VERSALOK PEEK ANCHOR WITH ORTHOCORD SUTURE, MODELS 210818, 210819

K100532 · Depuy Mitek, A Johnson & Johnson Company · HWC · Mar 17, 2010 · Orthopedic

Device Facts

• Record ID: K100532
• Device Name: VERSALOK PEEK ANCHOR WITH ORTHOCORD SUTURE, MODELS 210818, 210819
• Applicant: Depuy Mitek, A Johnson & Johnson Company
• Product Code: HWC · Orthopedic
• Decision Date: Mar 17, 2010
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 888.3040
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

VERSALOCK Anchor is indicated for use in the following: Shoulder: Rotor Cuff Repair, Biceps Tenodesis Knee: Medial Collateral Ligament Repair, Lateral Collateral Ligament Repair, Posterior Oblique Ligament Repair, Iliotibial Band Tenodesis; Joint Capsule Closure Elbow: Biceps Tendon Reattachment

Device Story

Versalok Peek Anchor is a bone fixation fastener system used in orthopedic surgeries. The system consists of a PEEK anchor pre-mounted on an inserter shaft with an anvil, a threader tab, and optional Orthocord #2 suture. It is deployed using a reusable deployment gun. The device is operated by surgeons in a clinical setting. The anchor allows for knotless tissue fixation; the deployment gun features a tension wheel allowing the surgeon to control tissue tension. By eliminating the need for manual knot tying and providing precise tension control, the device facilitates soft tissue-to-bone reattachment, potentially improving surgical efficiency and clinical outcomes.

Clinical Evidence

No clinical data. Safety and performance were established through bench testing, including pull-out testing, shelf life, sterilization, and biocompatibility verification.

Technological Characteristics

Material: PEEK. Form factor: Threaded bone anchor pre-mounted on inserter shaft. Deployment: Reusable deployment gun with tension wheel. Connectivity: None. Sterilization: Provided sterile.

Indications for Use

Indicated for patients requiring soft tissue-to-bone fixation in shoulder (rotator cuff repair, biceps tenodesis), knee (MCL, LCL, and posterior oblique ligament repair, iliotibial band tenodesis, joint capsule closure), and elbow (biceps tendon reattachment) procedures.

Regulatory Classification

Identification

A smooth or threaded metallic bone fixation fastener is a device intended to be implanted that consists of a stiff wire segment or rod made of alloys, such as cobalt-chromium-molybdenum and stainless steel, and that may be smooth on the outside, fully or partially threaded, straight or U-shaped; and may be either blunt pointed, sharp pointed, or have a formed, slotted head on the end. It may be used for fixation of bone fractures, for bone reconstructions, as a guide pin for insertion of other implants, or it may be implanted through the skin so that a pulling force (traction) may be applied to the skeletal system.

Predicate Devices

• Trident Anchor (K060914)
• Versalok Ti Anchor (K063478)
• Arthrex Pushlock Anchor (K063479)

Submission Summary (Full Text)

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

## 510(k) SUMMARY

KI00532

ﺍﻟﺘﻲ ﺗﻌﻠﻴﻘﺎﺕ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌﺔ ﺍﻟﻤﺘﻮﻗﻌ

## Versalok Peek Anchor

| Submitter's Name and Address: | DePuy Mitek, Inc.<br>a Johnson & Johnson company<br>325 Paramount Drive<br>Raynham, MA 02767 |
|-------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| | MAR 1 7 2010 |
| Contact Person | Kristine Christo<br>Regulatory Affairs Project Manager<br>DePuy Mitek, Inc.<br>a Johnson & Johnson company<br>325 Paramount Drive<br>Raynham, MA 02767<br>Telephone: [phone]<br>Facsimile: 508-977-6911<br>e-mail: [e-mail]<br>Prepared: 2/24/10 |
| Name of Medical Device | Classification Name: Fastener, Fixation, Nondegradable, Soft<br>Tissue Smooth or threaded metallic bone<br>fixation fasteners<br>Common/Usual Name: Bone Anchor<br>Proprietary Name: Versalok Peek Anchor |
| Substantial Equivalence | Versalok Peek Anchor is substantially equivalent to:<br>Trident Anchor (K060914)<br>Versalok Ti Anchor (K063478)<br>Arthrex Pushlock Anchor (K063479) |
| Device Classification | This device carries an FDA product code MBI and HWC, and is<br>classified as Fastener, Fixation, Nondegradable, Soft Tissue Smooth or<br>threaded metallic bone fixation fasteners under 21 CFR 888.3040. |
| Device Description | The Versalok Peek Anchor System includes the Versalok Peek Anchor,<br>which will be presented sterile, pre-mounted on an inserter shaft w/anvil |

510(k) Premarket Notification: Special
Versalok Peek Anchor ConfidentialVersalok Peek Anchor

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

.

イ

with a threader tab and suture. The System will be deployed with the use of a reusable Deployment Gun. The system is provided with and without a Orthocord#2 suture.

The VERSALOK Anchor System offers several additional clinical benefits as the anchor allows the surgeon to fix the tissue without tying knots and the delivery system allows the surgeon to control the tension placed on the tissue with the tension wheel of the deployment gun.

Technologies characteristics including material, design, packaging and indications are the same as the predicate cleared devices and use similar or identical material and packaging as the predicates.

Indications for Use

Nonclinical testing:

Safety and Performance

Predicate Comparison

The Versalok Peek Anchor is indicated for use in the following: Shoulder: Rotator Cuff Repair, Biceps Tenodesis, Knee: Medial Collateral Ligament Repair, Lateral Collateral Ligament Repair, Posterior Oblique Ligament Repair, Iliotibial Band Tenodesis; Joint Capsule Closure Elbow: Biceps Tendon Reattachment

Verification activities were performed on the implant or its predicates. Testing includes pull out testing, shelf life, sterilization and biocompatibility.

Results of performance and safety testing have demonstrated that the modified device is substantially equivalent to the predicate devices.

Based on the indications for use, technological characteristics, and comparison to predicate devices, the Versalok Peek Anchor has been shown to be substantially equivalent to predicate devices under the Federal Food, Drug and Cosmetic Act.

The proposed Versalok Peek Anchor is compared to the predicate Trident Anchor (K063478), Versalok Anchor (K060914) and Arthrex Pushlock (K063479) below.

510(k) Premarket Notification: Special Versalok Peek Anchor

Confidential

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

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle-like symbol with three curved lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol.

MAR 1 7 2010

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring. MD 20993-0002

DePuy Mitek % Ms. Kristine Christo Regulatory Affairs Project Manager 325 Paramount Drive Raynham, Massachusetts 02767

Re: K100532 Trade/Device Name: VERSALOCK Anchor Regulation Number: 21 CFR 888.3040 Regulation Name: Smooth or threaded metallic bone fixation fastener Regulatory Class: II Product Code: HWC, MBI Dated: February 24, 2010 Received: February 25, 2010

Dear Ms. Christo:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

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

Page 2 - Ms. Kristine Christo

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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Sincerely yours,

Mark N. Melkerso Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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

## Indications for Use

510(k) Number (if known):

K100537

Device Name:

VERSALOCK Anchor is indicated for use in the following:

Shoulder: Rotor Cuff Repair, Biceps Tenodesis Knee: Medial Collateral Ligament Repair, Lateral Collateral Ligament Repair, Posterior Oblique Ligament Repair, Iliotibial Band Tenodesis; Joint Capsule Closure Elbow: Biceps Tendon Reattachment

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)

Daniel Krone for MXM
(Division Sign-Off)

Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K100532