Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series

BACKGROUND: Distraction arthrodesis (DA) and stabilization of the sacroiliac (SI) joint by placing standalone structural allograft (SA) into the joint from a posterior trajectory has recently been introduced as a surgical procedure for chronic SI joint pain refractory to non-operative care. METHODS:...

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Autores principales: Kranenburg, Andy, Garcia-Diaz, Gabriel, Cook, Judson H, Thambuswamy, Michael, James, Whitney, Stevens, David, Bruggeman, Adam, Chen, Ying, Capobianco, Robyn, Reckling, W Carlton, Siegal, Joel D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309279/
https://www.ncbi.nlm.nih.gov/pubmed/35899066
http://dx.doi.org/10.2147/MDER.S369808
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author Kranenburg, Andy
Garcia-Diaz, Gabriel
Cook, Judson H
Thambuswamy, Michael
James, Whitney
Stevens, David
Bruggeman, Adam
Chen, Ying
Capobianco, Robyn
Reckling, W Carlton
Siegal, Joel D
author_facet Kranenburg, Andy
Garcia-Diaz, Gabriel
Cook, Judson H
Thambuswamy, Michael
James, Whitney
Stevens, David
Bruggeman, Adam
Chen, Ying
Capobianco, Robyn
Reckling, W Carlton
Siegal, Joel D
author_sort Kranenburg, Andy
collection PubMed
description BACKGROUND: Distraction arthrodesis (DA) and stabilization of the sacroiliac (SI) joint by placing standalone structural allograft (SA) into the joint from a posterior trajectory has recently been introduced as a surgical procedure for chronic SI joint pain refractory to non-operative care. METHODS: Retrospective case series of patients with recurrent and/or persistent pain after placement of one or more interpositional/intraarticular standalone SAs between the ilium and sacrum using a posterior procedure to treat SI joint pain/dysfunction. Patients subsequently underwent surgical revision with porous titanium fusion implants using a lateral transfixing procedure. The demographic, clinical, and radiographic features of these cases are described. RESULTS: Data were available for 37 patients. The average (SD) age was 57 (13) years, 62% were female, and the average BMI was 31 (5.4). On average, two SA implants were placed per joint; 46% of cases were bilateral. At follow-up, two common themes were identified: lucencies around the implants and suboptimal implant position. None of the cases showed radiographic fusion of the SI joint prior to revision. One patient had an inflammatory reaction to the SA. All patients presented for revision due to either continued (49%) or recurrence (51%) of pain. In one revision case, the SA was forced ventrally, resulting in a sacral fracture, which was treated conservatively without sequelae. CONCLUSIONS: The popularity of standalone SA for SI joint stabilization/fusion with a posterior procedure is increasing. This case series demonstrates that clinical failures from this procedure may require surgical revision. The proposed fusion strategy (DA) for these products is unproven in the SI joint, and, therefore, properly conducted prospective randomized clinical trials with long-term clinical and radiographic follow-up are important to establish the safety and efficacy of this approach. In the meantime, the placement of lateral titanium implants appears to be an effective revision strategy.
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spelling pubmed-93092792022-07-26 Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series Kranenburg, Andy Garcia-Diaz, Gabriel Cook, Judson H Thambuswamy, Michael James, Whitney Stevens, David Bruggeman, Adam Chen, Ying Capobianco, Robyn Reckling, W Carlton Siegal, Joel D Med Devices (Auckl) Case Series BACKGROUND: Distraction arthrodesis (DA) and stabilization of the sacroiliac (SI) joint by placing standalone structural allograft (SA) into the joint from a posterior trajectory has recently been introduced as a surgical procedure for chronic SI joint pain refractory to non-operative care. METHODS: Retrospective case series of patients with recurrent and/or persistent pain after placement of one or more interpositional/intraarticular standalone SAs between the ilium and sacrum using a posterior procedure to treat SI joint pain/dysfunction. Patients subsequently underwent surgical revision with porous titanium fusion implants using a lateral transfixing procedure. The demographic, clinical, and radiographic features of these cases are described. RESULTS: Data were available for 37 patients. The average (SD) age was 57 (13) years, 62% were female, and the average BMI was 31 (5.4). On average, two SA implants were placed per joint; 46% of cases were bilateral. At follow-up, two common themes were identified: lucencies around the implants and suboptimal implant position. None of the cases showed radiographic fusion of the SI joint prior to revision. One patient had an inflammatory reaction to the SA. All patients presented for revision due to either continued (49%) or recurrence (51%) of pain. In one revision case, the SA was forced ventrally, resulting in a sacral fracture, which was treated conservatively without sequelae. CONCLUSIONS: The popularity of standalone SA for SI joint stabilization/fusion with a posterior procedure is increasing. This case series demonstrates that clinical failures from this procedure may require surgical revision. The proposed fusion strategy (DA) for these products is unproven in the SI joint, and, therefore, properly conducted prospective randomized clinical trials with long-term clinical and radiographic follow-up are important to establish the safety and efficacy of this approach. In the meantime, the placement of lateral titanium implants appears to be an effective revision strategy. Dove 2022-07-20 /pmc/articles/PMC9309279/ /pubmed/35899066 http://dx.doi.org/10.2147/MDER.S369808 Text en © 2022 Kranenburg et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Case Series
Kranenburg, Andy
Garcia-Diaz, Gabriel
Cook, Judson H
Thambuswamy, Michael
James, Whitney
Stevens, David
Bruggeman, Adam
Chen, Ying
Capobianco, Robyn
Reckling, W Carlton
Siegal, Joel D
Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series
title Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series
title_full Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series
title_fullStr Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series
title_full_unstemmed Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series
title_short Revision of Failed Sacroiliac Joint Posterior Interpositional Structural Allograft Stabilization with Lateral Porous Titanium Implants: A Multicenter Case Series
title_sort revision of failed sacroiliac joint posterior interpositional structural allograft stabilization with lateral porous titanium implants: a multicenter case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309279/
https://www.ncbi.nlm.nih.gov/pubmed/35899066
http://dx.doi.org/10.2147/MDER.S369808
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