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  • Author: Klaus-Peter Günther x
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Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Thomas M Grupp Aesculap AG Research & Development & Medical Scientific Affairs, Tuttlingen, Germany
Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Rob GHH Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands
Technical University Delft, Delft, the Netherlands

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Luca Cristofolini Department of Industrial Engineering, School of Engineering and Architecture, Alma Mater Studiorum - Università di Bologna, Bologna, Italy

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Anne Lübbeke Division of Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Switzerland
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK

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Marcus Jäger Department of Orthopaedics, Trauma & Reconstructive Surgery St. Marien Hospital Mülheim an der Ruhr & Chair of Orthopaedics and Trauma Surgery University of Duisburg–Essen, Essen, Germany

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Matthias Fink TÜV Süd Product Service GmbH, Clinical Centre of Excellence, Munich Germany

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Sabine Rusch Aesculap AG Research & Development & Medical Scientific Affairs, Tuttlingen, Germany

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Hassan Achakri Zimmer Biomet, Clinical, Regulatory & Quality Affairs, Winterthur, Switzerland

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Francesco Benazzo IUSS Pavia, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy

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Dario Bergadano Medacta International SA, Medical Affairs, Castel San Pietro, Switzerland

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Georg N Duda Julius Wolff Institute and Center for Muskuloskeletal Surgery, Berlin Institute of Health at Charité Universitätsmedizin Berlin, Germany

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Christian Kaddick EndoLab Mechanical Engineering GmbH, Riedering, Germany

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Volkmar Jansson Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany

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Klaus-Peter Günther University Clinic Carl Gustav Carus, Center for Orthopaedic & Trauma Surgery, Technical University Dresden, Dresden, Germany

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  • With the implementation of the new MDR 2017/745 by the European Parliament, more robust clinical and pre-clinical data will be required due to a more stringent approval process.

  • The EFORT Implant and Patient Safety Initiative WG1 ‘Introduction of Innovation’, combined knowledge of orthopaedic surgeons, research institutes, orthopaedic device manufacturers, patient representatives and regulatory authorities to develop a comprehensive set of recommendations for the introduction of innovations in joint arthroplasty within the boundaries of MDR 2017/745.

  • Recommendations have been developed to address key questions about pre-clinical and clinical requirements for the introduction of new implants and implant-related instrumentation with the participation of a steering group, invited by the EFORT Board in dialogue with representatives from European National Societies and Speciality Societies.

  • Different degrees of novelty and innovation were described and agreed on in relation to when surgeons can start, using implants and implant-related instrumentation routinely.

  • Before any clinical phase of a new implant, following the pre-market clinical investigation or the equivalent device PMCF pathway, it is a common understanding that all appropriate pre-clinical testing (regulatory mandatory and evident state of the art) – which has to be considered for a specific device – has been successfully completed.

  • Once manufacturers receive the CE mark for a medical device, it can be used in patients routinely when a clinical investigation has been conducted to demonstrate the conformity of devices according to MDR Article 62 or full equivalence for the technical, biological and clinical characteristics has been demonstrated (MDR, Annex XIV, Part A, 3.) and a PMCF study has been initiated.

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