Advanced destruction of the shoulder joint resulting from: Omarthrosis. Rheumatoid arthritis Post-traumatic arthritis Avascular necrosis of the humeral head . Cuff-tear arthropathy (BF heads with heights of 27mm or greater) . Conditions following earlier operations (including revision shoulder arthroplasty). . The Anatomical Shoulder Combined System is intended for cemented or cementless use. When used with the following humeral stems the Anatomical Shoulder Combined System is intended for cemented use: Anatomical Shoulder Standard Cemented Humeral Stem. Anatomical Shoulder Revision Stem. When used with the following humeral stem the Anatomical Shoulder Combined System is intended for cementless use: Anatomical Shoulder Standard Uncemented Stem. When used with the following humeral stems the Anatomical Shoulder Combined System is intended for cemented or cementless use: Anatomical Shoulder Fracture Stem. Anatomical Shoulder Fracture Long Stem. When used with the following glenoids the Anatomical Shoulder Combined System is intended for cemented use: Bigliani/Flatow Glenoid (pegged and keeled). Trabecular Metal Glenoid.
Device Story
Anatomical Shoulder Combined System is a modular shoulder prosthesis designed for total or hemi-shoulder arthroplasty. System components include humeral stems (cemented/uncemented), Bigliani/Flatow (B/F) humeral heads, B/F glenoids, Trabecular Metal glenoids, and a new AS B/F Adaptor. The adaptor serves as an interface, featuring two taper geometries: one connecting to Anatomical Shoulder humeral stems and the other to B/F humeral heads. This allows surgeons to combine components from the Anatomical Shoulder and Bigliani/Flatow systems. The device is implanted by orthopedic surgeons in a clinical/hospital setting. By restoring joint articulation, the system aims to alleviate pain and improve function in patients with advanced shoulder joint destruction. The adaptor's taper interfaces are designed to match the geometry of predicate components, ensuring secure assembly.
Clinical Evidence
No clinical data provided. Substantial equivalence is supported by non-clinical bench testing, including evaluation of loading conditions, fatigue analysis, fretting corrosion, and assembly strength tests.
Technological Characteristics
Modular shoulder prosthesis. Materials: Protasul-1 (Co-Cr-Mo), Protasul-100 (titanium alloy), Zimaloy (Co-Cr-Mo), UHMWPE, and Trabecular Metal. Features dual-taper adaptor for component compatibility. Cemented or cementless fixation. Mechanical assembly via taper interfaces.
Indications for Use
Indicated for patients with advanced shoulder joint destruction due to omarthrosis, rheumatoid arthritis, post-traumatic arthritis, avascular necrosis of the humeral head, cuff-tear arthropathy (for head heights ≥27mm), or conditions following prior surgery/revision arthroplasty.
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.”
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K103404 (1/4)
Image /page/0/Picture/1 description: The image shows the logo for Zimmer. The logo consists of a large, bold letter 'Z' inside of a circle. Below the circle is the word 'zimmer' in lowercase letters.
·
| Summary of Safety and Effectiveness | MAR 15 2011 |
|-------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Sponsor: | Zimmer GmbH<br>SulzerAllee 8<br>CH-8404 Winterthur, Switzerland |
| Contact Person: | Jason Heckaman<br>Associate Manager, Regulatory Affairs<br>Telephone: (574) 371-8675<br>Fax: (574) 372-4605 |
| Date: | February 25, 2011 |
| Trade Name: | Anatomical Shoulder™ Combined System |
| Product Code / Device: | KWT - Prosthesis, Shoulder, Non-constrained,<br>Metal/Polymer Cemented<br>KWS - Prosthesis, Shoulder, Semi-constrained,<br>Metal/Polymer Cemented<br>HSD - Prosthesis, Shoulder, Hemi-, Humeral,<br>Metallic Uncemented |
| Regulation Number / Description: | 21 CFR § 888.3650 - Shoulder joint metal/polymer<br>non-constrained cemented prosthesis.<br>21 CFR § 888.3660 - Shoulder joint metal/polymer<br>semi-constrained cemented prosthesis<br>21 CFR § 888.3690 - Shoulder joint humeral (hemi-<br>shoulder) metallic uncemented prosthesis. |
| Predicate Device: | Anatomical Shoulder with Removable Head,<br>manufactured by Zimmer GmbH, K030259, cleared<br>04/24/2003<br>Anatomical Shoulder Fracture System,<br>manufactured by Zimmer GmbH, K062029, cleared<br>October 31, 2006)<br>Bigliani/Flatow® The Complete Shoulder System,<br>manufactured by Zimmer, Inc., K982981, cleared<br>12/17/1998; Trabecular Metal Glenoid,<br>manufactured by Zimmer TMT, K022377, cleared<br>12/10/2002 |
--
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### Device Description:
The Anatomical Shoulder (AS) Combined System consists of the following:
- AS Humeral Stem (cemented or . uncemented)
- AS Fracture Humeral Stem �
- Bigliani/Flatow Head .
- Bigliani/Flatow Gleniod .
- Trabecular Metal (TM) Glenoid .
- AS Bigliani/Flatow (AS B/F) Adaptor .
The AS B/F Adaptor is a new product designed to be used with the humeral stems of the Anatomical Shoulder System and Anatomical Shoulder Fracture System and with any humeral head of the Bigliani/Flatow (BF) System in a conventional hemi or total shoulder arthroplasty procedure. The B/F humeral heads are used with existing UHMWPE B/F glenoids and TM glenoids manufactured from Trabecular Metal and UHMWPE. AS cemented humeral stems are manufactured from Protasul -1 (Co-Cr-Mo); the uncemented and fracture stems from Protasul-100 (titanium alloy). The B/F heads are manufactured from Zimaloy® (Co-Cr-Mo). Collectively, these components are identified as the Anatomical Shoulder Combined System.
The Adaptor features two taper interfaces, one connecting to the Anatomical Shoulder humeral stems and the other connecting to the Bigliani/Flatow humeral heads. The proximal taper of the adaptor (connecting to the Bigliani/Flatow heads) is identical to the male taper geometry from the predicate Bigliani/Flatow humeral stems. The distal taper of the adaptor (connecting to the Anatomical Shoulder humeral stem) is a male oval taper, identical to the oval taper of the predicate Anatomical Shoulder Ball-Taper component. Both the AS B/F Adaptor and the predicate AS Ball-Taper component are manufactured from Protasul-100, a forged titanium alloy.
Advanced destruction of the shoulder joint resulting from:
- Omarthrosis. ●
- Rheumatoid arthritis .
Intended Use:
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- Post-traumatic arthritis
- Avascular necrosis of the humeral head .
- Cuff-tear arthropathy (BF heads with heights of . 27mm or greater)
- Conditions following earlier operations . (including revision shoulder arthroplasty).
The Anatomical Shoulder Combined System is intended for cemented or cementless use. When used with the following humeral stems the Anatomical Shoulder Combined System is intended for cemented use:
- Anatomical Shoulder Standard Cemented t Humeral Stem.
- Anatomical Shoulder Revision Stem. .
When used with the following humeral stem the Anatomical Shoulder Combined System is intended for cementless use:
- Anatomical Shoulder Standard Uncemented . Stem.
When used with the following humeral stems the Anatomical Shoulder Combined System is intended for cemented or cementless use:
- Anatomical Shoulder Fracture Stem. .
- Anatomical Shoulder Fracture Long Stem. .
When used with the following glenoids the Anatomical Shoulder Combined System is intended for cemented use:
- Bigliani/Flatow Glenoid (pegged and keeled). .
- Trabecular Metal Glenoid. .
Comparison to Predicate Device:
The proposed Anatomical Shoulder Combined System consists of some of the same devices as the referenced predicates, including: Anatomical Shoulder humeral stems, Bigliani/Flatow humeral heads and glenoids, and the Trabecular Metal glenoid. Additionally, the new AS B/F component has identical proximal taper geometry to that of the predicate Bigliani/Flatow humeral stem and identical distal taper geometry to that of the predicate Anatomical Shoulder Ball-Taper component. Collectively, the proposed system has the same intended use, has similar performance
{3}------------------------------------------------
characteristics, is manufactured from similar materials using similar processes, and is similar in design to the predicate devices.
Performance Data (Nonclinical and/or Clinical):
Non-Clinical Performance and Conclusions: The results of non-clinical (lab) performance testing and/or analyses demonstrate that the devices are safe and effective and substantially equivalent to the predicate devices. Performance testing and/or analyses included: Evaluation of Loading Conditions, Fatigue Analysis, Fretting Corrosion, Assembly Strength Test.
Clinical Performance and Conclusions: Clinical data and conclusions were not needed for this device.
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Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services USA. The seal features a stylized eagle with three lines representing its wings, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" encircles the eagle. The text is arranged in a circular fashion around the eagle symbol.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
Zimmer GmbH % Zimmer. Inc. Mr. Jason Heckaman P.O Box 708 Warsaw, Indiana 46581-0708
MAR 1 5 2011
Re: K103404
Trade/Device Name: Anatomical Shoulder™ Combined System Regulation Number: 21 CFR 888.3660 Regulation Name: Shoulder joint metal/polymer semi-constrained cemented prosthesis Regulatory Class: II Product Code: KWT, KWS, HSD Dated: February 25, 2011 Received: February 28, 2011
Dear Mr. Heckaman:
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. 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
{5}------------------------------------------------
Page 2 - Mr. Jason Heckaman
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/CDRHOffices/ucm117800.html 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" (21)FP, 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/ResourcesforYou/Industry/default.htm.
Sincerely yours,
Aty B. R.h
for
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): K103404
#### Device Name:
Anatomical Shoulder™ Combined System
#### Indications for Use:
Advanced destruction of the shoulder joint resulting from:
- Omarthrosis. ◆
- Rheumatoid arthritis �
- Post-traumatic arthritis ●
- Avascular necrosis of the humeral head .
- Cuff-tear arthropathy (BF heads with heights of 27mm or greater) .
- Conditions following earlier operations (including revision shoulder arthroplasty). .
The Anatomical Shoulder Combined System is intended for cemented or cementless use. When used with the following humeral stems the Anatomical Shoulder Combined System is intended for cemented use:
- Anatomical Shoulder Standard Cemented Humeral Stem. .
- Anatomical Shoulder Revision Stem. t
When used with the following humeral stem the Anatomical Shoulder Combined System is intended for cementless use:
- Anatomical Shoulder Standard Uncemented Stem. ●
When used with the following humeral stems the Anatomical Shoulder Combined System is intended for cemented or cementless use:
- . Anatomical Shoulder Fracture Stem.
- Anatomical Shoulder Fracture Long Stem. ●
When used with the following glenoids the Anatomical Shoulder Combined System is intended for cemented use:
- # Bigliani/Flatow Glenoid (pegged and keeled).
- Trabecular Metal Glenoid. .
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)
M. Melkerson
(Division Sign-off)
Page 1 of 1
(División Sign-pn.
Division of Surgical, Orthopedic,
and Restorative Devices
Page 1 of 1
510(k) Number
い
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.
