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AltiVate Reverse® Shoulder System, Reverse® Shoulder Prosthesis (RSP®), SMR Shoulder System, PRIMA Humeral System, and PRIMA Glenoid System are intended for various forms of partial or total, primary or revision shoulder joint replacement. Specific indications depend on the system and configuration (modular, monoblock, anatomic, reverse), addressing conditions such as:

• Grossly rotator cuff deficient shoulder joint with severe arthropathy
• Previously failed joint replacement with a grossly rotator cuff deficient shoulder joint
• Functional deltoid muscle is necessary to use the device
• Fracture of glenohumeral joint from trauma or pathologic conditions of the shoulder (including humeral head fracture or displaced 3- or 4-part fractures of proximal humerus)
• Bone defect in proximal humerus
• Non-inflammatory degenerative disease including osteoarthritis and avascular necrosis of the natural humeral head and/or glenoid
• Inflammatory arthritis including rheumatoid arthritis
• Correction of functional deformity
• Treatment of acute fractures of the humeral head that cannot be treated with other fracture fixation methods
• Revision of a failed primary implant (if sufficient bone stock remains)
• Cuff tear arthropathy (CTA Heads only)
• Glenoid arthrosis without excessive glenoid bone loss: A1, A2 and B1 according to Walch classification (SMR TT Hybrid Glenoid only)
• Massive irreparable rotator cuff tear

The patient's joint must be anatomically and structurally suited to receive the selected implant(s). Some components are intended for cemented and/or cementless application, often with the addition of screws for fixation. Revision surgery can include conversion from anatomic to reverse arthroplasty if the stem is stable, well positioned, and tissue integrated.

This 510(k) submission proposes updated labeling to reflect additional compatibility between previously cleared shoulder systems from Encore Medical, L.P. (AltiVate Reverse® Shoulder System) and LimaCorporate S.p.A. (SMR and PRIMA Shoulder Systems). The update allows for cross-system use of humeral and glenoid components for reverse total shoulder arthroplasty, where compatible sizes exist. There are no changes to the design, materials, function, or intended use of the devices, and no new implants or instruments are introduced. The proposed configurations include using an AltiVate Reverse® humeral stem and insert with SMR or PRIMA glenoid components, and vice versa.

It appears there might be a misunderstanding of the provided FDA 510(k) clearance letter. The document, K251184, is for orthopedic implants (shoulder prostheses, specifically reverse shoulder systems and related components), not for an AI/software as a medical device (SaMD) or diagnostic device that would typically have acceptance criteria, performance studies involving human readers, and ground truth establishment in the way described in your request.

The letter explicitly states:

• "Trade/Device Name: AltiVate Reverse® Shoulder System; Reverse® Shoulder Prosthesis (RSP®); SMR Shoulder System; PRIMA Humeral System; PRIMA Glenoid System"
• "Regulation Name: Shoulder joint metal/polymer semi-constrained cemented prosthesis"
• "Device Description: This 510(k) submission proposes updated labeling to reflect additional compatibility between previously cleared shoulder systems... The update allows for cross-system use of humeral and glenoid components for reverse total shoulder arthroplasty, where compatible sizes exist. There are no changes to the design, materials, function, or intended use of the devices, and no new implants or instruments are introduced."
• "Performance testing: Performance testing, including Wear Testing and Range of Motion Analysis, demonstrates substantial equivalence between the subject and predicate devices and did not raise different questions of safety and effectiveness."

This means the "device" in question is a physical medical implant, and the 510(k) is about demonstrating "substantial equivalence" to previously cleared implants, primarily regarding material compatibility and mechanical performance (wear, range of motion).

Therefore, the requested information about acceptance criteria for an AI/diagnostic device, sample sizes for test sets in medical imaging, number of experts for ground truth, MRMC studies, standalone algorithm performance, and training set details are not applicable to this specific 510(k) clearance letter. The testing mentioned ("Wear Testing and Range of Motion Analysis") would involve mechanical engineering and biomechanical testing, not clinical studies with human readers or AI performance metrics.

To answer your request based on the provided document would require fabricating information not present in the letter. If you have an FDA 510(k) clearance letter for an AI/SaMD or diagnostic device, I would be happy to analyze it against your criteria.

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The PRIMA Humeral System is intended for partial or total, primary or revision, shoulder joint replacement in skeletally mature patient's joint must be anatomically and structurally suited to receive the selected implants and a functional deltoid muscle is necessary to use the device. The PRIMA Short Stem and PRIMA Short Stem Plus are intended for use in cementless and cemented applications, at the discretion of the surgeon.

The PRIMA Anatomic implant is indicated for partial or total, primary or revision shoulder joint replacement, in patients suffering from pain and disability due to:

• . Non-inflammatory degenerative joint disease (i.e. osteoarthritis),
• Inflammatory arthritis of the glenohumeral join including rheumatoid arthritis, .
• Avascular necrosis of the humeral head, ●
• . Traumatic/post-traumatic arthritis,
• Fractures of the humeral head where adequate fixation can be achieved and adequate bone . stock remains,
• . Post-fracture deformity with intact rotator cuff, where adequate fixation can be achieved and adequate bone stock remains,
• . Cuff tear arthropathy (CTA Heads only).

The PRIMA Reverse implant is indicated for primary reverse total shoulder replacement or for revision when converting an anatomic PRIMA arthroplasty to a reverse total shoulder arthroplasty (i.e. in case of cuff tear arthropathy or in a grossly rotator cuff deficiency joint with severe arthropathy).

Revision surgery with retention of the PRIMA Short Stem and PRIMA Short Stem Plus are intended as conversion surgery from anatomic to reverse, where the stem is stable, well positioned and tissue integrated. Other revisions of the humeral prosthesis part should be treated with traditional shoulder prostheses.

The PRIMA reverse implant is indicated for patients suffering from pain and disability due to:

• Rotator cuff tear arthropathy,
• Osteoarthritis with rotator cuff tear,
• Rheumatoid arthritis with rotator cuff tear,
• Massive irreparable rotator cuff tear,
• Avascular necrosis of the humeral head,
• Correction of functional deformity, where adequate fixation can be achieved and adequate bone stock remains,

The PRIMA Glenoid System is indicated for primary, fracture or revision total shoulder replacement in a grossly rotator cuff deficient joint with severe arthropathy (disabled shoulder). The patient's joint must be anatomically and structurally suited to receive the selected implants and a functional deltoid muscle is necessary to use the device. The PRIMA Glenoid System components are intended for uncemented use with the addition of screw fixation.

This 510(k) submission aims at introducing new components to the previously cleared PRIMA Humeral (K212800) and Glenoid (K222427) systems.

The PRIMA Short Stem Plus is introduced as part of the PRIMA Humeral System. As the already cleared PRIMA Short Stem, the PRIMA Short Stem Plus is a convertible short stem component with proximal (metaphyseal) fixation with Trabecular Titanium to be used in both anatomic and reverse configurations. Depending on the configuration, the stem component can be coupled with an Adaptor for the humeral heads for the anatomic configuration and with a Reverse Tray and Reverse Insert in reverse configuration.

The PRIMA Short Stem Plus is intended for use in cementless and cemented applications.

The PRIMA Short Stem Plus is made of Ti6A14V (ISO 5832-3) and is available in two different lengths: 86 mm and 96 mm. Each length is available in seven different sizes, varying from 28mm to 40mm in the proximal diameter.

The PRIMA TT Glenoid Central Compressive Cortical and Cancellous Screws in length 20mm are introduced as part of the PRIMA Glenoid System, as an additional option to the already available sizes (length 25 to 50mm), cleared via K222427. The PRIMA TT Glenoid Central Compressive Cortical and Cancellous Screws are intended to be inserted in the central hole of the glenoid baseplate and are used to fix the PRIMA TT Glenoid baseplates to the glenoid bone.

As for the already cleared central compressive screws of PRIMA TT Glenoid, the PRIMA TT Glenoid Central Compressive Cortical and Cancellous Screws in length 20 mm are manufactured from Ti6A14V (ASTM F1472, ISO 5832-3) and have respectively diameter 5mm (cortical) and 6.5mm (cancellous).

The provided document is a 510(k) Premarket Notification from the FDA, which assesses the substantial equivalence of medical devices to legally marketed predicate devices. It does not contain information about acceptance criteria or a study proving that a device meets specific performance criteria related to AI or diagnostic accuracy.

The document describes the PRIMA Humeral System and PRIMA TT Glenoid devices, which are shoulder joint replacement prostheses. The review focuses on their substantial equivalence in terms of intended use, design, materials, and mechanical non-clinical testing to previously cleared devices.

Therefore, I cannot provide an answer based on the given prompt about acceptance criteria and a study proving device performance in the context of diagnostic accuracy or AI assistance, as this information is not present in the provided text.

Specifically, the document states:

• "Clinical testing was not necessary to demonstrate substantial equivalence of PRIMA Humeral System and PRIMA TT Glenoid to the predicate devices." (Page 8)

This confirms that no clinical study for performance (like diagnostic accuracy, AI assistance, or human reader improvement) was conducted or needed for this particular 510(k) clearance.

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PRIMA Humeral System: The PRIMA humeral system is intended for partial or total, primary or revision, shoulder joint replacement in skeletally mature patients. The patient's joint must be anatomically suited to receive the selected implants and a functional deltoid muscle is necessary to use the device. The PRIMA Stem is intended for use in cementless and cemented applications, at the discretion of the surgeon.

The PRIMA Anatomic implant is indicated for partial or total, primary or revision shoulder joint replacement, in patients suffering from pain and disability due to:

• Non-inflammatory degenerative joint disease (i.e. osteoarthritis),
• Inflammatory arthritis of the glenohumeral join including rheumatoid arthritis,
• Avascular necrosis of the humeral head,
• Traumatic/post-traumatic arthritis,
• Fractures of the humeral head where adequate fixation can be achieved and adequate bone stock remains,
• Post-fracture deformity with intact rotator cuff, where adequate fixation can be achieved and adequate bone stock remains,
• Cuff tear arthropathy (CTA Heads only).

The PRIMA Reverse implant is indicated for primary reverse total shoulder replacement or for revision when converting an anatomic PRIMA arthroplasty to a reverse total shoulder arthroplasty (i.e. in case of cuff tear arthropathy or in a grossly rotator cuff deficiency joint with severe arthropathy).

Revision surgery with retention of the PRIMA Stem is intended as conversion surgery from anatomic to reverse, where the PRIMA Stem is stable, well positioned and tissue integrated. Other revisions of the humeral prosthesis part should be treated with traditional shoulder prostheses.

The PRIMA reverse implant is indicated for patients suffering from pain and disability due to:

• Rotator cuff tear arthropathy,
• Osteoarthritis with rotator cuff tear,
• Rheumatoid arthritis with rotator cuff tear,
• Massive irreparable rotator cuff tear,
• Avascular necrosis of the humeral head,
• Correction of functional deformity, where adequate fixation can be achieved and adequate bone stock remains,
• Fractures of the humeral head where adequate fixation can be achieved and adequate bone stock remains.

The PRIMA Humeral System consists of the following single use components:

• Anatomic configuration:
  • stem
  • adaptor for humeral heads.
• Reverse configuration:
  • stem
  • reverse tray and
  • reverse insert.

The PRIMA Humeral System is intended to be used with all SMR glenoids implants.

SMR Glenosphere Ø42: The SMR Shoulder System is intended for partial or total, primary or revision shoulder joint replacement. The SMR Anatomic Shoulder System is indicated for partial or total, primary or revision shoulder joint replacement in patients suffering from disability due to:

• non-inflammatory degenerative joint disease including osteoarthritis and avascular necrosis;
• inflammatory degenerative joint disease such as rheumatoid arthritis;
• treatment of acute fractures of the humeral head that cannot be treated with other fracture fixation methods;
• revision of a failed primary implant; in case of SMR Short Stems only if sufficient bone stock remains);
• cuff tear arthropathy (CTA Heads only);
• glenoid arthrosis without excessive glenoid bone loss: A1, A2 and B1 according to Walch classification (SMR TT Hybrid Glenoid only).

The SMR Reverse Shoulder System is indicated for primary, fracture or revision total shoulder replacement in a grossly rotator cuff deficient joint with severe arthropathy (disabled shoulder). The patient's joint must be anatomically and structurally suited to receive the selected implants and a functional deltoid muscle is necessary to use the device.

The SMR TT Hybrid Glenoid Reverse Baseplate must not be used in cases of excessive glenoid bone loss and/or when bone graft is needed.

The Modular SMR Shoulder System allows the assembly of components in various humeral and glenoid constructs. The constructs are intended for cemented and uncemented use as specified in the following table.

In the Anatomic shoulder the humeral consists of the humeral stem, the humeral body, the adaptor taper and the humeral head. In the Reverse shoulder the humeral construct consists of the humeral stem, the reverse humeral body and the reverse liner. On the humeral side the fixation of the humeral stem determines if the construct is cemented or uncemented.

The Anatomic glenoid construct consists of an all polyethylene glenoid, a polyethylene glenoid with metal peg or a metal back assembled with a liner; the Reverse glenoid consists of a metal back/connector/glenosphere construct or of a peg/baseplate/glenosphere construct.

On the glenoid side, the fixation of the all polyethylene glenoid, the polyethylene glenoid with metal peg or the metal back determines if the construct is cemented or uncemented.

The PRIMA Humeral System is the subject of this 510(k) and includes the SMR Glenosphere Ø42.

The PRIMA Stem is a convertible short stem component with proximal fixation with Trabecular Titanium to be used in both anatomic and reverse configurations. Depending on the configuration, the short stem component (Ti6Al4V) can be coupled with an Adaptor for the humeral heads (Ti6Al4V) in case on anatomic system and with a Reverse Tray (Ti6Al4V) and Reverse Insert (LimaVit E UHMWPE Ti6A14V ring) only in case of reverse. The PRIMA Stem is intended for use in cementless and cemented applications, at the discretion of the surgeon.

When used in reverse configuration, the PRIMA Stem is coupled with a Glenosphere through a Reverse Tray and a Reverse Insert. PRIMA Stem is compatible with already cleared SMR Glenospheres Ø36 and Ø40 (K110598, K163397). In addition, PRIMA Stem is compatible with the new SMR Glenosphere Ø42 (CoCrMo), subject of the present 510(k).

This is a 510(k) premarket notification for a medical device, not a study evaluating device performance or artificial intelligence (AI) algorithm. Therefore, the typical acceptance criteria and study design for AI algorithms are not applicable here.

The document describes a medical device, the PRIMA Humeral System and SMR Glenosphere Ø42, and seeks to demonstrate its substantial equivalence to already legally marketed predicate devices. This means the manufacturer is showing that their new device is as safe and effective as existing similar devices, without necessarily conducting efficacy studies on human subjects as might be required for new, higher-risk devices or completely novel technologies.

Here's why the requested information cannot be provided from this document:

• Acceptance Criteria for AI Performance: This device is a shoulder joint prosthesis, a physical implant. It doesn't involve any AI algorithms and therefore doesn't have acceptance criteria related to AI performance metrics like sensitivity, specificity, accuracy, or F1-score.
• Study Proving Device Meets Acceptance Criteria (in the context of AI): There are no studies here that would "prove the device meets acceptance criteria" in the way an AI algorithm's performance is evaluated. Instead, this document relies on non-clinical testing (mechanical tests, material biocompatibility, sterility) and a comparison to predicate devices to demonstrate substantial equivalence.
• Sample size for test set, data provenance, number of experts, adjudication method, MRMC comparative effectiveness study, standalone performance, ground truth type, training set size, how ground truth for training set was established: All these points are relevant to AI/ML algorithm validation. Since the PRIMA Humeral System and SMR Glenosphere Ø42 are physical orthopedic implants and not AI software, this information is not present or relevant to this 510(k) submission.

What is present in the document related to "acceptance criteria" and "study":

The "acceptance criteria" for this device, in the context of a 510(k) submission, are largely based on substantial equivalence to predicate devices. This involves demonstrating that the new device:

• Has the same intended use.
• Has similar technological characteristics (design features, materials, principles of operation).
• Is as safe and effective as the predicate device(s).

The "studies" mentioned are non-clinical tests to ensure the mechanical integrity, material compatibility, and safety of the implant. These are not clinical trials evaluating patient outcomes in the same way an AI algorithm's clinical effectiveness might be assessed.

Non-clinical testing performed (as listed in the document):

• Fretting Fatigue in anatomic and reverse configuration
• Fatigue test on polyethylene liner
• Dynamic Evaluation of the Glenoid Loosening or Disassociation (ASTM F2028)
• Coupling resistance under static load: push-out, lever-out and torque-out tests
• Wear test, as per ISO 14242 - 2 and ASTM F2003
• Biocompatibility evaluation, as per ISO 10993-1
• Endotoxin assessment, as per ANSI/AAMI ST72
• Packaging and shelf life validation as per ISO 11607-1/-2
• Sterilization validation, as per ISO 11137-1/-2/-3

The conclusion states that "Clinical testing was not necessary to demonstrate substantial equivalence of PRIMA Humeral System and SMR Glenosphere Ø42."

Therefore, I cannot provide the requested information in the format specific to AI/ML performance evaluation because this document pertains to a traditional medical device (a physical implant) and not an AI algorithm.

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