Observational, Non-interventional Use of LIPUS to Mitigate Fracture Non-union in Patients at Risk

Study Overview
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Brief Summary
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This study is one of three separate studies of the Bioventus Observational Non-interventional EXOGEN Studies (BONES) program. Eligibility for each study is determined by fractured bone.

Detailed Description
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The prospective arm of this non-interventional, observational study is designed to collect real world evidence from patients at risk of a fracture non-union across the US receiving EXOGEN treatment. Patients will be followed for 9 months post fracture. As a non-interventional study, the treating clinician will continue to provide routine care without research intervention or dictation by a protocol. A medically staffed Direct-to-Patient Contact Center will serve as a central investigational site with scheduled and structured direct-to-patient contacts via phone/email/text/web based surveys to obtain informed consent and collect data directly from the patient. For all prospective patients, primary effectiveness data will be obtained directly from the medical records of the treating physician. The comparator arm of this study will be a retrospective cohort of patients within a national health insurance claims database. An extract of this database will be taken and eligible controls derived via propensity score analysis.

Official Title
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A Prospective, Patient-centric, Observational, Consecutive Enrollment, Non-interventional Study of Patients At Risk for Fracture Non-union Treated With EXOGEN Compared to a National Healthcare Claims Database Control

Conditions
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Mitigation of Fracture Non-union in Patients at Risk

Intervention / Treatment
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* Device: Low intensity pulsed ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must be willing to provide voluntary informed consent Male or female age 21-80 on fracture date Must be willing to sign for release of medical insurance claim billing records from the treating clinician, pertaining to the fracture and fracture treatment Fluency in English and/or Spanish Prescriptive initiation of therapy with the EXOGEN Ultrasound Bone Healing System (Model number 71034400) for a specified fracture Bone specific fracture Exclusion Criteria: Patient report of treatment with an electrical bone growth stimulation device (e.g., pulsed electromagnetic field (PEMF) or capacitive coupling (CC) based devices) for bone fracture in 9-months pre-index period up to baseline phone contact Pregnant on fracture index date Evidence that prescription for EXOGEN has been written to treat a fracture non-union or mal-union (i.e, ICD-10-CM code with seventh character modifier of K, P or S). Evidence that prescription for EXOGEN has been written to treat a pathologic fracture (ICD-10-CM code M80. or M84.) or neuropathic bone (ICD-10-CM code M14.6) Patient with a concurrent fracture of the other bones of interest Patients who are or anticipate living or receiving fracture treatment outside of the US during the post-index fracture period Patient report of history of primary or metastatic bone cancer Patient report of bone infection or osteomyelitis of index fracture at baseline contact Patient report of prior bone specific fracture in 9-months pre-index period Patient prescribed EXOGEN as part of a Worker Compensation claim

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| EXOGEN Treated<br>Patients prescribed EXOGEN and treatment initiated | Device: Low intensity pulsed ultrasound<br>* bone growth stimulator<br>* Other names: EXOGEN;|
| Non-EXOGEN Treated<br>Patients in insurance claims database who have not been treated with a bone growth stimulator; derived via propensity score subclassification | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adjunctive treatment with low intensity pulsed ultrasound therapy mitigates the risk of fracture non-union in patients at risk | To compare incidence of fracture non-union in patients utilizing the EXOGEN device with patients receiving standard of care alone | 9 month |