BRAINLAB KNEE

K102990 · Brainlab AG · OLO · Apr 4, 2011 · Neurology

Device Facts

• Record ID: K102990
• Device Name: BRAINLAB KNEE
• Applicant: Brainlab AG
• Product Code: OLO · Neurology
• Decision Date: Apr 4, 2011
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 882.4560
• Device Class: Class 2

Intended Use

Brainlab knee is intended to be an intraoperative image guided localization system to enable minimally invasive surgery. It links a freehand probe, tracked by a passive marker sensor system to virtual computer image space on an individual 3D-model of the patient's bone, which is generated through acquiring multiple landmarks on the bone surface. The system is indicated for any medical condition in which the use of stereotactic surgery may be appropriate and where a reference to a rigid anatomical structure, such as the skull, a long bone, or vertebra, can be identified relative to a CT, x-ray, MR-based model of the anatomy. The system aids the surgeon to accurately navigate a knee prosthesis to the intraoperatively planned position. Ligament balancing and measurements of bone alignment are provided by Brainlab knee.

Device Story

Intraoperative image-guided surgery system for total knee replacement; utilizes freehand probe tracked by passive marker sensor system; maps physical landmarks on femur/tibia to virtual 3D bone models; enables navigation of knee prosthesis to planned positions; provides ligament balancing and bone alignment measurements. Used in OR by surgeons; integrates with Smith & Nephew Motorized Cutting Guide (MCG) for automated block positioning. Features disposable clip-on remote control for point/direction acquisition. Benefits include minimally invasive surgical guidance and improved alignment accuracy. Surgeon views real-time navigation data on display to guide instrumentation and implant placement.

Clinical Evidence

Bench testing only. Validation included comparison to established predicate history, literature research, usability testing, prototyping, simulations, design reviews, and cadaver testing. Workbench tests compared cut and implant positions to theoretical values on milled model bones.

Technological Characteristics

Image-guided stereotaxic instrument; passive marker sensor system; freehand probe; disposable clip-on remote control. Integrates with motorized cutting guides. Software-based landmark visualization and alignment calculation. Operates on released hardware platforms. Sterilization requirements for instruments apply.

Indications for Use

Indicated for patients undergoing orthopedic surgical procedures, including total knee replacement, ligament balancing, range of motion analysis, and patella tracking, where stereotactic surgery is appropriate and anatomical structures (skull, long bone, vertebra) can be referenced to CT, x-ray, or MR-based models.

Regulatory Classification

Identification

A stereotaxic instrument is a device consisting of a rigid frame with a calibrated guide mechanism for precisely positioning probes or other devices within a patient's brain, spinal cord, or other part of the nervous system.

Predicate Devices

• Brainlab knee (K073615)
• PiGalileo Total Knee Replacement (TKR) System (K061362)

Submission Summary (Full Text)

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# K102990

APR - 4 2011

## 510 (k) Summary of Safety and Effectiveness for Brainlab knee

#### Manufacturer:

Address:

BrainLAB AG Kapellenstrasse 12 85622 Feldkirchen Germany [phone] Phone: ് [phone] Fax:

Mr. Alexander Schwiersch

Contact Person:

Summary Date:

#### Device:

| Trade name: | Brainlab knee |
|-----------------------------|----------------------------------------------------------------------------------|
| Common/Classification Name: | Brainlab knee, BrainLAB Image Guided Surgery<br>System / Instrument, Stereotaxic |
| Regulation Number: | 21 CFR 852.4560 |
| Product code: | OLO |

#### Predicate Device:

Brainlab knee (K073615) PiGalileo Total Knee Replacement (TKR) System (K061362 )

Device Classification Name: Instrument, Stereotaxic Requlatory Class: Class II

#### Intended Use:

、

Brainlab knee is intended to be an intraoperative image guided localization system to enable minimally invasive surgery. It links a freehand probe, tracked by a passive marker sensor system to virtual computer image space on an individual 3D-model of the patient's bone, which is generated through acquiring multiple landmarks on the bone surface. The system is indicated for any medical condition in which the use of stereotactic surgery may be appropriate and where a reference to a rigid anatomical structure, such as the skull, a long bone, or vertebra, can be identified relative to a CT, x-ray, MR-based model of the anatomy. The system aids the surgeon to accurately navigate a knee prosthesis to the intraoperatively planned position. Ligament balancing and measurements of bone alignment are provided by Brainlab knee.

Page 1 of 2

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Example orthopedic surgical procedures include but are not limited to:

- · Total Knee Replacement
- · Ligament Balancing
- · Range of Motion Analysis
- · Patella Tracking

#### Device Description:

Brainlab knee is an image guided surgery system for total knee replacement surgery . based on landmark based visualization of the femur and tibia.

#### Substantial equivalence:

Brainlab knee has been verified and validated according to BrainLAB procedures for product design and development. The information provided by BrainLAB in this 510 (k) application was found to be substantially equivalent with the predicate device Brainlab knee (K073615) and "PiGalileo Total Knee Replacement (TKR) System (K061362)".

#### Changes to Predicate Device

Brainlab knee has changed in the following from Predicate Device:

- Compatibility to Smith&Nephew's Motorized Cutting Guide (MCG). Which . itself has FDA clearance under PiGalileo Total Knee Replacement (K061362). The MCG is brings the cutting block into the position, which is planned in the software.
- Alignment Verification Procedure. A condensed workflow, based entirely on . existing algorithms without the necessity to attach reference arrays to the bone. This procedure allows measurement of the alignment of a static cutting block with patient anatomy.
- Disposable Clip-on Remote Control. A facultative enhancement of the existing . pointer. Instead of pivoting the user can press a button on the clip to acquire points. It is also possible to acquire direction with a simple button click instead of holding the pointer still.

#### Verification/validation summary

To verify the correct functionality of the system Brainlab knee, all relevant test documentation coming from the risk analysis and specifications of each component has been compiled into one system. The system guarantees that all risks and associated tests are traceable and verify that no open risks or untested specifications occur. All inherited modules such as hardware platform, instruments, licenses etc. are taken into account.

The functionality is verified on all released platforms. BrainLAB industrial designers verified compliance of the interface to Brainlab standard. Workbench test have been

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performed on precisely milled model bones. Cut and implant positions have been compared to theoretical values.

The following validation methods were used to validate system Brainlab Knee:

- Comparison of the design to a previous product having an established history . of successful use
- Literature research and corresponding database search ●
- Testing and evaluation under real world conditions .
- Usability tests, prototyping and simulations .
- Design reviews .
- t Software Validation

Validation activities have successfully been performed according to the indications for use. The validation is supported by design reviews with many of the initial design surgeons and a cadaver test.

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Food and Drug Administration i 0903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

BrainLAB AG % Mr. Alexander Schwiersch Kapellenstrasse 12 85622 Feldkirchen. Germany

APR - 4 2511

Re: K102990

Trade/Device Name: Brainlab Knee Regulation Number: 21 CFR 882.4560 Regulation Name: Stereotaxic instrument Regulatory Class: Class II Product Code: OLO Dated: March 24, 2011 Received: March 28, 2011

Dear Mr. Schwiersch:

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

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Page 2 – Mr. Alexander Schwiersch

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 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/CDRH0ffices/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 [phone] or [phone] or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Ay B. Rh
fr

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

Enclosure

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### Indications for Use

510(k) Number (if known): |<| 02990

Device Name: Brainlab Knee

Indications For Use:

Brainlab Knee is intended to be an intraoperative image guided localization system to enable minimally invasive surgery. It links a freehand probe, tracked by a passive marker sensor system to virtual computer image space on an individual 3D-model of the patient's bone, which is generated through acquiring multiple landmarks on the bone surface. The system is indicated for any medical condition in which the use of stereotactic surgery may be appropriate and where a reference to a rigid anatomical structure, such as the skull, a long bone, or vertebra, can be identified relative to a CT, x-ray, MR-based model of the anatomy. The system aids the surgeon to accurately navigate a knee prosthesis to the intraoperatively planned position. Ligament balancing and measurements of bone alignment are provided by Brainlab Knee.

Example orthopedic surgical procedures include but are not limited to:

- · Total Knee Replacement
- · Ligament Balancing
- · Range of Motion Analysis
- · Patella Tracking

Prescription Use X (Per 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)

NeK.R.P.de/m for mxm
(Division Sign-Off)

Division of Surgical, Orthopedic, and Restorative Devices

. 510(k) Number K102990