Are Hydroxyapatite-Coated Screws a Good Option for Sacroiliac Joint Stabilization? A Prospective Outcome Study

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Sacroiliac joint (SIJ) dysfunction can significantly impact patient quality of life.
• Percutaneous SIJ stabilization is a minimally invasive surgical option.
• Hydroxyapatite (HA)-coated screws are utilized in orthopedic procedures to enhance bone integration.

Purpose of the Study:

• To prospectively evaluate the clinical and radiologic outcomes of SIJ stabilization using HA-coated, fully threaded screws.
• To assess the efficacy and safety of this specific implant in patients with SIJ dysfunction.

Main Methods:

• A prospective study involving 40 patients undergoing percutaneous SIJ stabilization with HA-coated screws.
• Patient-reported outcome measures (PROMs), including SF-36, Oswestry Disability Index, EuroQol-5D-5L, and Majeed Pelvic Scores, were collected preoperatively and at 12 months post-surgery.
• Radiologic assessment for screw-related complications, such as lysis, was performed.

Main Results:

• Thirty-three patients completed the 12-month follow-up.
• Statistically significant improvements were observed in mental component of SF-36, Oswestry Disability Index, Majeed Pelvic Scores, and EuroQol-5D-5L.
• Screw lysis occurred in 63% of patients, with significantly poorer PROM improvements in this subgroup.
• Revision surgery was required for four patients due to persistent pain, with limited success.

Conclusions:

• Percutaneous SIJ fixation can yield positive clinical outcomes.
• The use of HA-coated fully threaded screws for SIJ stabilization is not recommended based on the observed high rate of screw lysis and compromised patient outcomes.
• Further research may be needed to explore alternative fixation methods or implant designs for SIJ stabilization.