STABILIZER SOFT TISSUE ANCHOR 5MM MODEL TA1005, ANCHOR INSERTER/SUTURE ORGANIZER 5MM AI1005, STABILIZER DRILL 5MM NONSTE

K973031 · R. Thomas Grotz, M.D., Inc. · MRI · Nov 3, 1997 · Physical Medicine

Device Facts

• Record ID: K973031
• Device Name: STABILIZER SOFT TISSUE ANCHOR 5MM MODEL TA1005, ANCHOR INSERTER/SUTURE ORGANIZER 5MM AI1005, STABILIZER DRILL 5MM NONSTE
• Applicant: R. Thomas Grotz, M.D., Inc.
• Product Code: MRI · Physical Medicine
• Decision Date: Nov 3, 1997
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 890.3490
• Device Class: Class 1
• Attributes: Therapeutic

Intended Use

The Stabilizer Soft Tissue Anchor is a stainless steel implant intended for use as an attachment means for soft tissue and bone in Anterior Cruciate Ligament (ACL) repair or reconstruction. Stabilizer instruments must be used to install the Stabilizer Soft Tissue Anchor.

Device Story

Stabilizer Soft Tissue Anchor is 316L stainless steel implant for ACL repair/reconstruction. Procedure involves drilling hole in bone, inserting anchor, and expanding internal teeth via anchor inserter to secure anchor into bone. Optional use of up to three sutures to attach ACL to anchor; crimper tool secures suture to anchor and prepares device for insertion. Used in clinical/surgical setting by physicians. Device provides mechanical fixation of soft tissue to bone, facilitating ligament repair.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Material: 316L stainless steel. Mechanical fixation via expandable teeth. Dimensions: 6 mm diameter. Installation requires specific manual instruments (drill, anchor inserter, crimper). No software or electronic components.

Indications for Use

Indicated for patients requiring soft tissue to bone attachment during Anterior Cruciate Ligament (ACL) repair or reconstruction.

Regulatory Classification

Identification

A truncal orthosis is a device intended for medical purposes to support or to immobilize fractures, strains, or sprains of the neck or trunk of the body. Examples of truncal orthoses are the following: Abdominal, cervical, cervical-thoracic, lumbar, lumbo-sacral, rib fracture, sacroiliac, and thoracic orthoses and clavicle splints.

Predicate Devices

• Stabilizer Soft Tissue Anchor, 8mm (K964297)
• Mitek Ligament Anchor (K92670)

Submission Summary (Full Text)

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R. Thomas Grotz, M.D.

510(k) Premarket Notification 6 mm Stabilizer™ Soft Tissue Anchor for ACL Repair/Reconstruction

- Confidential -

# 1973031 510(k) SUMMARY

#### SUBMITTED BY:

NOV - 3 1997

R. Thomas Grotz, M.D. 530 Bush Street, 10th Floor San Francisco, California 94108 Telephone: [phone] [phone] Fax:

Date Submitted: August 13, 1997

# CLASSIFICATION, COMMON OR USUAL NAME, DEVICE NAME

| Classification Name: | Fastener, fixation, nondegradable, soft<br>tissue |
|----------------------|---------------------------------------------------|
| Common/Usual Name: | Soft Tissue Anchor |
| Proprietary Name: | Stabilizer™ Soft Tissue Anchor, 6 mm |

## PREDICATE DEVICES

Stabilizer Soft Tissue Anchor, 8mm, cleared February 7, 1997 under 510(k) K964297 and the Mitek Ligament Anchor manufactured by Mitek Surgical Products, Inc [510(k) 92670].

### DEVICE DESCRIPTION

The Stabilizer Soft Tissue Anchor is a 316L stainless steel implant intended for use as an attachment means for soft tissue and bone in Anterior Cruciate Ligament (ACL) repair or reconstruction. Stabilizer instruments must be used to install the Stabilizer Soft Tissue Anchor.

Stabilizer placement is accomplished by drilling an appropriately sized hole in uncompromised bone with a specifically designed drill, inserting the soft tissue anchor into the bone, expanding the stabilizer teeth of the implant to secure the anchor into bone using the anchor inserter, and optionally securing the ACL to the implanted anchor by using up to three sutures. The anchor inserter (which spreads the stabilizer teeth of the implant) also serves as a suture organizer for delivery of sutures, as may be required, to the implant site during the implantation procedure. A crimper is also included to help secure the suture of choice to the Stabilizer, and to prepare the Stabilizer for entry into the predrilled hole. If sutures are not used, use of the crimper is optional.

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Image /page/1/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the caduceus symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

R. Thomas Grotz, M.D. 530 Bush Street 10th Floor San Francisco, California 94108

NOV - 3 1997

Re: K973031 6 mm Stabilizer™ Soft Tissue Anchor Trade Name: Requlatory Class: II Product Codes: MBI and HWC Dated: August 13, 1997 Received: August 14, 1997

#### Dear Dr. Grotz:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions The general controls provisions of the Act of the Act. include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions aqainst misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major requlations affecting your device can be found in the Code of Federal Requlations, Title 21, Parts 800 to 895. ಗಿ substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory In addition, FDA may publish further announcements action. concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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This letter will allow you to beqin marketing your device as described in your 510 (k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling requlation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to
premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

Celia M. Witten, Ph.D.

Celia M. Witten, Ph.D., M.D. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Premarket Notification ... ...... 6 mm Stabilizer™ Soft Tissue Anchor for ACL Repair/Reconstruction

- Confidential -

Page 1 of 1

510(k) Number (if known): Not Known

Device Name: Stabilizer™ Soft Tissue Anchor, 6 mm

The Stabilizer Soft Tissue Anchor is a stainless steel Indications for Use: implant intended for use as an attachment means for soft tissue and bone in Anterior Cruciate Ligament (ACL) repair or reconstruction. Stabilizer instruments must be used to install the Stabilizer Soft Tissue Anchor.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

to coee

Division Sign-Off) Division of General Restorative Devices \$10(k) Number.

Prescription Use (PER 21 CFR 801.109)

OR

Over-The-Counter Use

(Optional Format 1-2-96)