MONTAGE Settable, Resorbable Bone Putty
K221933 · Orthocon, Inc. · GXP · Jan 13, 2023 · Neurology
Device Facts
| Record ID | K221933 |
| Device Name | MONTAGE Settable, Resorbable Bone Putty |
| Applicant | Orthocon, Inc. |
| Product Code | GXP · Neurology |
| Decision Date | Jan 13, 2023 |
| Decision | SESE |
| Submission Type | Traditional |
| Regulation | 21 CFR 882.5300 |
| Device Class | Class 2 |
| Attributes | Therapeutic |
Intended Use
Orthocon MONTAGE Settable, Resorbable Bone Putty is a self-setting calcium phosphate cement indicated for use in the repair of neurosurgical burr holes, contiguous craniotomy cuts and other cranial defects with a surface area no larger than 25cm². MONTAGE Settable, Resorbable Bone Putty should be used only in skeletally mature individuals.
Device Story
MONTAGE is a sterile, resorbable, self-setting calcium phosphate bone cement for cranial defect repair. Device consists of two putty components containing granular calcium phosphate, calcium stearate, vitamin E acetate, triacetin, 1,4-butanediol, and lactide/polyester-based polymers. Components are manually mixed immediately prior to surgery to form a putty-like material that hardens in situ. Used by neurosurgeons in clinical settings to fill burr holes and cranial defects. Hardened material is primarily calcium phosphate and resorbs over time (>30 days). Benefits include stable defect repair without significant exothermic reaction during curing. Manual application allows for precise placement in cranial voids.
Clinical Evidence
No clinical studies conducted. Evidence consists of bench testing (visual inspection, penetrometer stiffness, mixing time, water uptake/dissolution, package integrity) and in-vivo animal testing (New Zealand White rabbit critical-sized cranial defect model) comparing histopathology and histomorphometric implant absorption against the predicate.
Technological Characteristics
Two-part putty/putty system; components include granular calcium phosphate (hydroxyapatite/β-tricalcium phosphate), calcium stearate, vitamin E acetate, triacetin, 1,4-butanediol, and lactide/caprolactone polymers. Cures to calcium phosphate-based material. Manual mixing (45 sec); working time 2 min; sets within 10 min. No significant exothermic reaction. Sterile (gamma irradiation). Single-patient use. Packaged in foil blisters/pouches with desiccant.
Indications for Use
Indicated for repair of neurosurgical burr holes, contiguous craniotomy cuts, and cranial defects ≤ 25cm² in skeletally mature individuals.
Regulatory Classification
Identification
Methyl methacrylate for cranioplasty (skull repair) is a self-curing acrylic that a surgeon uses to repair a skull defect in a patient. At the time of surgery, the surgeon initiates polymerization of the material and forms it into a plate or other appropriate shape to repair the defect.
Predicate Devices
- Stryker Injectable Cement (K060763)
Related Devices
- K231475 — MONTAGE-QS Settable, Resorbable Bone Putty · Orthocon, Inc. · Oct 12, 2023
- K232771 — Montage Flowable Settable, Resorbable Bone Paste · Orthocon, Inc. · Feb 16, 2024
- K253854 — MONTAGE XT Cranial Cement · Orthocon, Inc. · Jan 2, 2026
- K241027 — Permatage Settable Bone Putty · Orthocon, Inc. · Sep 26, 2024
- K253732 — Permatage Flowable, Settable Bone Paste · Orthocon, Inc. · Mar 13, 2026
Submission Summary (Full Text)
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Image /page/0/Picture/0 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.
January 13, 2023
Orthocon, Inc. Howard Schrayer, Consultant 8 Lookout Hilton Head Island. South Carolina 29928
Re: K221933
Trade/Device Name: MONTAGE Settable, Resorbable Bone Putty Regulation Number: 21 CFR 882.5300 Regulation Name: Methyl Methacrylate For Cranioplasty Regulatory Class: Class II Product Code: GXP Dated: December 14, 2022 Received: December 14, 2022
Dear Howard Schrayer:
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 medical devices and radiation-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.
Image /page/1/Picture/5 description: The image shows the text "Adam D." on the first line and "Pierce -S" on the second line. The text is black and the background is a light blue and white grid pattern. The text is large and easy to read.
Digitally signed by Adam D. Pierce -S Date: 2023.01.13 13:22:26 -05'00'
Adam Pierce, Ph.D. Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration
### Indications for Use
510(k) Number (if known) K221933
Device Name
MONTAGE Settable, Resorbable Bone Putty
Indications for Use (Describe)
Orthocon MONTAGE Settable, Resorbable Bone Putty is a self-setting calcium phosphate cement indicated for use in the repair of neurosurgical burr holes, contiguous cranial defects with a surface area no larger than 25cm2. MONTAGE Settable, Resorbable Bone Putty should be used only in skeletally mature individuals.
Type of Use (Select one or both, as applicable)
> Prescription Use (Part 21 CFR 801 Subpart D)
_ Over-The-Counter Use (21 CFR 801 Subpart C)
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FORM FDA 3881 (6/20)
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# General Company Information
| Name: | Orthocon, Inc. |
|---------------|-----------------------------------------------------|
| Address: | 700 Fairfield Avenue, Suite 1<br>Stamford, CT 06902 |
| Telephone: | (855) 475 - 9175 |
| Contact: | Howard Schrayer |
| Date Prepared | January 12, 2023 |
### General Device Information
| Product Name: | MONTAGE Settable, Resorbable Bone Putty |
|-----------------|-----------------------------------------|
| Common Name: | Calcium Phosphate Cement |
| Classification: | Class II |
| Product codes: | GXP |
| Regulation: | 21 CFR 882.5300 |
### Predicate Device
| Stryker | Stryker Injectable Cement |
|---------|---------------------------|
| | [510(k) Number K060763] |
# Device Description
MONTAGE Settable, Resorbable Bone Putty is a sterile, biocompatible, resorbable material for use in repair of cranial defects. The MONTAGE device comprises two separate components of putty consistency containing granular calcium phosphate, calcium stearate, a triglyceride, a polyalcohol and a mixture of a lactide-diester and polyester-based polymers. When mixed together, the components of the MONTAGE device form a putty-like material. The resulting hardened, resorbable material is primarily calcium phosphate. MONTAGE components must be mixed immediately prior to use.
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### Indications for Use
Orthocon MONTAGE Settable, Resorbable Bone Putty is a self-setting calcium phosphate cement indicated for use in the repair of neurosurgical burr holes, contiguous craniotomy cuts and other cranial defects with a surface area no larger than 25cm². MONTAGE Settable, Resorbable Bone Putty should be used only in skeletally mature individuals.
The following table shows comparisons of characteristics of MONTAGE Settable, Resorbable Bone Putty and the predicate device.
# SUBSTANTIAL EQUIVALENCE INFORMATION
### Orthocon, Inc. MONTAGE Settable. Resorbable Bone Putty 510(k) - 221933
### Stryker Injectable Cement HydroSet
### 510(k) - K060763
### Comparisons of Technological Characteristics
| Device is intended for use in the repair of<br>neurosurgical burr holes, contiguous<br>craniotomy cuts and other cranial defects<br>with a surface area no larger than 25cm². | Stryker Injectable Cement is intended for use in<br>the repair of neurosurgical burr holes,<br>contiguous craniotomy cuts and other cranial defects. |
|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| At the time of application, device is in the<br>form of a putty-like material | At the time of application, device is in the form<br>of a paste-like material |
| Device is designed to be manually applied to<br>the cranial defect | Device is designed to be manually applied to<br>the cranial defect |
| MONTAGE Settable, Resorbable Bone<br>Putty is formulated as a two-part putty/putty<br>device that forms a “settable” (hardening)<br>material when manually mixed at the time of<br>surgery | Stryker Injectable cement is formulated as a<br>two-part powder/liquid device that forms a<br>"settable" (hardening) material when manually<br>mixed at the time of surgery |
| Sterile mixture of two separate components<br>of putty-like consistency comprised of<br>granular calcium phosphate,<br>(hydroxyapatite and β-tricalcium<br>phosphate), calcium stearate, vitamin E<br>acetate, triacetin, 1,4-butanediol and a<br>mixture of a lactide-diester and polyester-<br>based (lactide and caprolactone)<br>absorbable polymers. MONTAGE is to be<br>mixed immediately prior to use. Resulting<br>settable material from the two putties is<br>primarily comprised of calcium phosphate | Sterile mixture of two separate components, a<br>powder comprised of dicalcium phosphate<br>dihydrate, tetracalcium phosphate and tri-<br>sodium citrate; and a liquid comprised of<br>sodium phosphate, polyvinylpyrrolidone and<br>water. Stryker Injectable Cement is to be<br>manually mixed immediately prior to use.<br>Resulting settable material from the two<br>components is primarily comprised of calcium<br>phosphate. |
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| Implanted device is resorbable in<br>greater than 30 days primarily due to<br>presence of calcium phosphate. | Implanted device is resorbable in greater<br>than 30 days primarily due to presence of<br>calcium phosphate. |
|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|
| Single-patient-use device is provided<br>sterile by gamma irradiation | Single-patient-use device is provided sterile<br>by gamma irradiation and ethylene oxide |
| The bone putty is available in individual<br>and/or multi-pack patient use sizes of<br>up to 5cc (approximately 10 grams). | The device is available in individual; and/or<br>multi-pack patient use sizes of 3, 5, 10 and<br>15cc. |
| Each putty is placed into a separate<br>inner foil "blister" which are contained<br>within a single outer foil pouch. The<br>outer foil pouch contains a desiccant.<br>The inner blister and outer pouch are<br>heat sealed and sterilized. | Each kit contains one liquid-filled glass<br>syringe and one plastic bowl of powder<br>packaged within a double pre-formed tray<br>with a Tyvek lid. |
| Mixing for homogeneity takes 45 sec. | Mixing for homogeneity takes 45 sec. |
| Material is settable within 10 minutes of<br>application | Material is settable within 10 minutes of<br>application |
| Material provides a working time of 2<br>minutes. | Material provides a working time of 2<br>minutes. |
| Device cures with no appreciable<br>exothermic reaction | Device cures with no appreciable<br>exothermic reaction |
# Performance Data
# Biocompatibility Testing
Testing was conducted to evaluate the device's biocompatibility in accordance with the recommendations of ISO 10993. The following biocompatibility studies were conducted on the final, finished, gamma-irradiation sterilized device and in accordance with the GLP requirements: cytotoxicity, irritation, sensitization, systemic toxicity, genotoxicity, local tissue toxicity, hemolysis, pyrogenicity and neurotoxicity.
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# Bench Testing
| Test | Description | Conclusions |
|-------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------|
| Visual Inspection | Evaluated putty component color<br>using a 3-point scale | Putty color and handling met<br>specification |
| Putty Handling | Evaluated putty stickiness to<br>gloves using a 3-point scale | |
| Putty Stiffness | Measured putty stiffness using a<br>Penetrometer | Putty stiffness met<br>specification |
| Putty Vitamin E Acetate<br>Concentration | Solvent extraction and chemical<br>analysis | Putty vitamin E acetate<br>concentration met<br>specification |
| Hand Mixing Time | Evaluated hand-mixing time using<br>a 2-point scale | Mixing time, stickiness, and<br>mixability met specification |
| Hand Mixing Stickiness | Evaluated stickiness to gloves<br>using a 3-point scale | |
| Mixability | Evaluated mixability using a 2-<br>point scale | |
| Device Stiffness | Measured device stiffness using a<br>Penetrometer | Device stiffness met<br>specification |
| Package Gross Leak | Bubble emission leak test | All test articles passed |
| Temperature Sensitivity | Determined maximum<br>temperature increase observed<br>during mixing | Acceptable maximum<br>temperature increase<br>following hand-mixing |
| Water Uptake, Swelling<br>and Dissolution | Measured volume and mass<br>changes during 72 hours in<br>phosphate buffered saline, pH<br>7.4, at 37°C | Acceptable water uptake,<br>swelling and dissolution |
# In-Vivo Testing
In-vivo animal testing was used to demonstrate substantial equivalence of MONTAGE Settable, Resorbable Bone Putty in the repair of a critical sized cranial bone defect of New Zealand White rabbits compared to the predicate device. Substantial equivalence was assessed from histopathologic evaluation and histomorphometric measurements of implant absorption over time.
# Clinical Testing
No clinical studies have been conducted in support of this 510(k).
# Conclusions
This submission supports the position that Orthocon MONTAGE Settable. Resorbable Bone Putty is substantially equivalent to the predicate device.
The information provided establishes that similar legally marketed devices have been used for the same clinical applications as Orthocon MONTAGE Settable, Resorbable Bone Putty and that Substantial Equivalence to the predicate device has been established. Each of the tests conducted passed the requirements as stated in the protocols and in recognized standards. The data presented demonstrate that the device is suitable for its indicated use. The materials from which the Orthocon device is fabricated have an established history of use, and the devices have been tested in accordance with applicable FDA guidelines.