5 things to know about SI-BONE’s iFuse-TORQ Implant System

In April 2021, SI-BONE® launched the iFuse-TORQ™ Implant System for the treatment of pelvic fractures, and for SI joint fusion.

 Here are five things to know:

1. The U.S. pelvic fracture market includes as many as 120,000 patients per year who receive hospital care.1 There are also an additional 100,000 people each year who experience a pelvic fracture that goes undiagnosed.2-4 For Medicare patients (age 65 and older) diagnosed with a pelvic fracture, 78 percent receive bedrest as treatment, which can lead to long hospital stays (14 to 45 days), and a high mortality rate (14 to 27 percent at one year).5-10

2. SI-BONE has been an innovator in the surgical treatment of sacropelvic disorders since 2008 when it introduced the iFuse Implant System® for minimally invasive SI joint fusion. The iFuse Implant System utilizes unique, patented triangular shaped titanium implants designed to stabilize and fuse the SI joint. Today, over 300 million Americans have access to the iFuse procedure via favorable coverage policies from their health plans. In April 2021, SI-BONE expanded its innovative sacropelvic treatment offerings with the launch of iFuse-TORQ, a novel 3D-printed threaded implant. iFuse-TORQ is designed with advanced features for increased functional surface area, bone harvesting, and rotational resistance vs conventional screws for SI joint fusion and trauma.11,12 iFuse-TORQ now allows surgeons to perform pelvic fracture fixation and SI joint fusion with one device.

3. We interviewed Bharat Desai, MD, orthopedic trauma surgeon and chief medical officer of OrthoColorado Hospital, the only orthopedic specialty hospital in Colorado. Among the more than 50 pelvic trauma patients Dr. Desai treats surgically each year, approximately 40 percent involve treatment with both internal fixation of the pelvis and concurrent fusion of the SI joint. Depending upon the procedure performed, hospitals may receive DRG-based payment for SI joint fusion, or for fracture repair when iFuse-TORQ is used as an internal fixation device in the case.

4. In 2020, Dr. Desai was closely involved in discussions with the Centers for Medicare and Medicaid Services (CMS) about how Medicare currently pays hospitals for these more complex cases. Dr. Desai said, “Over the past 10 years, there has been a 300 percent rate of growth in the use of pelvic instrumentation, with more complex and costly hardware used in those procedures. Yet the DRGs have stayed the same. That seemed a mismatch, so we reviewed the data further with Medicare.” In April 2021, CMS proposed it would be beneficial to examine future inpatient claims for non-fusion, pelvic fracture fixation procedures that include internal fixation devices, to determine whether factors such as length of stay, facility-reported case costs, or other variance in resources among these cases may prompt a reassignment to “MCC” (higher paying) DRGs whenever instrumentation is reported.13

5. iFuse-TORQ surgical candidates may present with comorbid disorders or injuries of the sacrum and the sacroiliac joint. This may require concurrent inpatient hospital treatment via sacroiliac joint fusion and sacral fracture fixation. Dr. Desai said of these hospital-based procedures, “When the trauma case involves a fusion of the SI joint, the DRG maps to a spinal fusion. Our hospitals are quite efficient in managing case costs associated with these DRGs, due to the complexity of the cases and the CCs or MCCs the patients often have. It is comforting to know I can offer iFuse-TORQ as a cost-efficient treatment option to my patients, whether the treatment is elective or for acute pelvic trauma.”

References:

1. Davis D, et al. StatPearls. 2021 Jan.
2. Burge R, et al. J Bone Miner Res. 2007 Mar; 22(3):465-75.
3. Alnaib et al J Orthop Traumatol. 2012 Jun; 13(2): 97–103
4. Per Medicare ICD-10 Code Search includes patients >65 y/o by Watson Policy Analysis. June 2020
5. Per Medicare ICD-10 Code Search includes patients >65 y/o by Watson Policy Analysis. June 2020.
6. Taillandier J, et al. Joint Bone Spine. 2003;70 (4):287–289.
7. Breuil V, et al. Joint Bone Spine. 2008;75:585–8.
8. Koval KJ, et al. J Orthop Trauma. 1997;11 (1):7–9.
9. Babayev M, et al. Am J Phys Med Rehab. 2000; 79: 404-09
10. Morris R, et al. Postgrad Med J. 2000;76 (900):646
11. SI-BONE 300922-TS 
12. SI-BONE 300930-TS
13. FY 2022 CMS Inpatient Hospital Proposed Rule (CMS-1752-P) (available at: https://www.cms.gov/medicare/acute-inpatient-pps/fy-2022-ipps-proposed-rule-home-page)