechanical engineering tests for orthopedic implants, not performance studies for AI/ML algorithms.

Therefore, I cannot provide the requested information regarding:

• A table of acceptance criteria and reported device performance (for AI/ML).
• Sample size for the test set and data provenance.
• Number and qualifications of experts for ground truth.
• Adjudication method.
• MRMC comparative effectiveness study.
• Standalone performance study.
• Type of ground truth used.
• Sample size for the training set.
• How ground truth for the training set was established.

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EXULT Knee Replacement System is indicated for the treatment of diseases as follows:

· Painful, disabling joint disease of the knee resulting from non-inflammatory degenerative joint disease (including osteoarthritis traumatic arthritis or avascular necrosis) or rheumatoid arthritis.

· Post-traumatic loss of knee joint configuration and function.

• Moderate varus, valgus, or flexion deformity in which the ligamentous structures can be returned to adequate function and stability.

· Correction or revision of unsuccessful osteotomy, arthrodesis, or failure of previous arthroplasty procedure.

EXULT Knee Replacement System is intended for cemented application only.

The purpose of the submission is a line extension of the EXULT Tibial Insert (UC-type) to the EXULT Knee Replacement System (K192507). The UC-type Tibial Inserts are designed based on the design of the other Tibial Inserts of the EXULT Knee Replacement System (PS-type and CR-type). The UC-type, which is ultra-congruent, has high conformity and increased anterior/posterior edge height, which limits anterior/posterior motion instead of a post structure, like the PS-type. The UC-type Tibial Insert matches Femoral Components of one-size up and down. The UC-type Tibial Insert is symmetrical and used in both the right and left knee. It is only used in combination with the Femoral component/Tibial baseplate of the predicate device (K192507).

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

1. Table of Acceptance Criteria and Reported Device Performance

Important Note: The document does not provide specific numerical acceptance criteria or numerical reported device performance values for any of these tests. It only states that the device was "evaluated to demonstrate substantial equivalence to the predicate devices" based on these tests.

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

This information is not provided in the document. The text mentions "non-clinical testing" but does not specify sample sizes for materials tested, nor does it refer to patient data (retrospective or prospective) or countries of origin.

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

This information is not applicable and therefore not provided in the document. The device is a knee replacement system (implant), not an AI/software device that requires expert-established ground truth for image interpretation or diagnosis. The tests described are mechanical and material performance tests.

4. Adjudication Method for the Test Set

This information is not applicable and therefore not provided in the document. As noted above, this is a mechanical device, not an AI/software device involving human reader interpretation.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and the Effect Size of How Much Human Readers Improve with AI vs. Without AI Assistance

This information is not applicable and therefore not provided in the document. This is a medical device (knee implant), not an AI-assisted diagnostic or treatment planning software.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

This information is not applicable and therefore not provided in the document. This is a medical device (knee implant), not an AI algorithm.

7. The Type of Ground Truth Used

The "ground truth" for the non-clinical testing of this knee implant system would be the physical and mechanical properties of the device and its predicate, measured according to established international and ASTM standards. For instance, in wear testing, the "ground truth" is the actual material loss measured. In contact pressure testing, it's the measured pressure distribution.

8. The Sample Size for the Training Set

This information is not applicable and therefore not provided in the document. This is a medical device (knee implant), not a machine learning model that requires a training set.

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

This information is not applicable and therefore not provided in the document. As this is not an AI/ML device, there is no training set or ground truth in that context.

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LOSPA II Knee System (EXULT Knee Replacement System) is indicated for the treatment of diseases as follows:

· Painful, disabling joint disease of the knee resulting from non-inflammatory degenerative joint disease (including osteoarthritis, traumatic arthritis or avascular necrosis) or rheumatoid arthritis;

· Post-traumatic loss of knee joint configuration and function;

· Moderate varus, valgus, or flexion deformity in which the ligamentous structures can be returned to adequate function and stability;

· Correction of unsuccessful osteotomy, arthrodesis, or failure of previous arthroplasty procedure.

LOSPA II Knee System (EXULT Knee Replacement System) is intended for cemented application only.

The Additional components being added to the LOSPA II Knee Replacement System (EXULT Knee Replacement System) are:

• Revised Size 12 PS, CR Femoral Component -
• Additional Size 13 PS, CR Femoral Component -
• -Instrumentation

The subject LOSPA II Knee System (EXULT Knee Replacement System) components specification inclusions are a line extension of Femoral Components and Instrumentation system.

The provided text does not describe an AI/ML powered device, nor does it detail any clinical studies involving such technology.

The document is a 510(k) clearance letter from the FDA for a LOSPA II Knee System (EXULT Knee Replacement System), which is a traditional medical device (a knee replacement prosthesis). The clearance is for additional components to an already cleared system.

Therefore, I cannot provide answers to the questions regarding acceptance criteria, study details, sample sizes, expert qualifications, or ground truth establishment for an AI/ML device, as this information is not present in the provided text.

The "PERFORMANCE TESTING - BENCH" section refers to mechanical testing of the knee replacement components against established ASTM and ISO standards, not clinical studies for an AI/ML algorithm.

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