Exactech Equinoxe Reverse Shoulder 46x21mm Glenosphere

K150458 · Exactech, Inc. · PHX · May 14, 2015 · Orthopedic

Device Facts

• Record ID: K150458
• Device Name: Exactech Equinoxe Reverse Shoulder 46x21mm Glenosphere
• Applicant: Exactech, Inc.
• Product Code: PHX · Orthopedic
• Decision Date: May 14, 2015
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 888.3660
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Equinoxe Reverse Shoulder System is indicated for use in skeletally mature individuals with degenerative diseases of the glenohumeral joint and a grossly deficient, irreparable rotator cuff. The Equinoxe Reverse Shoulder is also indicated for a failed glenohumeral joint replacement with loss of rotator cuff function resulting in superior migration of the humeral head.

Device Story

The Exactech Equinoxe Reverse Shoulder 46x21mm Glenosphere is a prosthetic component for reverse shoulder arthroplasty. It serves as a dimensional modification to the predicate 46x25mm glenosphere, featuring a reduced lateral offset of 21mm (4mm shorter). The device is intended for surgical implantation by orthopedic surgeons to restore joint function in patients with severe rotator cuff deficiency or failed previous replacements. It functions as a semi-constrained cemented prosthesis, replacing the natural glenohumeral joint surface to improve stability and range of motion. The device provides surgeons with an additional sizing option to better accommodate patient-specific anatomy.

Clinical Evidence

No clinical data. Substantial equivalence is supported by bench testing, including glenoid loosening and cyclic fatigue testing, deltoid abductor moment arm analysis, and range of motion analysis.

Technological Characteristics

Shoulder joint metal/polymer semi-constrained cemented prosthesis. Dimensional modification: 46x21mm glenosphere with 21mm lateral offset. Class II device (21 CFR 888.3660).

Indications for Use

Indicated for skeletally mature individuals with degenerative glenohumeral joint disease and irreparable rotator cuff deficiency, or failed prior glenohumeral joint replacement with rotator cuff loss and superior humeral head migration.

Regulatory Classification

Identification

A shoulder joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace a shoulder 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 have a humeral resurfacing 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 “Specification for Titanium-6 Aluminum-4 Vanadium Alloy Castings for Surgical Implants,” (vi) F 1147-95 “Test Method for Tension Testing of Porous Metal,” (vii) F 1378-97 “Standard Specification for Shoulder Prosthesis,” and (viii) F 1537-94 “Specification for Wrought Cobalt-28 Chromium-6 Molybdenum Alloy for Surgical Implants.”

Predicate Devices

• Equinoxe Reverse Shoulder System (K063569)

Submission Summary (Full Text)

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

May 14, 2015

Exactech, Incorporated Mr. Thomas McNamara Regulatory Affairs Specialist 2320 North West 66th Court Gainesville, Florida 32653

Re: K150458

Trade/Device Name: Exactech® Equinoxe® Reverse Shoulder 46x21mm Glenosphere Regulation Number: 21 CFR 888.3660 Regulation Name: Shoulder joint metal/polymer semi-constrained cemented prosthesis Regulatory Class: Class II Product Code: PHX Dated: April 14, 2015 Received: April 16, 2015

Dear Mr. McNamara:

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

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Page 2 - Mr. Thomas McNamara

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 contact the Division of Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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 Industry and Consumer Education at its toll-free number [phone] or [phone] or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

# Mark N. Melkerson -S

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

Enclosure

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#### DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

# Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

510(k) Number (if known) K150458

#### Device Name

Exactech® Equinoxe® Reverse Shoulder 46x21mm Glenosphere

Indications for Use (Describe)

The Equinoxe Reverse Shoulder System is indicated for use in skeletally mature individuals with degenerative diseases of the glenohumeral joint and a grossly deficient, irreparable rotator cuff. The Equinoxe Reverse Shoulder is also indicated for a failed glenohumeral joint replacement with loss of rotator cuff function resulting in superior migration of the humeral head.

Type of Use (Select one or both, as applicable)

| <div> <span> <b> ☑ Prescription Use (Part 21 CFR 801 Subpart D) </b> </span> </div> |
|---------------------------------------------------------------------------------------------------------------------------------|
| <div> <span> ☐ Over-The-Counter Use (21 CFR 801 Subpart C) </span> </div> |

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| Sponsor: | Exactech®, Inc<br>2320 NW 66th Court<br>Gainesville FL, 32653<br><br>Phone: [phone]<br>Fax: [phone] |
|--------------------------|-------------------------------------------------------------------------------------------------------------------|
| FDA Establishment Number | 1038671 |
| Date: | April 14, 2015 |
| Contact Person: | Thomas McNamara<br>Regulatory Affairs Specialist<br>Telephone: [phone]<br>Fax: [phone] |
| Proprietary Name: | Exactech® Equinoxe® Reverse Shoulder 46x21mm<br>Glenosphere |
| Common Name: | Reverse Shoulder Arthroplasty |

# Classification Name:

Shoulder Prosthesis, Reverse Configuration (21 CFR Section 888.3660, Class II, Product Code PHX).

#### Legally Marketed Device to Which Substantial Equivalence Is Claimed:

| Name | Manufacturer | 510(k) Number |
|----------------------------------|---------------|---------------|
| Equinoxe Reverse Shoulder System | Exactech, Inc | K063569 |

### Indication for Use:

The Equinoxe Reverse Shoulder System is indicated for use in skeletally mature individuals with degenerative diseases of the glenohumeral joint and a grossly deficient. irreparable rotator cuff. The Equinoxe Reverse Shoulder is also indicated for a failed glenohumeral joint replacement with loss of rotator cuff function resulting in superior migration of the humeral head.

### Device Description

The proposed Exactech Equinoxe Reverse Shoulder 46x21mm Glenosphere represents a modification of the predicate Exactech Equinoxe Reverse Shoulder 46x25mm Glenosphere cleared in K063569. Both the predicate and proposed devices have the same intended use, general design features and basic fundamental scientific technology. The only difference between the predicate and the proposed device are the following dimensional modifications:

- 1. Reduced Lateral Offset The proposed glenosphere has a lateral offset of 21mm, which is 4mm shorter than the predicate 46x25mm glenosphere.

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These modifications are proposed to provide another glenosphere option to the existing glenospheres cleared in K063569.

# Testing:

The following engineering analyses were conducted to demonstrate substantial equivalence of the proposed Exactech Equinoxe Reverse Shoulder 46x21mm Glenosphere to the predicate Exactech Equinoxe Reverse Shoulder Glenospheres:

- Glenoid Loosening and Cyclic Fatigue Testing ●
- Analysis Of Deltoid Abductor Moment Arms ●
- Range of Motion Analysis

### Substantial Equivalence Conclusion:

Results of engineering studies referenced in this 510(k) submission demonstrate the proposed Exactech Equinoxe Reverse Shoulder 46x21mm Glenosphere are substantially equivalent to the cleared Exactech Equinoxe Reverse Shoulder 46x25mm Glenosphere.