Orthopedic & Spinal PMCF · EU MDR & MDCG 2020-7

The orthopedic PMCF playbook that keeps your implant CE certificate valid.

Joint replacements and spinal implants live in the body for a decade or more, so their PMCF cannot rest on a short pre-market study. Eclevar builds registry-based, survivorship-driven PMCF for orthopedic and spinal devices under EU MDR, with in-house biostatisticians and former Notified Body reviewers designing every plan. Get our free strategy cheat sheet to see the full playbook.

Registry-based PMCF Implant survivorship Validated PROMs Level 4 surveys MILO Studio
Radiographic review of a hip implant during orthopaedic post-market clinical follow-up under EU MDR Registry-based PMCF · 7 countries

PMCF designed by orthopedic specialists, not a generalist template.

One accountable team builds your survivorship model, PROMs schedule and registry integration, on the MILO Studio platform that won the Platinum Award at the xShare & EUCROF 2026 Open Call.

Co-funded by the European Union

Horizon Europe · Grant Agreement No. 101136734 · Amsterdam, 2 Feb 2026

50+EU MDR device programs delivered
7Countries with in-house CRAs
5Offices: Paris, London, Tokyo & more
PlatinumxShare EUCROF Award 2026
Social proof

Trusted by global MedTech manufacturers.

Device leaders across orthopedics, spine, cardiovascular, wound care and more choose Eclevar. Read all client success stories.

TERUMO Meril NIHON KOHDEN VYGON Coloplast SHOFU ASAHI INTECC RegenLab TERUMO Meril NIHON KOHDEN VYGON Coloplast SHOFU ASAHI INTECC RegenLab
Definition

What is PMCF for orthopedic devices?

PMCF for orthopedic and spinal devices is the proactive, continuous collection of clinical data on an implant already on the market, to prove its long-term safety and performance across the whole device lifetime.

Under EU MDR 2017/745 and MDCG 2020-7, post-market clinical follow-up is not optional for high-risk implantable devices. Hip and knee replacements, spinal cages, plates and screws are expected to function for ten to twenty years, and their true failure modes, aseptic loosening, polyethylene wear, periprosthetic fracture and revision, emerge long after a pre-market study closes. A short trial simply cannot demonstrate that the benefit-risk balance holds over that horizon.

That is why orthopedic PMCF leans on three pillars: registry-based real world evidence from national arthroplasty and spine registries, implant survivorship analysis with revision as the endpoint, and validated patient-reported outcome measures (PROMs) collected at defined follow-up points. Together they give a Notified Body the longitudinal evidence that a bespoke study rarely delivers alone.

Eclevar delivers this as one connected service, from post-market clinical follow-up and registry-based real world evidence through to the clinical evaluation report that keeps your CE certificate valid.

Dr Mark Da Costa, COO at Eclevar MedTech and former TÜV SÜD Notified Body reviewer
Dr Mark Da Costa COO · Former Notified Body reviewer · Senior Consultant Surgeon Former reviewer at TÜV SÜD
Regulatory leadership

The reviewers who certified the files now build them.

Eclevar's model brings the regulatory perspective inside the CRO, closing the gap between what orthopedic manufacturers submit and what assessors expect to read. Dr Mark Da Costa, COO and former TÜV SÜD reviewer, leads alongside Dr Nikhil Khadabadi, CMO for orthopedics and spine and also a former TÜV SÜD senior reviewer, so PMCF plans for implantable devices are designed the way a Notified Body wants to assess them, from the first version of the plan.

400+Studies delivered across Europe
Ex NBFormer TÜV SÜD reviewers on the team
100%In-house clinical delivery
Former NB reviewers EU MDR Annex XIV ISO 13485 certified
LinkedIn
Compliant with EU MDR 2017/745 MDCG 2020-7 ISO 14155:2026 ISO 13485 21 CFR Part 11 GDPR
Why specialist orthopedic PMCF

A generic PMCF template versus a registry-driven orthopedic plan.

For a long-lived implant, how you design PMCF decides whether the evidence holds up ten years out. The gap between a copy-paste survey plan and a survivorship-led orthopedic strategy is structural.

Generic / reactive

PMCF as a box-ticking survey.

  • One-size-fits-all questionnairewith no orthopedic-specific endpoints.
  • No registry linkageso long-term revision data is never captured.
  • No survivorship modeland no benchmark against the state of the art.
  • Unvalidated or missing PROMsthat a reviewer will not accept as evidence.
  • PMCF plan disconnected from the CER and PSUR.
Eclevar MedTech

Registry-based, survivorship-led, MDCG 2020-7.

  • Endpoints built for implants:revision, loosening, wear and reoperation.
  • National registry integration(NJR, EPRD, LROI) for population-scale follow-up.
  • Kaplan-Meier survivorshipbenchmarked against registry and literature thresholds.
  • Validated PROMsOxford Hip and Knee, EQ-5D, Oswestry, on a defined schedule.
  • PMCF plan wired into the CER and PSUR from version 1.
The orthopedic PMCF playbook

From plan to survivorship, one team.

Every step of a lifetime PMCF program for hip, knee and spine, designed to MDCG 2020-7 and captured with full traceability for Notified Body review.

01

PMCF plan & gap analysis

A lifetime PMCF plan to MDCG 2020-7 that maps residual risks and open clinical questions for your implant, aligned from the outset to the clinical evaluation report.

02

Registry integration

Linkage to national arthroplasty and spine registries (NJR, EPRD, LROI and others) for population-scale real world evidence and revision tracking.

03

Survivorship analysis

Kaplan-Meier time-to-revision modeling by our biostatisticians, benchmarked against registry and literature thresholds to demonstrate long-term performance.

04

PROMs collection

Validated patient-reported outcome measures, Oxford Hip and Knee Scores, WOMAC, EQ-5D and the Oswestry Disability Index, captured on MILO Studio at defined follow-up points.

05

Level 4 PMCF surveys & studies

Structured post-market clinical follow-up surveys and, where needed, a focused PMCF study under ISO 14155 with in-house monitoring.

06

CER & PSUR reporting

Survivorship, registry and PROMs data written up into the CER and Periodic Safety Update Report, backed by our ISO 13485 quality system.

Services

End-to-end EU MDR clinical evidence.

One accountable team covers every stage of the implant evidence lifecycle, so nothing is lost between a PMCF plan, a registry dataset and a Notified Body submission.

01

Clinical operations: PMCF studies

Post-market investigations under ISO 14155, from feasibility and site selection through multi-country ethics submissions and on-site and remote monitoring.

02

Medical writing: clinical evaluation & CER

The clinical evaluation report under MDCG 2020-6, PMCF Plans and SSCP, written by clinicians and reviewed by former Notified Body assessors.

03

Data management: clinical data & EDC

100% in-house clinical data management and EDC: eCRF design, DMP and DVP, powered by MILO Studio, natively built for EU MDR.

04

PMCF surveys: Level 4

Structured post-market clinical follow-up meeting MDCG 2020-7 Level 4 criteria, with validated questionnaires and MILO Studio capture.

05

Real world evidence: registry-based PMCF

National registry integration (NJR, EPRD, EUDAMED) for long-term real world evidence and survivorship follow-up of implantable devices.

06

Regulatory: EU MDR strategy

Regulatory affairs and clinical strategy for CE mark pathways and equivalence, backed by a quality management system certified to ISO 13485.

Case study · Joint replacement implant

Registry-based PMCF that held up at inspection.

An orthopedic manufacturer of a hip replacement system faced a Notified Body finding that its PMCF plan could not demonstrate long-term performance beyond the short pre-market cohort. Eclevar rebuilt the strategy around the orthopedic playbook: revision was set as the primary survivorship endpoint, national joint registry data was linked for population-scale follow-up, and validated PROMs (Oxford Hip Score and EQ-5D) were collected on MILO Studio at defined intervals.

Kaplan-Meier survivorship was benchmarked against registry and literature thresholds for the state of the art, and every dataset fed a clean, traceable file. When the Notified Body re-reviewed, the long-term evidence was complete and defensible, and it directly supported the clinical evaluation report and ongoing PMCF.

Outcome: a lifetime PMCF plan the reviewer accepted, survivorship evidence against the state of the art and a valid CE certificate, instead of a repeat nonconformity.

RegistryLinked for long-term follow-up
SurvivorshipRevision endpoint, Kaplan-Meier
Validated PROMsOxford Hip Score & EQ-5D
Why Eclevar MedTech

What makes the difference.

NB

Notified Body intelligence

Former Notified Body reviewers from TÜV SÜD, including an orthopedics and spine lead. We know what fails inspection and design PMCF to avoid it.

IH

100% in-house delivery

Clinical ops, biostatistics, writing and data management. One point of accountability, no handoff fragmentation.

ML

MILO Studio

Proprietary EDC built natively for EU MDR, with Annex XIV mapping and AI eCRF generation for PROMs capture.

MC

Multi-corridor presence

Paris, London, Tokyo and Pune. In-house CRAs in seven countries, not a network of subcontractors.

EU

Ranked #1 CRO in Europe

Platinum Award winner, EUCROF 2026, ranked first for clinical innovation and data strategy.

QA

Audit-ready from day 1

ISO 13485 certified. Every program structured for file completeness and Notified Body inspection readiness.

Global presence

Five offices, in-house CRAs across seven countries.

A network of employed CRAs and project leads, not subcontractors, gives sponsors consistent quality and one accountable team across the EU, the UK and Japan corridors.

ParisHQ
LondonUKCA corridor
TokyoPMDA corridor
Pune, IndiaTech & data ops
FranceGermanyUnited KingdomItalySpainSwedenDenmarkJapanBrazilColombia
Official content

Our content, signed Eclevar.

Whitepapers, client testimonials and publications produced by our teams and partners (BSI, TÜV SÜD, RegenLab).

Whitepaper by BSI and Eclevar on the EU MDR
Whitepaper · BSI × Eclevar

A BSI and Eclevar whitepaper on the EU MDR.

Written with Notified Body BSI: a practical reading of the clinical evidence expectations under EU MDR 2017/745, relevant to any high risk implantable device program.

PMCF Studies · Regenerative Medicine · 5 EU Countries

A client's live testimonial on Eclevar's capability to run complex trials.

Eclevar manages RegenLab's PMCF program on chronic wound devices. This is a randomized study of 160 patients across 14 sites in 5 EU countries, covering both diabetic foot ulcer (DFU) and venous leg ulcer (VLU) indications. The partnership combines Eclevar's ISO 14155 clinical expertise with the Milo Studio platform to deliver post-market clinical follow-up evidence that supports both Notified Body scrutiny and reimbursement endpoints, from protocol design through to final study report.

« Eclevar, with its tailor-made approach and advanced Milo Studio platform, represents a major strategic asset. »
Antoine Turzi, CEO, RegenLab
160patients · 14 sites
5EU countries
RegenLab video testimonial on the PMCF programme managed by Eclevar
FAQ

Questions manufacturers ask about orthopedic PMCF.

What is PMCF for orthopedic devices?

Post-market clinical follow-up (PMCF) for orthopedic and spinal devices is the continuous, proactive collection of clinical data on an implant already on the market, to confirm long-term safety and performance under EU MDR 2017/745 and MDCG 2020-7. Because joint replacements and spinal implants are expected to function for ten to twenty years, orthopedic PMCF leans heavily on national registries, implant survivorship analysis and patient-reported outcome measures rather than short pre-market trials alone.

Why are orthopedic and spinal implants a special PMCF case?

Orthopedic implants are long-lived, load-bearing and operator-dependent, so their real failure modes, aseptic loosening, wear, periprosthetic fracture and revision, often appear years after implantation. A short pre-market study cannot capture this, which is why EU MDR expects a lifetime PMCF plan built on registry data, survivorship curves and validated PROMs to show the benefit-risk profile holds over the device lifetime.

How do national joint registries support PMCF?

National arthroplasty and spine registries such as the NJR (England and Wales), EPRD (Germany), LROI (Netherlands) and the Swedish registries capture implant, procedure and revision data at population scale. Linked to a PMCF plan they provide long-term survivorship, benchmarking against the state of the art and early signals of underperformance, giving a Notified Body robust real world evidence that a bespoke study rarely matches on its own.

What is implant survivorship analysis?

Survivorship analysis uses time-to-event (Kaplan-Meier) methods to estimate the probability that an implant remains in place without revision at, for example, five, ten or fifteen years, with revision as the primary endpoint. For orthopedic PMCF, survivorship benchmarked against registry and literature thresholds is the clearest evidence that a device's long-term performance meets or exceeds the state of the art.

Which PROMs are used for orthopedic PMCF?

Common validated patient-reported outcome measures include the Oxford Hip Score and Oxford Knee Score, the Harris Hip Score, WOMAC, EQ-5D for general health, and the Oswestry Disability Index and Neck Disability Index for spine. Structured PROMs collected at defined follow-up points turn subjective recovery into quantifiable clinical benefit that supports the clinical evaluation report and Level 4 PMCF surveys.

How does Eclevar run orthopedic PMCF?

Eclevar designs a lifetime orthopedic PMCF plan to MDCG 2020-7, combining registry integration for survivorship, validated PROMs and, where needed, a focused PMCF study under ISO 14155. Data is captured on MILO Studio with full traceability, analyzed by our biostatisticians and written up by clinicians and former Notified Body reviewers so the evidence feeds the CER and PSUR without gaps.

What is in the free orthopedic PMCF strategy cheat sheet?

The cheat sheet is a field-tested one-page map of the orthopedic PMCF playbook: which registries to use for hip, knee and spine, how to set survivorship endpoints and revision benchmarks, which PROMs to collect and when, and how to align the PMCF plan with the CER and Notified Body expectations so it passes first-round scrutiny. Request it and a specialist medical device CRO team sends it directly.

Guaranteed response within 24 hours

Get the free orthopedic PMCF strategy cheat sheet.

A field-tested playbook for hip, knee and spine: registries, survivorship endpoints and PROMs, mapped to your CER and Notified Body expectations. Talk to our specialists about your implant.

Get the free cheat sheet

Registry-based PMCF · Survivorship · Validated PROMs

Reforming Clinical Evaluation of Medical Devices in Europe