SMS Cementless Stem

K203041 · Medacta International S.A. · LZO · Dec 2, 2020 · Orthopedic

Device Facts

• Record ID: K203041
• Device Name: SMS Cementless Stem
• Applicant: Medacta International S.A.
• Product Code: LZO · Orthopedic
• Decision Date: Dec 2, 2020
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 888.3353
• Device Class: Class 2
• Attributes: Therapeutic

Intended Use

The SMS system is designed for cementless use in total or partial hip arthroplasty, for primary or revision surgery. Hip replacement is indicated in the following cases: - Severely painful and/or disabled joint as a result of arthrosis, traumatic arthritis, rheumatoid polyarthritis or congenital hip dysplasia - Avascular necrosis of the femoral head - Acute traumatic fracture of the femoral head or neck - Failure of previous hip surgery: joint reconstruction, internal fixation, arthroplasty, hip resurfacing replacement or total hip arthroplasty

Device Story

SMS Cementless Stem is a femoral implant for total or partial hip arthroplasty; designed for proximal fixation. Device is a line extension of existing SMS product line, adding a collared solid version. Implants are used in primary or revision surgery; implanted by orthopedic surgeons in clinical settings. Device functions as a structural component of the hip joint replacement system, articulating with modular femoral heads and acetabular components. Provides mechanical stability and joint function restoration for patients with degenerative or traumatic hip conditions. Benefits include pain relief and improved joint mobility.

Clinical Evidence

No clinical studies were conducted. Substantial equivalence is supported by non-clinical bench testing, including range of motion (EN ISO 21535), fatigue testing (ISO 7206-4, ISO 7206-6), pull-off force (ASTM F2009-00), and coating characterization (ISO 13779-1, ASTM F1147-99).

Technological Characteristics

Cementless femoral stem; materials and coatings consistent with predicate devices. Standards: ISO 7206-4/6 (fatigue), EN ISO 21535 (ROM), ASTM F2009-00 (taper disassembly), ISO 13779-1 (hydroxyapatite), ASTM F1147-99 (coating tension). Modular design for use with CoCr or ceramic heads and UHMWPE/HXUHMWPE acetabular liners.

Indications for Use

Indicated for patients requiring total or partial hip arthroplasty (primary or revision) due to arthrosis, traumatic arthritis, rheumatoid polyarthritis, congenital hip dysplasia, avascular necrosis of the femoral head, acute traumatic fracture of the femoral head/neck, or failure of previous hip surgery.

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

• SMS (K181693)
• SMS (K201673)
• Quadra P Collared (K192827)

Reference Devices

• AMIStem-H, Quadra-S and Quadra-H Femoral Stems (K093944)
• AMIStem and Quadra - Line Extension (K121011)
• AMIStem-P, AMIStem-P Collared and AMIStem-H Proximal Coating Femoral Stems (K173794)
• Quadra-H and Quadra-R Femoral Stems (K082792)
• AMIStem-H Proximal Coating (K161635)
• MiniMAX (K170845)
• Mpact DM (K143453)
• VersafitCup (K083116)
• VersafitCup (K092265)
• VersafitCup CC Trio (K103352)
• Mpact (K103721)
• Mpact (K132879)
• Mpact 3D Metal (K171966)
• Medacta Bipolar Head (K091967)
• CoCr ball heads (K072857)
• CoCr ball heads (K080885)
• CoCr ball heads (K103721)
• Endo Head (K111145)
• MectaCer BIOLOX Forte (K073337)
• MectaCer BIOLOX Delta Femoral Heads (K112115)
• MectaCer BIOLOX Option Heads (K131518)

Submission Summary (Full Text)

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December 2, 2020

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with the word "ADMINISTRATION" underneath.

Medacta International SA % Chris Lussier Director, Quality and Regulatory Medacta USA 3973 Delp Street Memphis, Tennessee 38118

Re: K203041

Trade/Device Name: SMS Cementless Stem 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: LZO, MEH, KWY, LZY Dated: November 18, 2020 Received: November 19, 2020

Dear Chris Lussier:

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

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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 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 ([e-mail]) or phone [phone] or 301-796-7100).

Sincerely,

Vesa Vuniqi 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

510(k) Number (if known)

K203041

Device Name SMS Cementless Stem

## Indications for Use (Describe)

The SMS system is designed for cementless use in total or partial hip arthroplasty, for primary or revision surgery. Hip replacement is indicated in the following cases:

- . Severely painful and/or disabled joint as a result of arthrosis, traumatic arthritis, rheumatoid polyarthritis or congenital hip dysplasia
- · Avascular necrosis of the femoral head
- · Acute traumatic fracture of the femoral head or neck
- · Failure of previous hip surgery: joint reconstruction, internal fixation, arthroplasty, hip resurfacing replacement or total hip arthroplasty

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

X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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# 3.0 510(k) Summary

#### I. Submitter

Medacta International SA Strada Regina 6874 Castel San Pietro (CH) Switzerland Phone [phone] Fax [phone]

Contact Person: Stefano Baj, Regulatory Affairs Director, Medacta International SA Applicant Correspondent: Chris Lussier, Senior Director of Quality and Regulatory, Medacta USA Date Prepared: October 6, 2020 Date Revised: October 22, 2020

#### II. Device

| Device Proprietary Name: | SMS Cementless Stem |
|--------------------------|--------------------------------------------------------------------------------------------------|
| Common or Usual Name: | Femoral Stems |
| Classification Name: | Hip joint, metal/ceramic/polymer, semi-constrained, cemented or nonporous, uncemented prosthesis |
| Primary Product Code: | LZO, MEH, KWY, LZY |
| Regulation Number: | 21 CFR 888.3353, 21 CFR 888.3390, 21 CFR 888.3360 |
| Device Classification | II |

#### III. Predicate Device

Primary predicate:

- . SMS, K181693, K201673 Medacta International SA
The following device is referenced:

- . Quadra P Collared, K192827, Medacta International SA.
#### IV. Device Description

The SMS femoral stem is a cementless bone preserving short stem designed for proximal fixation in total or partial hip arthroplasty for primary or revision surgery.

The SMS implants are comprised of the following products:

- SMS Cementless Solid Standard Stem (available in 15 sizes from size 1 to 15); and ●
- SMS Cementless Solid Lateralized Stem (available in 15 sizes from size 1 to 15). .

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Both are available on the US market via the clearance - K181693 and K201673.

SMS collared solid version, has been introduced as a product range extension to the stems currently marketed as the SMS product line (K181693 and K201673). Quadra P is the collared stem currently marked in US K192827.

The SMS implants are line extensions to Medacta's Total Hip Prosthesis - AMIStem-H, Quadra-S and Quadra-H Femoral Stems (K093944), AMIStem and Quadra - Line Extension (K121011), AMIStem-P, AMIStem-P Collared and AMIStem-H Proximal Coating Femoral Stems (K173794), Quadra-H and Quadra-R Femoral Stems (K082792), AMIStem-H Proximal Coating (K161635), MiniMAX (K170845), and SMS (K181693 and K201673).

The SMS implants are part of the Medacta Total Hip Prosthesis system. The Medacta Total Hip Prosthesis system consists of femoral stems, modular femoral heads and acetabular components. The acetabular components consist of metal cups and liners made of ultra-high molecular weight polyethylene (UHMWPE) or Highcross highly crosslinked ultra-high molecular weight polyethylene (HXUHMWPE). Acetabular components include the Mpact DM (K143453), VersafitCup (K083116 and K092265), VersafitCup CC Trio (K103352), Mpact (K103721 and K132879), Mpact 3D Metal (K171966) and Medacta Bipolar Head (K091967).

The SMS stems can be combined with the CoCr ball heads (K072857, K080885 and K103721), Endo Head (K111145) or with the MectaCer BIOLOX® Forte (K073337), MectaCer BIOLOX® Delta Femoral Heads (K112115) or MectaCer BIOLOX® Option Heads (K131518).

#### V. Indications for Use

The SMS system is designed for cementless use in total or partial hip arthroplasty, for primary or revision surgery.

Hip replacement is indicated in the following cases:

- Severely painful and/or disabled joint as a result of arthrosis, traumatic arthritis, rheumatoid polyarthritis or congenital hip dysplasia
- Avascular necrosis of the femoral head
- Acute traumatic fracture of the femoral head or neck ●
- Failure of previous hip surgery: joint reconstruction, internal fixation, arthrodesis, partial hip ● arthroplasty, hip resurfacing replacement or total hip arthroplasty.

#### VI. Comparison of Technological Characteristics

The SMS range extension implants and the predicate devices share the following characteristics:

- CCD angle; ●
- . cementless:
- material of construction; ●
- coatings and coatings composition; ●

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- . biocompatibility:
- device usage;
- sterility; ●
- shelf life; ●
- packaging;
- sizes:
- stem lengths; .

SMS Collared is technologically different from the predicate devices as follows:

- Medial Collar Shape and Dimensions
These differences do not introduce a new worst case from a clinical point of view or with respect to the biomechanical performance of the implants.

#### Performance Data VII.

The introduction of the SMS collared version does not create a new worst case; therefore, the following performance testing from the predicate device was leveraged to support this submission:

Non-Clinical Studies:

- Performance Tests .
- o range of motion (ROM): EN ISO 21535:2009 Non-Active Surgical Implants -Joint Replacement Implants - Specific Requirements for Hip-Joint Replacement Implants;
- o fatigue testing: ISO 7206-4 Third Edition 2010-06-15 Implants for Surgery -Partial and Total Hip Joint Prostheses - Part 4: Determination of Endurance Properties and Performance of Stemmed Femoral Components [Including AMENDMENT 1 (2016)];
- fatigue testing: ISO 7206-6 Second Edition 2013-11-15 Implants for Surgery o Partial and Total Hip Joint Prostheses - Part 6: Determination of Endurance Properties of Head and Neck Region of Stemmed Femoral Components;
- pull off force testing: ASTM F2009-00 (Reapproved 2011) Standard Test Method о for Determining the Axial Disassembly Force of Taper Connections of Modular Prostheses.
- Coating Tests ●
- o ISO 13779-1 Second Edition 2008-10-01 Implants for Surgery Hydroxyapatite -Part 1: Ceramic Hydroxyapatite; and
- ASTM F1147-99 Standard Test Method for Tension Testing of Calcium Phosphate o and Metal Coatings.
- Pyrogenicity ●
- Bacterial Endotoxin Test (LAL test) was conducted according to European о Pharmacopoeia §2.6.14 (which is equivalent to USP chapter <85>) and pyrogen test according to USP chapter <151> for pyrogenicity determination; and
- the subject devices are not labeled as non-pyrogenic or pyrogen free. o

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Clinical Studies:

- • No clinical studies were conducted.
## VIII. Conclusion

Based on the above information, the SMS Collared implants are substantially equivalent to the identified predicate devices. Substantial equivalence has been demonstrated through a comparison of intended use, design, and technological characteristics, as well as performance evaluations. The SMS Collared implants are as safe and effective as the predicate devices, SMS solid stem, (K181693 and K201673) and Quadra P collared (K192827).