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Cited by 5Bone fractures and treatmentsSpinal Fractures and Fixation TechniquesHip and Femur Fractures

Osteogenesis Stimulator Devices Reduce Surgical Intervention, Opioid Utilization, and Overall Costs in Patients with Fracture Nonunions

Open access
Segina, Daniel, Ryaby, James·2023·Orthopedic Reviews
DOI 10.52965/001c.88398PMC PMC10667263
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Abstract

Background: Approximately 10% of fractures result in delayed union or nonunion. These cases result in pain and disability as well as increased utilization of healthcare resources such as pain medication, physical therapy, and subsequent surgery. Osteogenesis stimulator devices are a safe and low-cost, non-invasive option to aid healing in nonunion cases. Objective: Study objectives aimed to evaluate real-world data of osteogenesis stimulator device usage in a variety of healthcare utilization endpoints including surgical intervention for nonunion, pain medication use, and overall healthcare costs. Data were stratified into three groups: the Stim Device group and the No Stim and Surgical control groups. Methods: A retrospective analysis of a large claims-based database was conducted. The database was queried for adult patients having a diagnosis of nonunion, with evidence of a prior fracture in the previous 180 days (n = 11,010). The osteogenesis stimulator group (Stim Device group, n = 1,628) was defined as those patients having at least one claim for an osteogenesis stimulator in the period 90 to 180 days following fracture and up to 60 days following the nonunion diagnosis. The control group (No Stim group, n = 9,382) had a nonunion diagnosis with evidence of a fracture in the prior 180 days but did not receive a device. A total of 1,751 patients from the No Stim group were sub-grouped into surgical/operative controls (No Stim - Surgical group). Results: Stim Device patients showed lower rates of surgical intervention for their bone nonunion compared to the No Stim patients (214/1,628, 13.1% vs. 1,751/9,382, 18.7%, p < 0.001). Stim Device patients had lower rates of opioid utilization post-index compared to No Stim patients (948/1,628, 58.2% vs. 6,359/9,382, 67.8%, p < 0.001). Overall healthcare costs were significantly reduced in the Stim Device group ($21,654) compared with No Stim ($29,101; p < 0.001) and Surgical ($35,914; p < 0.001) control groups. Conclusion: The results show that bone growth stimulator devices have a positive individual and societal impact on treating patients with fracture nonunions.

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Authors
Segina, D., & Ryaby, J.
Affiliations
Holmes Regional Medical Center (US)
Corresponding author
Segina, Daniel
ORCID
Ryaby, James
Venue
Orthopedic Reviews
Publisher
Open Medical Publishing
Published
2023-11-22
Volume
15
Pages
88398-88398
ISSN
2035-8164 (ISSN-L)
DOI
10.52965/001c.88398
PMC
PMC10667263
OpenAlex
W4388911424
Cited by
5
References
23
Citations by year
2026: 2 · 2025: 1 · 2024: 2
FWCI
1.00
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Orthopedic Reviews (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
  • Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
  • Health Sciences › Medicine › Surgery › Hip and Femur Fractures
Keywords
nonunion, bone growth stimulation, delayed union, opioid consumption, health care costs, surgical treatment, health care utilization, nonunion treatment, real-world evidence, claims data analysis, postoperative pain management

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