Trans-iliac removal of bullet fragments from the sacroiliac joint

The need for removal of intra-articular bullet fragments is well documented in the literature. Arthroscopy and arthrotomy are the preferred methods to access large superficial joints; however, these methods cannot be effectively used to access the sacroiliac joint. Its relationship to vital soft tissues and its convoluted joint anatomy make it almost impossible to explore even under open methods. We propose a new percutaneous technique for the removal of intra-articular bullet fragments from the sacroiliac joint. Our method meets two important goals: 1) percutaneous minimally invasive approach to the joint, and 2) removal of the bullet fragments while avoiding the potential morbidity of an open procedure.