LIMA-LTO SMR SHOULDER SYSTEM - FINNED HUMERAL STEMS, LIMA-LTO SMR SHOULDER SYSTEM - FINNED HUMERAL BODIES,

K101263 · Lima-Lto S.P.A. · KWT · Jan 28, 2011 · Orthopedic

Device Facts

Record IDK101263
Device NameLIMA-LTO SMR SHOULDER SYSTEM - FINNED HUMERAL STEMS, LIMA-LTO SMR SHOULDER SYSTEM - FINNED HUMERAL BODIES,
ApplicantLima-Lto S.P.A.
Product CodeKWT · Orthopedic
Decision DateJan 28, 2011
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 888.3650
Device ClassClass 2
AttributesTherapeutic

Intended Use

The SMR Shoulder system is intended for partial or total primary shoulder joint replacement. The components are intended for use in cemented and uncemented applications, as specified in the following table: COMPONENT USE Cemented Uncemented Cemented stems X Cementless Finned stems X Trauma Humeral Bodies X X Finned Humeral Bodies X X Humeral Heads X X Adaptor Tapers X X Cemented Glenoids X Total or hemi-shoulder replacement is indicated for 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

Device Story

Modular shoulder prosthesis system for partial or total primary shoulder arthroplasty. Components include humeral stems (60/80mm), humeral bodies, adaptor tapers, humeral heads, and glenoid components. System allows for cemented or uncemented applications. Humeral stems and bodies feature press-fit finned designs for uncemented fixation. Modular Morse-taper connections allow assembly of stem, body, and head; locking screws and cylindrical marks assist in alignment and eccentricity adjustment. Adaptor tapers adjust center of rotation and soft tissue tension. Used by orthopedic surgeons in clinical settings for joint replacement. Benefits include restoration of joint function and stability in patients with degenerative disease or trauma.

Clinical Evidence

No clinical data. Substantial equivalence demonstrated via bench testing, including static pull-out, torsional testing of modular connections, and fatigue testing of humeral stems, modular connections, and glenoid components.

Technological Characteristics

Modular shoulder prosthesis. Materials: Ti6Al4V (ISO 5832-3, ASTM F1472) for stems/bodies/adaptors; CoCrMo (ISO 5832-12, ASTM F1537) for humeral heads; UHMWPE (ISO 5834-2, ASTM F648) for glenoids. Mechanical fixation via press-fit fins or cement. Morse-taper connections. No software or electronics.

Indications for Use

Indicated for patients with disability due to non-inflammatory degenerative joint disease (osteoarthritis, avascular necrosis), inflammatory degenerative joint disease (rheumatoid arthritis), or acute humeral head fractures untreatable by other fixation methods. Intended for partial or total primary shoulder joint replacement.

Regulatory Classification

Identification

A shoulder joint metal/polymer non-constrained cemented prosthesis is a device intended to be implanted to replace a shoulder joint. The device limits minimally (less than normal anatomic constraints) translation in one or more planes. It has no linkage across-the-joint. This generic type of device includes prostheses that have a humeral 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 “Titanium-6 Aluminum-4 Vanadium Alloy Castings for Surgical Implants,” (vi) F 1147-95 “Test Method for Tension Testing of Porous Metal Coatings,” (vii) F 1378-97 “Specification for Shoulder Prosthesis,” and (viii) F 1537-94 “Specification for Wrought Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implants.”

Predicate Devices

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ K101263 p. 1/3 JAN 2 8 2011 # Summary of Safety and Effectiveness Date: April 28, 2010 Manufacturer: Lima-Lto S.p.A. Via Nazionale, 52 33038 - Villanova di San Daniele Udine - Italy U.S. Contact Person: Cheryl Hastings Principal Consultant Phone: 574-527-4220 | Product | Product Code | Regulation and Classification Name | |-----------------------------------|--------------|----------------------------------------------------------------------------------------------| | SMR Uncemented<br>Shoulder System | KWT | Shoulder joint metal/polymer non-constrained<br>cemented prosthesis per 21 CFR 888.3650 | | | HSD | Shoulder joint humeral (hemi-shoulder) metallic<br>uncemented prosthesis per 21 CFR 888.3690 | #### Device Description: The SMR Shoulder System consists of a humeral stem, a humeral body, an adaptor taper, a humeral head and a glenoid components are offered for hemi or total shoulder joint arthroplasty, in primary trauma surgery. Humeral components are provided in different designs and are intended for cementless use while glenoid components are intended for cemented use only. Two designs of humeral stems are available: the first one (object of this submission) is intended for uncemented use while the second one (submitted in 510(k): K100858) is intended for cemented use only. Two lengths of uncemented humeral stems are available: 60 and 80 mm. The 60 mm stems are characterized by an outline with a double conicity and they are finned to provide optimal proximal fixation. The stem is sand-blasted. The 80 mm stems are characterized by an outline with a triple conicity and are also finned to provide optimal fixation. The proximal part is sand-blasted while the distal part is polished. All stems are made from Ti6Al4V (ISO 5832-3, ASTM F1472). The stems are provided with a male Morse taper (identical to that described in K100858) to allow coupling with the humeral bodies. Humeral bodies are available in two designs. The first one (submitted in 510(k): K100858) is characterized by holes for humeral bone reconstruction as a consequence of trauma while the second one (object of this 510(k)) is finned to allow proximal press-fit fixation of the humeral system. Both designs of humeral bodies can be used in cemented (with cemented stems submitted in 510(k): K100858) and in uncemented applications (with uncemented stems submitted in this 510(k). Humeral bodies are made from Ti6Al4V (ISO 5832-3, ASTM F1472). Traditional 510(k) – SMR Uncemented Shoulder System April 28, 2010 Company Confidential Section 5 – Page 17 of 264 {1}------------------------------------------------ $$\xi \lor \Delta \langle \bullet \rangle$$ . p.2/3 They are coupled with the humeral stem via a female Morse-taper connection; a locking screw is provided to aid in initial mating of the stem / body assembly.. Cylindrical marks are designed at the base of this Morse-taper to provide correct alignment of the eccentricity of the humeral head during surgery. A male Morse-taper connection is designed for the coupling between the humeral body and the humeral head by means of specific adaptor tapers: an angle of 45° between the axis of this Morse-taper and the axis of the stem gives the correct varus-valgus alignment to the joint. The device descriptions for the adaptor tapers, humeral heads and glenoid components submitted in K100858 are repeated here in italic typing for a better understanding of the complete system. Adaptor tapers (neutral and eccentrical with different heights), are made from Ti6Al4V. They allow coupling between the humeral body and the humeral head. These devices are designed to adjust the centre of rotation of the joint and provide the required offset to the humeral head to achieve the correct tensioning to the soft tissues, optimizing joint stability. The humeral heads are made from CoCrMo (ISO 5832-12, ASTM F1537). They are intended to articulate with the glenoid bone in hemi-arthroplasty or with the glenoid component in total shoulder arthroplasty. The surface is polished to aid in the reduction of wear. The glenoid components are manufactured from Ultra-High Molecular Weight Polyethylene (UHMWPE ISO 5834-2, ASTM F648). The articulating surface has a radius of curvature greater than the corresponding humeral head, which allows translation in the superior/inferior and anterior/posterior directions. The back surface of the component is spherical in geometry and has a single central peg which is inserted in the hole drilled in the glenoid cavity during surgery. The peg surface has three grooves to provide enhanced cement fixation. #### Intended Use / Indications: The SMR Shoulder system is intended for partial or total primary shoulder joint replacement. The components are intended for use in cemented and uncemented applications, as specified in the following table: | COMPONENT | USE | | |-------------------------|----------|------------| | | Cemented | Uncemented | | Cemented stems | X | | | Cementless Finned stems | | X | | Trauma Humeral Bodies | X | X | | Finned Humeral Bodies | X | X | | Humeral Heads | X | X | | Adaptor Tapers | X | X | | Cemented Glenoids | X | | Total or hemi-shoulder replacement is indicated for patients suffering from disability due to: Traditional 510(k) – SMR Uncemented Shoulder System April 28, 2010 Company Confidential Section 5 – Page 18 of 264 {2}------------------------------------------------ - · Non-inflammatory degenerative joint disease including osteoarthritis and avascular necrosis; - · Inflammatory degenerative joint disease such as rheumatoid arthritis; K101263 - · Treatment of acute fractures of the humeral head that cannot be treated with other fracture fixation methods ### Predicate Devices: - Promos modular shoulder system (PlusOrthopedics, K032126, K063578); ● - Anatomical shoulder system (Centerpulse, K030259); � - Modular Shoulder System (Acumed, K992525) . ### Comparable Features to Predicate Device(s): The SMR Shoulder System is similar to the predicate devices in terms of intended use, indications, design and materials. The SMR Shoulder System and the predicates are all intended for partial or total primary shoulder joint replacement. The SMR humeral stems,are intended for cemented or uncemented use, depending on the design, as are the predicate humeral stems. The indications of all of the systems are similar with the exception that the SMR Shoulder System is not indicated for revision procedures. Like the Promos Modular and Acumed Modular Shoulder Systems, the SMR Shoulder System provides modular humeral stem and humeral body components. The Anatomical Shoulder System is designed as a one-piece humeral stem / body component. The SMR Shoulder System and the Promos Modular Shoulder System include modular adaptor tapers for adjustment of the humeral head. The Anatomical Shoulder System and the Acumed Modular Shoulder System do not include adaptor tapers. The components of the SMR Shoulder System are manufactured from the same or similar materials as the predicate devices. The SMR, Promos and Acumed humeral stems are manufactured from Ti6Al4V while the Anatomical cemented humeral stems are manufactured from cast CoCrMo. Non-Clinical Testing: The SMR Shoulder System has undergone static pull-out and/or torsional testing of all modular connections; fatigue testing to demonstrate both the strength of the humeral stem and the post-fatigue strength of the modular connections; static shear and torsional testing of the glenoid component; and fatigue testing of the glenoid component. All mechanical testing was done on worst case components or constructs. Where possible, standard test methods were used to allow comparison to testing of the predicate devices. The testing results demonstrated the device's ability to perform under expected clinical conditions. Clinical Testing: Clinical testing was not necessary to demonstrate substantial equivalence of the SMR Shoulder System to the predicate device(s). {3}------------------------------------------------ Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002 Limacorporate S.p.A. % Hastings Regulatory Consulting, LLC. Ms. Cheryl Hastings Principal Consultant P.O. Box 696 Winona Lake, Indiana 46590 JAN 2 8 2311 Re: K101263 Trade/Device Name: SMR Uncemented Shoulder System Regulation Number: 21 CFR 888.3650 Regulation Name: Shoulder joint metal/polymer non-constrained cemented prosthesis Regulatory Class: Class II Product Code: KWT, HSD Dated: January 10, 2011 Received: January 19, 2011 Dear Ms. Hastings: 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 {4}------------------------------------------------ ### Page 2 – Ms. Cheryl Hastings device-related adverse events) (21 CFR 803); good manufacturing practive 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. 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/CDRH/CDRHQffices/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/ReportalProblem/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 (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Sincerely yours, A. B. R. for- Mark N. Melkerson Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {5}------------------------------------------------ # K101263 \$\rho.i//\$ 510(k) Number (if known): Unknown Device Name: SMR Uncemented Shoulder System Indications for Use: ## SMR Uncemented Shoulder System Indications for Use The SMR Shoulder system is intended for partial or total primary shoulder joint replacement. The components are intended for use in cemented and uncemented applications, as specified in the following table: | COMPONENT | USE | | |-------------------------|----------|------------| | | Cemented | Uncemented | | Cemented stems | X | | | Cementless Finned stems | | X | | Trauma Humeral Bodies | X | X | | Finned Humeral Bodies | X | X | | Humeral Heads | X | X | | Adaptor Tapers | X | X | | Cemented Glenoids | X | | Total or hemi-shoulder replacement is indicated for patients suffering from disability due to: - · Non-inflammatory degenerative joint disease including osteoarthritis and vascular 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 Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR Over-The-Counter Use (21 CFR 801 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) for M.Meikerson Division of Surgical, Orthopedic, and Restorative Devices 510(k) Number K101263 Page 1 of 1 Traditional 510(k) - SMR Uncemented Shoulder System April 28, 2010 Company Confidential Section 4 = Page 16 of 264
Innolitics
510(k) Summary
Decision Summary
Classification Order
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