ANATOMICAL SHOULDER INVERSE/REVERSE

K053274 · Zimmer GmbH · PHX · Jan 25, 2006 · Orthopedic

Device Facts

• Record ID: K053274
• Device Name: ANATOMICAL SHOULDER INVERSE/REVERSE
• Applicant: Zimmer GmbH
• Product Code: PHX · Orthopedic
• Decision Date: Jan 25, 2006
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3660
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Anatomical Shoulder Inverse /Reverse system is indicated for primary, fracture or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency. 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 Anatomical Shoulder primary humeral stem is intended for cemented or cementless use. The Anatomical Shoulder revision humeral stem is intended for cemented use only. The Anatomical Shoulder Inverse /Reverse glenoid fixation is intended for cementless, press-fit use. It requires screws for initial fixation.

Device Story

Reverse shoulder prosthesis system allowing intra-operative conversion from conventional shoulder arthroplasty to reverse arthroplasty. Components include glenoid fixation baseplate, glenoid head, humeral cup, and humeral inlay; used with previously cleared polyaxial screws and humeral stems. Designed for surgical implantation by orthopedic surgeons in clinical settings. Provides mechanical joint replacement to relieve pain and restore function in patients with rotator cuff deficiency. System supports cemented or cementless humeral stem fixation and cementless, press-fit glenoid fixation requiring screws.

Clinical Evidence

No clinical data provided; bench testing only. Analysis performed on glenoid components, glenoid taper connection, glenoid fixation screw stability, humeral taper connection, humeral cup, and humeral cup-to-inlay connection to confirm adequacy for intended use.

Technological Characteristics

Reverse shoulder prosthesis system. Components: glenoid baseplate, glenoid head, humeral cup, humeral inlay. Fixation: cemented or cementless humeral stems; cementless, press-fit glenoid baseplate with screw fixation. Materials: metal/polymer. Design allows intra-operative conversion between conventional and reverse configurations.

Indications for Use

Indicated for primary, fracture, or revision total shoulder replacement in patients with pain and disability due to gross rotator cuff deficiency. Requires anatomically/structurally suitable joint and functional deltoid muscle.

Regulatory Classification

Identification

A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a shoulder joint. The device limits translation and rotation in one or more planes via the geometry of its articulating surfaces. It has no linkage across-the-joint. This generic type of device includes prostheses that have a humeral resurfacing component made of alloys, such as cobalt-chromium-molybdenum, and a glenoid resurfacing component made of ultra-high molecular weight polyethylene, and is limited to those prostheses intended for use with bone cement (§ 888.3027).

Special Controls

*Classification.* Class II. The special controls for this device are:(1) FDA's: (i) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Devices—Part I: Evaluation and Testing,’ ” (ii) “510(k) Sterility Review Guidance of 2/12/90 (K90-1),” (iii) “Guidance Document for Testing Orthopedic Implants with Modified Metallic Surfaces Apposing Bone or Bone Cement,” (iv) “Guidance Document for the Preparation of Premarket Notification (510(k)) Application for Orthopedic Devices,” and (v) “Guidance Document for Testing Non-articulating, ‘Mechanically Locked’ Modular Implant Components,” (2) International Organization for Standardization's (ISO): (i) ISO 5832-3:1996 “Implants for Surgery—Metallic Materials—Part 3: Wrought Titanium 6-aluminum 4-vandium Alloy,” (ii) ISO 5832-4:1996 “Implants for Surgery—Metallic Materials—Part 4: Cobalt-chromium-molybdenum casting alloy,” (iii) ISO 5832-12:1996 “Implants for Surgery—Metallic Materials—Part 12: Wrought Cobalt-chromium-molybdenum alloy,” (iv) ISO 5833:1992 “Implants for Surgery—Acrylic Resin Cements,” (v) ISO 5834-2:1998 “Implants for Surgery—Ultra-high Molecular Weight Polyethylene—Part 2: Moulded Forms,” (vi) ISO 6018:1987 “Orthopaedic Implants—General Requirements for Marking, Packaging, and Labeling,” and (vii) ISO 9001:1994 “Quality Systems—Model for Quality Assurance in Design/Development, Production, Installation, and Servicing,” and (3) American Society for Testing and Materials': (i) F 75-92 “Specification for Cast Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implant Material,” (ii) F 648-98 “Specification for Ultra-High-Molecular-Weight Polyethylene Powder and Fabricated Form for Surgical Implants,” (iii) F 799-96 “Specification for Cobalt-28 Chromium-6 Molybdenum Alloy Forgings for Surgical Implants,” (iv) F 1044-95 “Test Method for Shear Testing of Porous Metal Coatings,” (v) F 1108-97 “Specification for Titanium-6 Aluminum-4 Vanadium Alloy Castings for Surgical Implants,” (vi) F 1147-95 “Test Method for Tension Testing of Porous Metal,” (vii) F 1378-97 “Standard Specification for Shoulder Prosthesis,” and (viii) F 1537-94 “Specification for Wrought Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implants.”

Predicate Devices

• Tornier Aequalis Reversed Shoulder Prosthesis (K041873)
• DePuy Orthopaedics Delta Shoulder (K021478)
• Encore Medical Encore Reverse Shoulder Prosthesis (K041066)
• Centerpulse Orthopaedics Anatomical Shoulder System with Removable Heads (K030259)

Submission Summary (Full Text)

{0}------------------------------------------------

K 053274

# JAN 2 5 2006

# !②

# Summary of Safety and Effectiveness

| Submitter: | Zimmer, Inc.<br>P.O. Box 708<br>Warsaw, IN 46581-0708 |
|-----------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Dalene T. Binkley, RAC<br>Senior Associate, Regulatory Affairs<br>Telephone: [phone]<br>Fax: [phone] |
| Date: | January 18, 2006 |
| Trade Name: | Anatomical Shoulder™ Inverse / Reverse |
| Common Name: | Total Shoulder Prosthesis |
| Classification Names<br>and references: | 1. Prosthesis, shoulder, semi-constrained,<br>metal/polymer cemented (KWS) - 888.3660<br>2. Shoulder joint metal/polymer non-constrained<br>cemented prosthesis (KWT) - 888.3650 |
| Predicate Devices: | • Tornier Aequalis Reversed Shoulder Prosthesis,<br>K041873, cleared August 25, 2004<br>• DePuy Orthopaedics Delta Shoulder,<br>K021478, cleared November 18, 2003<br>• Encore Medical Encore Reverse Shoulder<br>Prosthesis, K041066, cleared March 24, 2005<br>• Centerpulse Orthopaedics Anatomical Shoulder<br>System with Removable Heads, K030259,<br>cleared April 24, 2003. |
| Device Description: | The Anatomical Shoulder Inverse / Reverse system<br>is a reverse shoulder prosthesis that allows an intra-<br>operative change from a conventional shoulder<br>arthroplasty to a reverse shoulder arthroplasty. The<br>components of the system include a glenoid fixation<br>baseplate, a glenoid head, a humeral cup and a<br>humeral inlay. These components are intended for<br>use with previously submitted polyaxial screws and<br>previously cleared humeral stems. |

{1}------------------------------------------------

053274
2012

| Intended Use: | The Anatomical Shoulder Inverse /Reverse system<br>is indicated for primary, fracture or revision total<br>shoulder replacement for the relief of pain and<br>significant disability due to gross rotator cuff<br>deficiency. |
|----------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | The patient's joint must be anatomically and<br>structurally suited to receive the selected implants<br>and a functional deltoid muscle is necessary to use<br>the device. |
| | The Anatomical Shoulder primary humeral stem is<br>intended for cemented or cementless use. The<br>Anatomical Shoulder revision humeral stem is<br>intended for cemented use only. The Anatomical<br>Shoulder Inverse /Reverse glenoid fixation is<br>intended for cementless, press-fit use. It requires<br>screws for initial fixation. |
| Comparison to Predicate Devices: | The Anatomical Shoulder Inverse /Reverse system<br>is substantially equivalent to the predicate devices<br>in regards to its intended use, design, size ranges,<br>materials and manufacturing methods. |
| Performance Data (Nonclinical<br>and/or Clinical): | Non-Clinical Performance and Conclusions:<br>Analysis of the glenoid components, the glenoid<br>taper connection, glenoid fixation screw stability,<br>the humeral taper connection, the humeral cup and<br>the connection between the humeral cup and the<br>humeral inlay indicate that all components are<br>adequate for their intended use. |
| | Clinical Performance and Conclusions:<br>Clinical data and conclusions were not needed for<br>this device. |

{2}------------------------------------------------

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health and Human Services (HHS). The logo features a stylized eagle with three heads, representing the department's focus on health, human services, and science. The eagle is surrounded by the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES - USA" in a circular arrangement.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN 2 5 2006

Zimmer GMBH C/O Dalene Binkley Zimmer, Inc P.O. Box 708 Warsaw, Indiana 46581

Re: K053274

Trade/Device Name: Anatomical Shoulder™ Inverse / Reverse Regulation Number: 21 CFR 888.3660 Regulation Name: Prosthesis, Shoulder, semi-constrained, metal/polymer cemented Regulatory Class: II Product Code: KWS, KWT Dated: November 22, 2005 Received: November 23, 2005

Dear Ms. Binkley:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencics. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

{3}------------------------------------------------

Page 2- Dalene T. Binkley

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Mark N. Melkerson

Mark N. Melkerson Acting Director Division of General, Restorative, and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{4}------------------------------------------------

## Indications for Use

#### 510(k) Number (if known):

### Device Name:

Anatomical Shoulder " Inverse / Reverse system

## Indications for Use:

The Anatomical Shoulder Inverse /Reverse system is indicated for primary, fracture or revision total shoulder replacement for the relief of pain and significant disability due to gross rovator off deficiency.

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 Anatomical Shoulder primary humeral stem is intended for cementless use. The Anatomical Shoulder revision humeral stem is intended for cemented use only. The Anatonical Shoulder Inverse /Reverse glenoid fixation is intended for cementless, press-fit use. It requires screws for initial fixation.

Prescription Use X (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

(Please do not write below this line - Continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Signature

(Division Sign of General, Restorative, and Neurological Devic

510(k) Num

Page 1 of 1