CT-guided percutaneous bilateral sacroiliac joint arthroplasty

Area of Science:

• Orthopedic surgery
• Radiology
• Biomaterials

Background:

• Pelvic fractures and sacroiliac joint (SI) diastasis cause significant morbidity, limiting function and mobility.
• Osteoporosis, particularly corticosteroid-induced, increases the risk of atraumatic pelvic fractures and SI joint disruption.
• Traditional management of these injuries can be challenging, with potential for chronic pain and limited mobility.

Observation:

• A case report details a patient with SI diastasis secondary to corticosteroid-induced osteoporosis and pelvic fractures.
• The patient was previously wheelchair-bound due to debilitating SI joint pain and instability.
• A novel percutaneous bilateral poly-methyl-methacrylate (PMMA) SI joint fusion was performed under CT-guidance.

Findings:

• The CT-guided percutaneous arthroplasty resulted in rapid resolution of SI joint pain.
• The patient regained the ability to ambulate, significantly improving functional capacity.
• This technique offers a potential solution for osteoporotic SI joint diastasis and pelvic fractures.

Implications:

• Percutaneous SI joint fusion may be a viable option for patients with osteoporotic fractures who are poor surgical candidates.
• This minimally invasive approach can restore mobility and alleviate chronic pain in select patient populations.
• CT-guided arthroplasty provides a precise and effective method for treating complex SI joint injuries.