Libertas E-XLPE Modular Liner

K192989 · Maxx Orthopedics, Inc. · OQI · Oct 29, 2020 · Orthopedic

Device Facts

• Record ID: K192989
• Device Name: Libertas E-XLPE Modular Liner
• Applicant: Maxx Orthopedics, Inc.
• Product Code: OQI · Orthopedic
• Decision Date: Oct 29, 2020
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 888.3353
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The Libertas™ Hip Replacement System is intended for use in total hip arthroplasty. Total hip arthroplasty is intended to provide patient mobility and reduce pain by replacing the damaged hip joint articulation in patients where there is evidence of sufficient sound bone to fix and support the components. Total hip replacement is indicated for the following conditions: · Non-inflammatory degenerative joint diseases including osteoarthritis and avascular necrosis. · Rheumatoid arthritis. · Congenital hip dysplasia. · Acute traumatic fracture of the femoral head or neck. · Certain cases of Ankylosis. · Dislocation of the hip. · Correction of functional deformity. · Revision of failed joint reconstruction or treatment. · Treatment of nonunion, femoral neck and trochanteric fractures of the proximal femur.

Device Story

Modular hip liner component for Libertas Hip Replacement System; manufactured from Vitamin E-containing highly cross-linked polyethylene (E-XLPE). Designed for use in total hip arthroplasty to replace damaged joint articulation; provides patient mobility and pain reduction. Available in multiple sizes and variants (neutral, offset, elevated wall, oblique). Used by orthopedic surgeons in clinical/hospital settings. Integrates with previously cleared Libertas acetabular shells and femoral stems. Clinical benefit derived from improved wear characteristics of E-XLPE material. Surgeon selects appropriate liner variant based on patient anatomy and surgical requirements to restore joint function.

Clinical Evidence

Bench testing only. Mechanical performance evaluated via axial disassembly, offset pull-out, torque-out, impingement, and range of motion testing per ASTM/ISO standards. Material characterization performed per ASTM/ISO standards. Biocompatibility and extraction testing conducted.

Technological Characteristics

Modular acetabular liner; material: Vitamin E-containing highly cross-linked polyethylene (E-XLPE). Standards: ASTM F1820, F2582, F2565, F2695, F2759, F648, F2003; ISO 21535, ISO 5834-1/2/3. Variants include neutral, offset, elevated wall, and oblique configurations. Designed for use with Libertas acetabular shells.

Indications for Use

Indicated for patients requiring total hip arthroplasty due to non-inflammatory degenerative joint disease (osteoarthritis, avascular necrosis), rheumatoid arthritis, congenital hip dysplasia, acute traumatic femoral head/neck fracture, ankylosis, hip dislocation, functional deformity, failed joint reconstruction, or proximal femur nonunion/fractures.

Regulatory Classification

Identification

A hip joint metal/ceramic/polymer semi-constrained cemented or nonporous uncemented prosthesis is a device intended to be implanted to replace a hip joint. This device limits translation and rotation in one or more planes via the geometry of its articulating surfaces. It has no linkage across-the-joint. The two-part femoral component consists of a femoral stem made of alloys to be fixed in the intramedullary canal of the femur by impaction with or without use of bone cement. The proximal end of the femoral stem is tapered with a surface that ensures positive locking with the spherical ceramic (aluminium oxide, A12 03 ) head of the femoral component. The acetabular component is made of ultra-high molecular weight polyethylene or ultra-high molecular weight polyethylene reinforced with nonporous metal alloys, and used with or without bone cement.

Predicate Devices

• Libertas™ – Hip Replacement System (K180973)
• Libertas™ Acetabular Hooded Liner (K183365)

Reference Devices

• Trinity Acetabular cup System ECIMA Liners (K111481)

Submission Summary (Full Text)

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October 29, 2020

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Maxx Orthopedics, Inc. Priscilla Herpai Regulatory Manager 2460 General Armistead Ave, Suite 100 Norristown, Pennsylvania 19403

Re: K192989

Trade/Device Name: Libertas E-XLPE Modular Liner Regulation Number: 21 CFR 888.3353 Regulation Name: Hip Joint Metal/Ceramic/Polymer Semi-Constrained Cemented Or Nonporous Uncemented Prosthesis Regulatory Class: Class II Product Code: OQI, LZO, OQG Dated: September 18, 2020 Received: October 1, 2020

Dear Priscilla Herpai:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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 of medical device-related adverse events) (21 CFR 803) for

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devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely.

Vesa Vuniqi, M.S. Assistant Director DHT6A: Division of Joint Arthroplasty Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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## Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: 06/30/2020 See PRA Statement below.

510(k) Number (if known)

### K192989

Device Name Libertas™ E-XLPE Modular Liner

### Indications for Use (Describe)

The Libertas™ Hip Replacement System is intended for use in total hip arthroplasty. Total hip arthroplasty is intended to provide patient mobility and reduce pain by replacing the damaged hip joint articulation in patients where there is evidence of sufficient sound bone to fix and support the components.

Total hip replacement is indicated for the following conditions:

- · Non-inflammatory degenerative joint diseases including osteoarthritis and avascular necrosis.
- · Rheumatoid arthritis.
- · Congenital hip dysplasia.
- · Acute traumatic fracture of the femoral head or neck.
- · Certain cases of Ankylosis.
- · Dislocation of the hip.
- · Correction of functional deformity.
- · Revision of failed joint reconstruction or treatment.
- · Treatment of nonunion, femoral neck and trochanteric fractures of the proximal femur.

### Note

· The Modular Shell, Uncemented Stem and Taper Uncemented Femoral Stem are intended for press-fit, uncemented use only.

· The Cemented stem is intended for cemented use only.

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

| <span style="font-size:16px">☑</span> Prescription Use (Part 21 CFR 801 Subpart D) |
|------------------------------------------------------------------------------------|
| <span style="font-size:16px">☐</span> Over-The-Counter Use (21 CFR 801 Subpart C) |

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Image /page/3/Picture/1 description: The image is a logo for Maxx Orthopedics. The word "maxx" is in large, bold, dark blue font. Below the word "maxx" is a thin, curved, orange line. Below the orange line is the word "orthopedics" in a smaller, dark blue font.

#### 5. 510(k) SUMMARY

## 510(k) Summary

This 510(k) Summary is submitted in accordance with the requirements of 21 CFR Part 807, Section 92.

#### 5.1 Applicant:

Maxx Orthopedics Inc. 2460 General Armistead Ave Suite 100, Norristown, PA 19403 USA

#### 5.2 Maxx Contact Person:

Priscilla Herpai Regulatory Manager Maxx Orthopedics E-mail: [e-mail] Phone: [phone] x 507

#### 5.3 Alternate contact Person:

Gayathri Nair Senior Manager- Regulatory Affairs/ Quality Assurance Meril Healthcare Private Limited E mail: gayathri.nair(@merillife.com Cell: [phone]

#### Date prepared: September 20, 2019 5.4

#### ર્સ્ડ Device information:

| Proprietary Name: | Libertas ^TM E-XLPE Modular Liner |
|----------------------|----------------------------------------------------------------------------------------------------------------|
| Common / Usual Name: | Hip Joint Prosthesis |
| Classification name: | Hip joint metal/Ceramic/Polymer Semi-constrained Cemented or Nonporous Uncemented Prosthesis (21 CFR 888.3353) |
| Product Code: | OQI, LZO, OQG |
| Device Class: | Class II |

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Image /page/4/Picture/1 description: The image shows the logo for Maxx Orthopedics. The word "maxx" is in large, bold, dark blue letters. Below the word "maxx" is a thin, curved, orange line. Below the orange line is the word "orthopedics" in smaller, dark blue letters.

| Component | Equivalent<br>device<br>category | Manufacturer | Trade name | 510(k) |
|---------------------------------------------------|----------------------------------|-------------------------------|-----------------------------------------------|---------|
| Vitamin E<br>containing<br>HXLPE<br>Modular Liner | Primary<br>Predicate<br>device | Maxx Orthopedics<br>Inc., USA | Libertas™ – Hip<br>Replacement System | K180973 |
| (E-XLPE<br>Modular liner) | Predicate<br>Device | Maxx Orthopedics<br>Inc., USA | Libertas™ Acetabular<br>Hooded Liner | K183365 |
| | Reference<br>device | Corin, USA | Trinity Acetabular cup<br>System ECIMA Liners | K111481 |

#### Predicate Devices: 5.6

#### 5.7 Device Description:

This 510k is intended to add a Modular Liner made from Vitamin E containing HXLPE (E-XLPE) to the Libertas™ - Hip Replacement System and Libertas™ Acetabular Hooded Liner cleared under K180973 and K183365, respectively. These Modular Liners are designed to be used with the Libertas components already cleared under K180973. These are available in different sizes i.e. MA, MB, MD, MF, MH, MJ, MK and different variants for each size Viz, neutral offset, "+4 mm offset", "Elevated wall", "10° Oblique", "15° Oblique" and "+4 mm offset 10° Oblique".

#### 5.8 Indications for use:

The Libertas™ Hip Replacement System is intended for use in total hip arthroplasty. Total hip arthroplasty is intended to provide patient mobility and reduce pain by replacing the damaged hip joint articulation in patients where there is evidence of sufficient sound bone to fix and support the components.

Total hip replacement is indicated for the following conditions:

- · Non-inflammatory degenerative joint diseases including osteoarthritis, post traumatic arthritis and avascular necrosis.
- · Rheumatoid arthritis.
- · Congenital hip dysplasia.
- · Acute traumatic fracture of the femoral head or neck.
- · Certain cases of Ankylosis.
- · Dislocation of the hip.
- · Correction of functional deformity.

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Image /page/5/Picture/1 description: The image is a logo for Maxx Orthopedics. The word "maxx" is written in large, bold, dark blue letters. Below the word "maxx" is a thin, curved, orange line. Below the orange line, the word "orthopedics" is written in smaller, dark blue letters.

- · Revision of failed joint reconstruction or treatment.
- · Treatment of nonunion, femoral neck and trochanteric fractures of the proximal femur.

## Note:

- · The Modular Shell, Uncemented Stem and Taper Uncemented femoral stem are intended for press-fit, uncemented use only.
- The Cemented stem is intended for cemented use only. ●

#### 5.9 Comparison of technological characteristics:

The Libertas™ E-XLPE Modular Liner is substantially equivalent to the previously cleared predicate devices based on similarities in intended use, device design/technological characteristics, materials, and sterilization method.

# 5.10 Non clinical Performance data:

Non-clinical testing conducted to evaluate device function/mechanical performance and to demonstrate substantial equivalence.

- . Axial disassembly (push out) test (ASTM F1820:13)
- Offset pull out ( Lever out) test (ASTM F1820:13) ●
- . Torque out disassembly test (ASTM F1820:13)
- Impingement Test (ASTM F2582:14) .
- Range of Motion (ISO 21535-2007/Amd 1:2016)
- Material Characterization of E-XLPE (ASTM F2565:13, ASTM F2695:12, ASTM ● F2759:11, ASTM F648:14, ASTM F2003:15, ISO 5834-3:19, ISO 5834-1:19 and ISO 5834-2:19)
- Extraction Testing ●
- Biocompatibility testing ●

# 5.11 Conclusion

Based on performance testing results and similarities in intended use, device design/technological characteristics, materials, and sterilization method, the Libertas™ E-XLPE Modular Liner is considered substantially equivalent to the previously cleared predicate and reference devices.