K062148 · DePuy Orthopaedics, Inc. · LPH · Oct 24, 2006 · Orthopedic
Device Facts
Record ID
K062148
Device Name
DEPUY PINNACLE ALTRX ACETABULAR CUP LINER
Applicant
DePuy Orthopaedics, Inc.
Product Code
LPH · Orthopedic
Decision Date
Oct 24, 2006
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 888.3358
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
The subject Pinnacle AltrX UHMWPE Liners are intended to be used with the DePuy Pinnacle metal acetabular shells, modular femoral heads, unipolar femoral heads, M-Spec heads, bi-polar self-centering heads and ceramic heads to resurface the acetabular socket in cementless total hip arthroplasty.
Device Story
Modular acetabular cup liner system for total hip replacement; replaces damaged hip joint articulation. Components: porous-coated titanium alloy (Ti-6Al-4V) outer shell; cross-linked UHMWPE liner. Liner locks into shell; articulates with modular femoral heads (28mm-48mm). Used in orthopedic surgery; implanted by surgeons. In-vitro hip simulator testing demonstrates reduced wear compared to conventional and previous cross-linked UHMWPE liners. Device provides increased patient mobility and pain reduction.
Clinical Evidence
Bench testing only. In-vitro hip simulator study (6 million cycles) compared AltrX liners to Marathon and Enduron controls. Wear rates: 3.4 ± 0.2 mg/MC (AltrX) vs 7.3 ± 1.0 mg/MC (Marathon) and 43.6 ± 5.0 mg/MC (Enduron). No clinical data provided; wear claims based on simulator results which may not predict clinical performance.
Technological Characteristics
Material: Cross-linked UHMWPE liner; Ti-6Al-4V titanium alloy shell. Dimensions: Liner ID 28mm-48mm; OD 44mm-76mm. Sterilization: Gas plasma. Energy source: N/A (mechanical). Connectivity: N/A. Design: Modular, cementless, semi-constrained.
Indications for Use
Indicated for total hip replacement in patients with sufficient sound bone to support components. Conditions: osteoarthritis, traumatic/rheumatoid arthritis, congenital hip dysplasia, avascular necrosis, acute traumatic fracture of femoral head/neck, failed previous hip surgery (reconstruction, fixation, arthrodesis, hemiarthroplasty, surface replacement), or ankylosis. For use with Pinnacle Acetabular Cups in cementless applications.
Regulatory Classification
Identification
A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a device intended to be implanted to replace a hip 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 has a femoral component made of a cobalt-chromium-molybdenum (Co-Cr-Mo) alloy or a titanium-aluminum-vanadium (Ti-6Al-4V) alloy and an acetabular component composed of an ultra-high molecular weight polyethylene articulating bearing surface fixed in a metal shell made of Co-Cr-Mo or Ti-6Al-4V. The femoral stem and acetabular shell have a porous coating made of, in the case of Co-Cr-Mo substrates, beads of the same alloy, and in the case of Ti-6Al-4V substrates, fibers of commercially pure titanium or Ti-6Al-4V alloy. The porous coating has a volume porosity between 30 and 70 percent, an average pore size between 100 and 1,000 microns, interconnecting porosity, and a porous coating thickness between 500 and 1,500 microns. The generic type of device has a design to achieve biological fixation to bone without the use of bone cement.
Predicate Devices
DePuy Pinnacle Acetabular Cup System ESL Marathon Polyethylene liners (K033273)
Wright Medical LINEAGE A-CLASS Poly Liner (K052026)
Submission Summary (Full Text)
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K06Z148
## SUMMARY OF SAFETY AND EFFECTIVENESS
OCT 2 4 2006
| NAME OF FIRM: | DePuy Orthopaedics, Inc.<br>P.O. Box 988<br>700 Orthopaedic Drive<br>Warsaw, IN 46581-0988 |
|-------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) CONTACT: | Anne M. Schuler<br>Sr Regulatory Affairs Associate |
| DATE PREPARED: | October 23, 2006 |
| TRADE NAME: | DePuy Pinnacle® AltrX™ Acetabular Cup Liner |
| COMMON NAME: | Acetabular Cup Liner |
| CLASSIFICATION: | CFR 888.3358 Hip joint metal/polymer/metal,<br>semi-constrained, porous-coated, uncemented<br>prosthesis, Class II device<br><br>CFR 888.3353 Hip joint metal/ceramic/polymer<br>semi-constrained cemented or non-porous<br>uncemented prosthesis, Class II device |
| DEVICE PRODUCT CODE: | 87 LPH, LZO |
| SUBSTANTIALLY EQUIVALENT<br>DEVICE: | DePuy Pinnacle® Acetabular Cup System ESL<br>Marathon™ Polyethylene liners (K033273,<br>cleared May 6, 2004)<br><br>DePuy Pinnacle® Acetabular System (K000306,<br>cleared March 23, 2000) |
Wright Medical LINEAGE® A-CLASS™ Poly Liner (K052026, cleared Dec 5, 2005)
## DEVICE INFORMATION:
## A. DEVICE DESCRIPTION
The Pinnacle AltrX Acetabular Cup Liner is part of a modular system designed to replace the natural articular surface of the hip joint in total hip replacement. The acetabular component is provided as two separate units, a porous coated hemispherical outer shell manufactured from titanium alloy (Ti-6Al-4V) and a liner
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manufactured from cross-linked ultra high molecular weight polyethylene (UHMWPE), which locks into the outer shell. The liner component articulates with a femoral head of an appropriate diameter.
The subject Pinnacle AltrX liners are cross-linked UHMWPE acetabular cup liners that are available in a neutral, lateralized neutral, lipped or lateralized face-changing orientation. The liners have inner diameters (ID) intended for use with modular, unipolar, self-centering (bipolar), M-Spec or ceramic femoral heads within the 28mm-48mm size range. The outer diameters (OD) are geometrically the same as other Pinnacle Acetabular Cup Liners, in a 44mm-76mm size range offering,
The following marketing claim will be made for the Pinnacle Altrx liner:
AltrX™ UHMWPE liners reduce wear by 53% compared to previously cleared DePuy Marathon® UHMWPE liners while maintaining similar physical and mechanical properties as Marathon® UHMWPE. In addition. AltrX™ UHMWPE liners reduce wear by 92% compared to previously cleared conventional noncrosslinked UHMWPE liners.
An in-vitro hip simulator wear study was conducted to support these wear claims. The study was conducted using test devices identified as AltrX™ Polyethylene liners and two control devices identified as Marathon® Polyethylene liners and Enduron® Polyethylene liners. The test and control liners were manufactured by DePuv Orthopaedics by a ram extrusion process. The test and control liners had a thickness of 0.374 inches with a 28mm inner diameter and were gas plasma sterilized prior to the study.
Test and control liners were tested for 6 million cycles using an orbital bearing hip wear test machine manufactured by Shore Western Manufacturing Inc. The articulating component for both the test and control liners was a 28mm CoCr femoral head manufactured by DePuy Orthopaedics. The lubricant used in the study was 90% bovine serum with 0.2% NaN3 and 20mM EDTA. The wear rates determined at the conclusion of the study were 43.6 + 5.0 mg/million cycles (mg/MC) for the Enduron control, 7.3 ± 1.0 mg/MC for the Marathon control and 3.4 ± 0.2 mg/MC for the AltrX test material.
Note: Reduced Wear Claims are based on the results of in-vitro hip wear simulator tests which have not been shown to quantitatively predict clinical wear performance
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## B. INTENDED USE AND INDICATIONS
#### Intended Use
The subject Pinnacle AltrX UHMWPE Liners are intended to be used with the DePuy Pinnacle metal acetabular shells, modular femoral heads, unipolar femoral heads, M-Spec heads, bi-polar self-centering heads and ceramic heads to resurface the acetabular socket in cementless total hip arthroplasty.
#### Indications
The Pinnacle AltrX Acetabular Cup Liner is indicated for use in total hip replacement procedures. Total hip arthroplasty is intended to provide increased patient mobility and reduce pain by replacing the damaged hip joint articulation in patients where there is evidence of sufficient sound bone to seat and support the components. Total hip replacement is indicated in the following conditions:
- 1. A severely painful and/or disabled joint from osteoarthritis, traumatic arthritis, rheumatoid arthritis, or congenital hip dysplasia.
- 2. Avascular necrosis of the femoral head.
- 3. Acute traumatic fracture of the femoral head or neck.
- 4. Failed previous hip surgery including joint reconstruction, internal fixation, arthrodesis, hemiarthroplasty, surface replacement arthroplasty, or total hip replacement.
- 5. Certain cases of ankylosis.
The Pinnacle AltrX is indicated for use with the Pinnacle Acetabular Cup in cementless application.
### C. BASIS OF SUBSTANTIAL EQUIVALENCE:
The Pinnacle AltrX Acetabular Cup Liners have the same design, intended use, manufacturing method, sterilization and packaging as the Pinancle Marathon Acetabular Liners cleared in K033273 and K000306. Mechanical testing shows that the AltrX liners perform similarly to the Marathon liners and exhibit less wear in hip simulator testing. Based on similarities in design, intended use, manufacturing method, sterilization and packaging DePuy believes that the Pinnacle® AltrX™ Acetabular Cup Liners are substantially equivalent to the previously cleared Pinnacle® Marathon™ Liners and to the previously cleared Wright Medical LINEAGE® A-CLASS™ Poly Liner which is similar in design, manufacturing method and intended use.
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#### DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized image of an eagle with its wings spread, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle. The logo is black and white.
#### Public Health Service
ood and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
DePuy Orthopaedics, Inc. % Ms. Anne M. Schuler Sr. Regulatory Affairs Associate P.O. Box 988 700 Orthopaedic Drive Warsaw, Indiana
OCT 8 4 2006
Re: K062148 Trade/Device Name: DePuy Pinnacle Altrx™ Acetabular Cup Liners Regulation Number: 21 CFR 888.3358 Regulation Name: Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis Regulatory Class: Class II Product Code: LPH Dated: July 26, 2006 Received: July 27, 2006
Dear Ms. Schuler:
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. Insting 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 agencies. 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.
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Page 2 -- Ms. Anne M. Schuler
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 (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 (800) 638-2041 or 240-276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours
Ron Kirk
Mark N. Melkerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Indications for Use
K062148
510(k) Number (if known): __ Ko 6 >14 8
Device Name: __ DePuv Pinnacle AltrXTMAce Device Name: DePuy Pinnacle AltrX™Acetabular Cup Liners
Indications for Use:
The Pinnacle AltrX™ Acetabular Cup Liners are indicated for use in total hip replacement procedures. Total hip arthroplasty is intended to provide increased patient mobility and reduce pain by replacing the damaged hip joint articulation in patients where there is evidence of sufficient sound bone to seat and support the components. Total hip replacement is indicated in the following conditions:
- 1. A severely painful and/or disabled joint from osteoarthritis, traumatic arthritis, theumatoid arthritis, or congenital hip dysplasia.
- 2. Avascular necrosis of the femoral head.
- 3. Acute traumatic fracture of the femoral head or neck.
- 4. Failed previous hip surgery including joint reconstruction, internal fixation, arthrodesis, hemiarthroplasty, surface replacement arthroplasty, or total hip replacement.
- 5. Certain cases of ankylosis.
The Pinnacle AltrX Acetabular Cup Liners are indicated for use with the Pinnacle Acetabular Cups in cementless applications.
| Prescription Use<br>(Part 21 CFR 801 Subpart D) | X | AND/OR | Over-The-Counter Use<br>(21 CFR 807 Subpart C) | No |
|-------------------------------------------------|---|--------|------------------------------------------------|----|
|-------------------------------------------------|---|--------|------------------------------------------------|----|
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)
(Division Sign-Off)
Division of Generen Restorative, Office of Device Evaluation (ODE)
and Neurological Devices
510 k02214/
0000003
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.