Abstract
Abstract
Background
Prospective study to compare patient reported outcome measures (PROM) for sacroiliac joint (SIJ) fusion using HA-coated screw (HACS) vs triangular titanium dowel (TTD). First study of its kind in English literature.
Methods
40 patients underwent SIJ stabilisation using HACS and TTD was used in 70 patients at CAVUHB, Cardiff. PROMs were collected prospectively before surgery and 12 months post-op. Short Form (SF)-36, Oswestry Disability Index, EuroQol-5D-5L and Majeed Pelvic Scores were collected. Shapiro-wilk test was used to determine normality of data. Mann-whitney U test was used to compared non-parametric data and Independent sample T test for parametric data.
Results
33 patients in HACS group and 61 in TTD group completed follow-up. There was no significant difference in all preoperative PROMs in both groups hence the data was considered comparable. All postoperative PROMs were significantly higher in TTD group. In HACS group, 21 patients (63%) had lysis around screw and sub-group analysis showed that PROMs were lower in patients with lysi. 4 patients with lysis around screw were offered revision due to ongoing pain. Revision was successful in only 1 patient. In TTD group only 5 patients (8.2 %) patients had radiological evidence of lysis. Relative risk of developing lysis was 6.7 times higher in HACS group.
Conclusion
Percutaneous SIJ fixation procedure has good clinical outcomes and TTD leads to significantly better patient reported outcomes compared to HACS. There is a 6.7 time higher risk of lysis with use of HACS and lysis is a risk factor for poor outcomes.
