TSolution One Total Knee Application

K193135 · THINK Surgical, Inc. · OLO · Dec 11, 2019 · Neurology

Device Facts

Record IDK193135
Device NameTSolution One Total Knee Application
ApplicantTHINK Surgical, Inc.
Product CodeOLO · Neurology
Decision DateDec 11, 2019
DecisionSESE
Submission TypeSpecial
Regulation21 CFR 882.4560
Device ClassClass 2
AttributesTherapeutic

Intended Use

The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan. The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA). The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made. The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes.

Device Story

TSolution One is a robotic surgical system for primary total knee arthroplasty (TKA). It comprises TPLAN (preoperative planning workstation) and TCAT (robotic surgical tool). Input: patient CT scans. Process: TPLAN creates 3D bone models; surgeon plans implant position/orientation; TCAT implements the plan via an electromechanical arm. Operation: surgeon-directed; uses pinless point-to-surface registration with mechanical tracking; includes bone motion recovery markers. Output: precise bone resection and implant positioning. Used in surgical settings; operated by surgeons. Benefits: provides submillimeter precision for bone preparation; serves as an alternative to manual planning/resecting techniques. Compatible with specific knee implant systems (Zimmer Persona, Corin Unity, Aesculap Columbus, DJO Surgical EMPOWR 3D).

Clinical Evidence

No clinical data. Evidence consists of bench testing (cutting accuracy verification) and simulated surgical validation testing using a cadaver model. All testing met pre-defined acceptance criteria.

Technological Characteristics

System includes TPLAN workstation and TCAT electromechanical arm. Uses CT imaging for 3D modeling. Features include pinless point-to-surface registration, mechanical tracking, and bone motion recovery markers. User controls include keyboard, mouse, and pendant with mechanically latched stop button. Software-driven robotic arm implements pre-surgical plans. Compatible with specific knee implant systems.

Indications for Use

Indicated for patients undergoing primary total knee arthroplasty (TKA) where resecting techniques for the distal femur and proximal tibia are safe and effective and rigid anatomical references are available.

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

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ December 11, 2019 Image /page/0/Picture/1 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA acronym with the full name of the agency on the right. The FDA part of the logo is in blue, with the acronym in a square and the full name written out to the right of the square. Think Surgical, Inc. Meliha Mulalic Director, Regulatory Affairs and Quality Assurance 47201 Lakeview Blvd Fremont, California 94538 Re: K193135 Trade/Device Name: TSolution One Total Knee Application Regulation Number: 21 CFR 882.4560 Regulation Name: Stereotaxic Instrument Regulatory Class: Class II Product Code: OLO Dated: November 11, 2019 Received: November 12, 2019 Dear Meliha Mulalic: 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 {1}------------------------------------------------ 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 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 (OS) 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 (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100). Sincerely, Shumaya Ali, M.P.H. Assistant Director DHT6C: Division of Restorative, Repair and Trauma Devices OHT6: Office of Orthopedic Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ # Indications for Use 510(k) Number (if known) K193135 Device Name TSolution One® Total Knee Application #### Indications for Use (Describe) The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan. The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA). The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made. The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes. The TSolution One® Total Knee Application is compatible with the following Knee Implant Systems: - · Zimmer Persona™ Knee System - · Corin Unity Knee System - Aesculap Columbus Knee System - · DJO Surgical® EMPOWR 3D Knee® System Type of Use (Select one or both, as applicable) | <div> <input checked="true" type="checkbox"/> Prescription Use (Part 21 CFR 801 Subpart D) </div> | |------------------------------------------------------------------------------------------------------| | <div> <input type="checkbox"/> Over-The-Counter Use (21 CFR 801 Subpart C) </div> | #### CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. #### *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.* The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." {3}------------------------------------------------ Image /page/3/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in a bold, sans-serif font, with a blue triangle replacing the "I". Below the word "THINK" is the word "SURGICAL" in a smaller, sans-serif font. The logo is simple and modern, and the blue triangle adds a touch of color and visual interest. ## SECTION 6 K193135 # 510(k) SUMMARY ## Applicant Information: | Owner Name: | THINK Surgical, Inc. | |------------------------------------|-----------------------------------------| | Address: | 47201 Lakeview Blvd., Fremont, CA 94538 | | Phone number: | 510-249-2337 | | Fax number: | 510-249-2396 | | Establishment Registration Number: | 3000719653 | | Contact Person: | Meliha Mulalic | | Date Prepared: | 11 November 2019 | ### Device Information: | Device Classification: | Class II | |------------------------|---------------------------------------| | Trade Name: | TSolution® One Total Knee Application | | Common name: | Orthopedic Stereotaxic Instrument | | Classification name: | Stereotaxic Instrument | | Regulation number: | 882.4560 | | Product Code: | OLO | #### Predicate Device: The TSolution® One Total Knee Application is substantially equivalent in intended use, fundamental scientific technology and performance to TSolution One® Total Knee Application cleared via K191369. #### Device Modification: The following changes have been made to the TSolution® One Total Knee Application: - Compatible implants Addition of the Corin Unity Knee System, Aesculap . Columbus Knee System and DJO Surgical® EMPOWR 3D Knee® System. - . Labeling - Implant compatibility has been modified in the Indications for Use. ## Device Description: The TSolution One® Total Knee Application is a three-dimensional, graphical, preoperative planning workstation and implementation tool for treatment of patients who require total joint arthroplasty. The device is intended as an alternative to manual template planning and preparation of the bone with patients requiring primary total knee arthroplasty (TKA). Page 1 of 4. {4}------------------------------------------------ Image /page/4/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in bold, sans-serif font, with a blue triangle replacing the "I". Below the word "THINK" is the word "SURGICAL" in a smaller, sans-serif font. The logo is simple and modern, and the blue triangle adds a touch of color and visual interest. ## TSolution One® Total Knee Application Special 510(k) Submission The TSolution One® Total Knee Application consists of TPLAN and TCAT. TPLAN is a three-dimensional (3D) preoperative planning workstation that aids a surgeon in planning the position and orientation of the implant components relative to 3D models of the patient's anatomy. TCAT consists of an electromechanical arm, an arm base including control electronics and computer, a display monitor, operating software, pendant control, and tools and accessories, for the implementation of the preoperative plan. TCAT and TPLAN when used according to the instructions for use, make submillimeter precision bone preparation possible before and during TKA surgical procedures. ### Intended Use / Indications for Use: The TSolution One® Total Knee Application is intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with preoperative planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan. The preoperative planning software and robotic surgical tool are used as an alternative to manual planning and resecting techniques for the distal femur and proximal tibia preparation in primary total knee arthroplasty (TKA). The TSolution One® Total Knee Application is indicated for orthopedic procedures in which resecting techniques used for the distal femur and proximal tibia may be considered to be safe and effective and where references to rigid anatomical structures may be made. The TSolution One® Total Knee Application is also intended to assist the surgeon in determining reference alignment axes in relation to anatomical and instrumentation structures during stereotactic orthopedic surgical procedures. The TSolution One® Total Knee Application facilitates accurate positioning of TKA implants, relative to these alignment axes. The TSolution One® Total Knee Application is compatible with the following Knee Implant Systems: - Zimmer Persona™ Knee System - Corin Unity Knee System ● - Aesculap Columbus Knee System . - DJO Surgical® EMPOWR 3D Knee® System . #### Substantial Equivalence: Both the TSolution One® Total Knee Application, and the predicate device have the same intended use. Both are intended for use as a device that uses diagnostic images of the patient acquired specifically to assist the physician with presurgical planning and to provide orientation and reference information during intraoperative procedures. The robotic surgical tool, under the direction of the surgeon, precisely implements the presurgical software plan. The difference between the new device and the predicate is that the new device provides additional compatible total knee implant systems to those previously cleared. {5}------------------------------------------------ Image /page/5/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in large, bold, gray letters, with a blue triangle in place of the "I". Below the word "THINK" is the word "SURGICAL" in smaller, gray letters. The indications for use of the new device adds three new total knee implant systems that are compatible with the TSolution One® Total Knee Application. Performance testing to verify the cutting accuracy of the subject device was conducted following similar test methods and acceptance criteria to those used for the predicate device. This testing demonstrated that the TSolution One® Total Knee Application met all test criteria and specifications. Validation testing, with methods and acceptance criteria similar to that used for the predicate device, was conducted using simulated surgical testing in a cadaver model and all test criteria were met. Substantial equivalence in technological characteristic and performance of the TSolution One® Total Knee Application to the predicate device is outlined in the table below: | Product | TSolution One Total Knee<br>Application | TSolution One Total Knee<br>Application | Conclusion | |------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------| | 510(k) number | Subject Device | K191369 | | | Manufacturer | THINK Surgical Inc | THINK Surgical Inc | SAME | | Technological<br>Characteristics | | | | | -Patient Imaging | CT Scan | CT Scan | SAME | | -User Controls | Keyboard, mouse, Pendant<br>with mechanically latched<br>Stop Button | Keyboard, mouse, Pendant<br>with mechanically latched<br>Stop Button | SAME | | -Preoperative<br>planning<br>workstation | TPLAN three-dimensional<br>preoperative planning<br>workstation | TPLAN three-dimensional<br>preoperative planning<br>workstation | SAME | | -Pre-surgical Plan | CT images used to create<br>a 3D model of the bone,<br>library of FDA cleared<br>components used to<br>develop optimal implant<br>size and location | CT images used to create a<br>3D model of the bone,<br>library of FDA cleared<br>components used to<br>develop optimal implant<br>size and location | SAME | | -Surgical Plan<br>Data | High level operative plan<br>based on preoperative plan<br>with predetermined control<br>file developed to control the<br>robotic arm. | High level operative plan<br>based on preoperative plan<br>with predetermined control<br>file developed to control the<br>robotic arm. | SAME | | -Surgical<br>Exposure | Similar to traditional<br>surgical exposure for the<br>anatomic site | Similar to traditional<br>surgical exposure for the<br>anatomic site | SAME | | Electromechanical<br>arm to implement<br>pre-surgical plan | TCAT electromechanical<br>arm system implements<br>pre-surgical plan | TCAT electromechanical<br>arm system implements<br>pre-surgical plan | SAME | | -Patient/Robot<br>Registration | Pinless point to surface<br>registration with<br>mechanical tracking.<br>Percutaneous probe thin<br>enough to make contact via<br>direct puncture through<br>skin | Pinless point to surface<br>registration with<br>mechanical tracking.<br>Percutaneous probe thin<br>enough to make contact via<br>direct puncture through<br>skin | SAME | {6}------------------------------------------------ Image /page/6/Picture/0 description: The image shows the logo for Think Surgical. The logo consists of the word "THINK" in bold, sans-serif font, with the "I" replaced by a blue, elongated triangle pointing downwards. Below the word "THINK" is the word "SURGICAL" in a smaller, sans-serif font. ## TSolution One® Total Knee Application Special 510(k) Submission | Product | TSolution One Total Knee<br>Application | TSolution One Total Knee<br>Application | Conclusion | |------------------------------------|-----------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------|------------| | 510(k) number | Subject Device | K191369 | | | Manufacturer | THINK Surgical Inc | THINK Surgical Inc | | | -Bone Motion<br>Recovery | Two bone motion recovery<br>markers are used to<br>recover registration after<br>bone motion. | Two bone motion recovery<br>markers are used to<br>recover registration after<br>bone motion. | SAME | | Performance<br>Testing | | | | | -Cutting Accuracy<br>Verification | Passed | Passed | SAME | | -Cadaver Lab<br>Validation Testing | Passed | Passed | SAME | | -Software Testing | Passed | Passed | SAME | ### Conclusion The TSolution One® Total Knee Application is equivalent to the predicate, TSolution One® Total Knee Application, in the following ways: it has the same intended use, the same technological characteristics and operating principles, incorporates the same design and materials. Performance testing has demonstrated that the characteristics of the TSolution One® Total Knee Application are equivalent to the predicate device, and that the device is as safe and effective as the predicate device and does not raise any new questions of safety and effectiveness; therefore, a determination of Substantial Equivalence is supported.
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