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

This is a single-surgeon series to prospectively evaluate the clinical and radiologic results of sacroiliac joint (SIJ) stabilization using hydroxyapatite (HA)-coated, fully threaded screws in patients with SIJ dysfunction.

A total number of 40 patients underwent percutaneous SIJ stabilization using HA-coated screws between 2013 and 2015 at the University Hospital of LLandough with an age range of 33-84 years. Patients were followed up closely, and outcome scores were collected preoperative and 12 months after surgery. Preoperative and postoperative outcomes were evaluated using patient-reported outcome measures (PROMs), Short Form-36, Oswestry Disability Index, EuroQol-5D-5L, and Majeed Pelvic Scores.

Thirty-three patients (8 male and 32 female) out of the 40 patients completed follow-up. There was an overall improvement in all PROMs; however, only mental component of SF-36, Oswestry Disability Index, Majeed Pelvic Scores, and EuroQol-5D-5L were statistically significant. Twenty-one patients (63%) had lysis around the screw, and a subgroup analysis showed that improvement in PROMs was significantly less in patients with lysis around the screw. Four patients with lysis around the screw were offered revision due to ongoing pain. Revision was successful in only 1 patient.

Percutaneous SIJ fixation procedure has been shown to have good clinical outcomes, but the use of HA-coated fully threaded screws in this procedure is not recommended on the basis of patient-reported outcome measures and radiologic findings in this prospective study.