PROFEMUR Z REVISION HIP STEM

K122778 · Wrightmedicaltechnologyinc · KWA · Oct 11, 2012 · Orthopedic

Device Facts

• Record ID: K122778
• Device Name: PROFEMUR Z REVISION HIP STEM
• Applicant: Wrightmedicaltechnologyinc
• Product Code: KWA · Orthopedic
• Decision Date: Oct 11, 2012
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 888.3330
• Device Class: Class 3
• Attributes: Therapeutic

Intended Use

Wright Medical total hip systems are indicated for use in total hip arthroplasty for reduction or relief of pain and/or improved hip function in skeletally mature patients. non-inflammatory degenerative joint disease such as osteoarthritis, avascular necrosis, 1. ankylosis, protrusio acetabuli, and painful hip dysplasia; inflammatory degenerative joint disease such as rheumatoid arthritis; 2. correction of functional deformity; and, 3. revision procedures where other treatments or devices have failed ধ: Rough grit blast surfaces are intended for uncemented arthroplasty. The PROFEMUR® Z Revision Hip Stem is intended for cementless hip arthroplasty.

Device Story

PROFEMUR® Z Revision Hip Stem is a modular, cementless hip prosthesis used in total hip arthroplasty. Device consists of titanium alloy stems with heavy grit-blasted surfaces, available in 9 sizes. Intended for surgical implantation by orthopedic surgeons in clinical settings to replace diseased or damaged hip joints. Device functions as a structural implant to restore hip function and reduce pain. Design features include proximal geometries consistent with predicate devices and extended distal stem lengths. Safety and effectiveness established through mechanical fatigue testing per ISO 7206-4, -6, and -8 standards. No clinical data provided.

Clinical Evidence

No clinical data provided. Safety and effectiveness supported by bench testing (distal and proximal fatigue evaluation per ISO 7206-4, -6, and -8).

Technological Characteristics

Cementless modular hip stem; titanium alloy construction; heavy grit-blasted surface finish; 9 available sizes (3-11); distal and proximal fatigue testing per ISO 7206-4, -6, and -8.

Indications for Use

Indicated for skeletally mature patients requiring total hip arthroplasty for non-inflammatory degenerative joint disease (osteoarthritis, avascular necrosis, ankylosis, protrusio acetabuli, painful hip dysplasia), inflammatory degenerative joint disease (rheumatoid arthritis), functional deformity correction, or revision procedures following failed prior treatments.

Regulatory Classification

Identification

A hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis is a two-part device intended to be implanted to replace a hip 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 includes prostheses that consist of a femoral and an acetabular component, both made of alloys, such as cobalt-chromium-molybdenum. The femoral component is intended to be fixed with bone cement. The acetabular component is intended for use without bone cement (§ 888.3027).

Predicate Devices

• STEM Hip Replacement System (K021346)
• PRESERVE HIP STEM (K112080)
• PROFEMUR Z Revision Hip Stem (K121221)

Submission Summary (Full Text)

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K122778 (pg. 1 of 2)

OCT 11 2012

# 510(K) Summary of Safety and Effectiveness

In accordance with the Food and Drug Administration Rule to implement provisions of the Safe Medical Devices Act of 1990 and in conformance with 21 CFR 807, this information serves as a Summary of Safety and Effectiveness for the use of the PROFEMUR® Z Revision Hip Stem .

Submitted By:

Date:

Contact Person:

Proprietary Name:

Common Name:

Classification Name and Reference:

Wright Medical Technology, Inc. 5677 Airline Rd, Arlington TN, 38002 [phone]

August 27, 2012

Dean Nachtrab Regulatory Affairs Specialist

PROFEMUR® Z Revision Hip Stem

Hip Stem

888.3330 KWA Hip joint metal/metal semiconstrained, with an uncemented acetabular component prosthesis Class III

888.3320 JDL Hip joint metal/metal semiconstrained, with a cemented acetabular component, prosthesis Class III

Subject Product Code and Panel Code:

Predicate Devices:

Orthopedics/87/ KWA, JDL

STEM Hip Replacement System 510(k)s: K021346

PRESERVE HIP STEM 510(K): K112080

PROFEMUR Z Revision Hip Stem 510(K): K121221

#### DEVICE INFORMATION

#### A. Intended Use

Wright Medical total hip systems are indicated for use in total hip arthroplasty for reduction or relief of pain and/or improved hip function in skeletally mature patients.

Indications for Use

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K12 2778 (pg. 2 of 2)

- non-inflammatory degenerative joint disease such as osteoarthritis, avascular necrosis, 1. ankylosis, protrusio acetabuli, and painful hip dysplasia;
- inflammatory degenerative joint disease such as rheumatoid arthritis; 2.
- correction of functional deformity; and, 3.
- revision procedures where other treatments or devices have failed ধ:

Rough grit blast surfaces are intended for uncemented arthroplasty. The PROFEMUR® Z Revision Hip Stem is intended for cementless hip arthroplasty.

## B. Device Description

Design features of the subject stems are summarized below:

- . Cementless modular stems
- Available in 9 sizes ●
- Manufactured from Titanium alloy with a heavy grit blasted surface .

The subject device is available in 9 sizes (from size 3 to 11). Although the proximal geometries are identical to the predicate from size 3-9, the distal stem length has increased, with two larger sizes (10 and 11) introduced.

## C. Nonclinical Testing

The PROFEMUR® Z Revision Hip Stems have been tested in distal and proximal fatigue evaluation per the loading regimen prescribed by ISO 7206-4, -6 and -8.

#### D. Clinical Testing

Clinical data was not provided for the class III hip stem.

## E. Conclusions

The indications for use of the PROFEMUR® Z Revision Hip Stems are identical to the previously cleared predicate devices. The design features and materials of the subject devices are substantially equivalent to those of the predicate devices. The fundamental scientific technology of the modified devices has not changed relative to the predicate devices. The safety and effectiveness of the PROFEMUR® Z Revision Hip Stem is adequately supported by the substantial equivalence information, materials information, and analysis data provided within this Premarket Notification.

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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 circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" around the perimeter. Inside the circle is a stylized image of an eagle with its wings outstretched.

#### Public Health Service

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

OCT 1 1 1 2012

Wright Medical Technology, Incorporated
% Mr. Dean Nachtrab
Regulatory Affairs Specialist
5677 Airline Road
Arlington, Tennessee 38002

Re: K122778

Trade/Device Name: PROFEMUR® Z Revision Hip Stem Regulation Number: 21 CFR 888.3330 Regulation Name: Hip joint metal/metal semi-constrained, with an uncemented acetabular component, prosthesis Regulatory Class: Class III Product Code: KWA, JDL Dated: August 29, 2012 Received: September 11, 2012

Dear Mr. Nachtrab:

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

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# Page 2 - Mr. Dean Nachtrab

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/CDRH/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/Resourcesfor You/Industry/default.htm.

Sincerely yours.

Eric Keith

⁄ 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): K122778

Device Name: PROFEMUR® Z Revision Hip Stem

Indications For Use:

- non-inflammatory degenerative joint disease such as osteoarthritis, avascular 1. necrosis, ankylosis, protrusio acetabuli, and painful hip dysplasia;
- inflammatory degenerative joint disease such as rheumatoid arthritis; 2.
- correction of functional deformity; and, ന്
- revision procedures where other treatments or devices have failed. 4.

Rough grit blast surfaces are intended for uncemented arthroplasty. The PROFEMUR® Z Revision Hip Stem is intended for cementless hip arthroplasty.

Prescription Use _ × (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)

Peter G. Allen

(Division Sign-C Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K122778