GENDER SOLUTIONS NATURAL-KNEE FLEX SYSTEM; NEX GEN COMPLETE KNEE SOLUTION CR-FLEX GENDER SOLUTIONS FEMALE FEMORAL COMPON

K071107 · Zimmer, Inc. · MBH · Jul 6, 2007 · Orthopedic

Device Facts

• Record ID: K071107
• Device Name: GENDER SOLUTIONS NATURAL-KNEE FLEX SYSTEM; NEX GEN COMPLETE KNEE SOLUTION CR-FLEX GENDER SOLUTIONS FEMALE FEMORAL COMPON
• Applicant: Zimmer, Inc.
• Product Code: MBH · Orthopedic
• Decision Date: Jul 6, 2007
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3565
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

N-K Flex System: · Components with CSTi porous coating are indicated for uncemented or cemented use in skeletally mature individuals with intact medial and lateral collateral ligaments undergoing primary surgery for rehabilitating knees damaged as a result of Noninflammatory Degenerative Joint Disease (NIDJD) or Inflammatory Joint Disease (IJD). · Components without CSTi porous coating are indicated for cemented use in skeletally mature individuals with intact medial and lateral collateral ligaments with conditions of Noninflammatory Degenerative Joint Disease (NIDJD) or Inflammatory Joint Disease (IJD), correctable varus-valgus deformity and moderate flexion contracture, or failed previous surgery where pain, deformity or dysfunction persists. · The N-K Flex femoral provides increased flexion capability for patients who have both the flexibility and desire to increase their flexion range. When used with N-K Flex, NexGen Trabecular Metal™ CR Monoblock, 90-prefix NexGen CR, 00-prefix 10, 12 or 14mm or 90prefix 17 or 20mm Prolong " Highly Crosslinked Polyethylene CR articular surfaces, it is designed for use when load bearing ROM is expected to be less than or equal to 155 degrees. NexGen CR-Flex GSF Femoral Components: · This device is indicated for patients with severe knee pain and disability due to: -Rheumatoid arthritis, osteoarthritis, traumatic arthritis, polyarthritis. -Collagen disorders, and/or avascular necrosis of the femoral condyle. -Post-traumatic loss of joint configuration, particularly when there is patellofemoral erosion, dysfunction or prior patellectomy. - Moderate valgus, varus, or flexion deformities. - The salvage of previously failed surgical attempts or for a knee in which satisfactory stability in flexion cannot be obtained at the time of surgery. · This device is intended for cemented use only. · Specific uses with CR-Flex GSF femorals: - Provides increased flexion capability for patients who have both the flexibility and desire to increase their flexion range. - The CR-Flex GSF femoral, when used with 90-prefix NexGen CR articular surfaces, 00-prefix 10, 12 or 14mm or 90-prefix 17 or 20mm Prolong Highly Crosslinked Polyethylene CR articular surfaces, or with Gender Solutions™ Natural-Knee® Flex Congruent articular surfaces, is designed for use with a functional posterior cruciate ligament and when load bearing range of motion (ROM) is expected to be less than or equal to 155 degrees.

Device Story

Semiconstrained, nonlinked condylar knee prosthesis; designed for maximum active flexion of 155 degrees. Femoral components modified to address specific distal femur anatomical features typical of male and female patients. Used by orthopedic surgeons in clinical settings for total knee arthroplasty. Provides increased flexion capability for patients desiring greater range of motion. Benefits include restoration of joint function, pain relief, and correction of deformities. Output is the physical implant system replacing damaged joint surfaces.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Semiconstrained, nonlinked condylar knee prosthesis. Materials include metal and polymer. Features CSTi porous coating for uncemented use or non-coated for cemented use. Designed for 155-degree flexion. Compatible with specific NexGen CR articular surfaces and Prolong Highly Crosslinked Polyethylene.

Indications for Use

Indicated for skeletally mature patients with intact medial/lateral collateral ligaments requiring primary knee surgery for NIDJD or IJD, or salvage of failed prior surgery. Includes patients with severe knee pain/disability due to RA, OA, traumatic arthritis, polyarthritis, collagen disorders, avascular necrosis, or post-traumatic joint loss. Contraindicated if collateral ligaments are not intact.

Regulatory Classification

Identification

A knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis is a device intended to be implanted to replace a knee 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 is designed to achieve biological fixation to bone without the use of bone cement. This identification includes fixed-bearing knee prostheses where the ultra high molecular weight polyethylene tibial bearing is rigidly secured to the metal tibial base plate.

Special Controls

*Classification.* Class II (special controls). The special control is FDA's guidance: “Class II Special Controls Guidance Document: Knee Joint Patellofemorotibial and Femorotibial Metal/Polymer Porous-Coated Uncemented Prostheses; Guidance for Industry and FDA.” See § 888.1 for the availability of this guidance.

Predicate Devices

• Gender Solutions Natural-Knee Flex System (K070214)
• NexGen Knee Gender Solutions Female (GSF) Femoral Components (K060370)

Submission Summary (Full Text)

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# KO71107 (ps 1 of 3)

### Summary of Safety and Effectiveness

JUL - 6 2007

| Submitter: | Zimmer, Inc.<br>P.O. Box 708<br>Warsaw, IN 46581-0708 |
|---------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Brandon Hipsher, RAC<br>Senior Associate, Corporate Regulatory Affairs<br>Telephone: [phone]<br>Fax: [phone] |
| Date: | April 18, 2007 |
| Trade Name: | Gender Solutions™ Natural-Knee® Flex System;<br>NexGen® Complete Knee Solution CR-Flex Gender<br>Solutions Female (GSF) Femoral Component |
| Common Name: | Total Knee Prosthesis |
| Classification Name<br>and Reference: | Knee joint patellofemorotibial<br>polymer/metal/polymer semiconstrained cemented<br>prosthesis<br>21 CFR § 888.3560 |
| | Knee joint patellofemorotibial metal/polymer<br>porous-coated uncemented prosthesis<br>21 CFR § 888.3565 |
| Predicate Devices: | Gender Solutions Natural-Knee Flex System,<br>manufactured by Zimmer, Inc., K070214, cleared<br>March 16, 2007.<br>NexGen Knee Gender Solutions Female (GSF)<br>Femoral Components, manufactured by Zimmer,<br>Inc., K060370, cleared April 28, 2006. |
| Device Description: | The Gender Solutions Natural-Knee Flex (N-K<br>Flex) and NexGen CR-Flex GSF components are<br>semiconstrained, nonlinked condylar knee<br>prosthesis that are designed to have a maximum<br>active flexion of 155 degrees. The GSM and GSF<br>femoral component designations indicate that the<br>design of the femoral components has been<br>modified to address specific anatomical features of |

:

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Kc71107 (pg. 2 of 3)

the distal femur that can be seen in patients of either gender, but are more typical of male and female patients, respectively.

Intended Use:

N-K Flex System:

- · Components with CSTi porous coating are indicated for uncemented or cemented use in skeletally mature individuals with intact medial and lateral collateral ligaments undergoing primary surgery for rehabilitating knees damaged as a result of Noninflammatory Degenerative Joint Disease (NIDJD) or Inflammatory Joint Disease (IJD).
- · Components without CSTi porous coating are indicated for cemented use in skeletally mature individuals with intact medial and lateral collateral ligaments with conditions of Noninflammatory Degenerative Joint Disease (NIDJD) or Inflammatory Joint Disease (IJD), correctable varus-valgus deformity and moderate flexion contracture, or failed previous surgery where pain, deformity or dysfunction persists.
- · The N-K Flex femoral provides increased flexion capability for patients who have both the flexibility and desire to increase their flexion range. When used with N-K Flex, NexGen Trabecular Metal™ CR Monoblock, 90-prefix NexGen CR, 00-prefix 10, 12 or 14mm or 90prefix 17 or 20mm Prolong " Highly Crosslinked Polyethylene CR articular surfaces, it is designed for use when load bearing ROM is expected to be less than or equal to 155 degrees.

NexGen CR-Flex GSF Femoral Components:

- · This device is indicated for patients with severe knee pain and disability due to:
- -Rheumatoid arthritis, osteoarthritis, traumatic arthritis, polyarthritis.
- -Collagen disorders, and/or avascular necrosis of the femoral condyle.
- -Post-traumatic loss of joint configuration, particularly when there is patellofemoral erosion, dysfunction or prior patellectomy.

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K071107 (pg. 3 of 3)

| | - Moderate valgus, varus, or flexion<br>deformities.<br>- The salvage of previously failed surgical<br>attempts or for a knee in which satisfactory<br>stability in flexion cannot be obtained at the<br>time of surgery.<br>• This device is intended for cemented use only.<br>• Specific uses with CR-Flex GSF femorals:<br>- Provides increased flexion capability for<br>patients who have both the flexibility and<br>desire to increase their flexion range.<br>- The CR-Flex GSF femoral, when used with<br>90-prefix NexGen CR articular surfaces, 00-<br>prefix 10, 12 or 14mm or 90-prefix 17 or<br>20mm Prolong Highly Crosslinked<br>Polyethylene CR articular surfaces, or with<br>Gender Solutions™ Natural-Knee® Flex<br>Congruent articular surfaces, is designed for<br>use with a functional posterior cruciate<br>ligament and when load bearing range of<br>motion (ROM) is expected to be less than or<br>equal to 155 degrees. |
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| Comparison to Predicate Device: | Except for changes in component compatibility, the<br>subject components are identical to the predicate<br>device. |
| Performance Data (Nonclinical<br>and/or Clinical): | Non-Clinical Performance and Conclusions: |
| | Mechanical testing of the subject devices<br>demonstrates that they are substantially equivalent<br>to the predicate devices. |
| | Clinical Performance and Conclusions: |
| | Clinical data and conclusions were not needed for<br>these devices. |

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three lines representing its wings and head. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL -6 2007

JUL

Zimmer, Inc. % Mr. Brandon Hipsher, RAC Senior Associate, Corporate Regulatory Affairs P.O. Box 708 Warsaw, Indiana 46581

Re: K071107

Trade/Device Name: Gender Solutions™ Natural-Knee® Flex System; NexGen® Complete Knee Solution CR-Flex Gender Solutions™ Female (GSF) Femoral Component Regulation Number: 21 CFR 888.3565 Regulation Name: Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis Regulatory Class: Class II Product Codes: MBH, JWH Dated: June 1, 2007 Received: June 4, 2007

Dear Mr. Hipsher:

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. Iisting 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

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Page 2 - Mr. Brandon Hipsher, RAC

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. 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 toll-free number [phone] or [phone] or the Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours, Mark N. Melkerson Director Division of General, Restorativ and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## K071107

#### Indications for Use

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

#### Device Name:

Gender Solutions™ Natural-Knee® Flex System; NexGen® Complete Knee Solution CR-Flex Gender Solutions™ Femoral Component

#### Indications for Use:

Gender Solutions "Natural-Knee" Flex System:

- · Components with CST porous coating are indicated for uncemented use in skeletally mature individuals with intact medial and lateral collateral ligaments undergoing primary surgery for rehabilitating knees damaged as a result of Noninflammatory Degenerative Joint Disease (NIDJD) or Inflammatory Joint Disease (IJD).
- · Components without CSTi are indicated for cemented use in skeletally mature individuals with intact medial and lateral collateral ligaments with conditions of Noninflammatory Degenerative Joint Disease (NIDJD) or Inflammatory Joint Disease (ID), correctable varus-valgus deformity and moderate flexion contracture, or failed previous surgery where pain, deformity or dysfunction persists.
- · The N-K Flex femoral provides increased flexion capability for patients who have both the flexibility and desire to increase their flexion range. When used with N-K Flex, NexGen Trabecular Metal" CR Monoblock, 90-prefix NexGen CR, 00-prefix 10, 12 or 14mm or 90-prefix 17 or 20mm Prolong "Highly Crosslinked Polyethylene CR articular surfaces, it is designed for use when load bearing ROM is expected to be less than or equal to 155 degrees.

NexGen® Complete Knee Solution CR-Flex Gender Solutions™ Femoral Component:

- · This device is indicated for patients with severe knee pain and disability due to:
- Rheumatoid arthritis, osteoarthritis, traumatic arthritis, polyarthritis,
- Collagen disorders, and/or avascular necrosis of the femoral condyle.
- Post-traumatic loss of joint configuration, particularly when there is patellofemoral erosion, dysfunction or prior patellectomy.
- Moderate valgus, varus, or flexion deformities.
- The salvage of previously failed surgical attempts or for a knee in which satisfactory stability in flexion cannot be obtained at the time of surgery.
- · This device is intended for cemented use only.
- · Specific uses with CR-Flex GSF femorals:
- Provides increased flexion capability for patients who have both the flexibility and desire to increase their flexion range.
- The CR-Flex GSF femoral, when used with 90-prefix NexGen CR articular surfaces, 00-prefix 10, 12 or 14mm or 90-prefix 17 or 20mm Prolong Highly Crosslinked Polyethylene CR articular surfaces, or with Gender Solutions Natural-Knee Flex Congruent articular surfaces, is designed for use with a functional posterior cruciate ligament and when load bearing range of motion (ROM) is expected to be less than or equal to 155 degrees.

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)

| (Division Sign-Off)<br>Division of General, Restorative,<br>and Neurological Devices | Page 1 of 1 |
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| 510(k) Number | K071107 |
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