Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
J Orthop Res. 2024 Aug;42(8):1820-1830. doi: 10.1002/jor.25820. Epub 2024 Mar 3.
Minimally invasive sacroiliac joint fusion has become increasingly prevalent and is described to reduce pain and improve function. In some patients, pain can recur several months after primary surgery. Lack of early implant osseointegration might be a cause of pain and hence an indication for revision surgery. Triangular titanium implants are the most documented implant for minimally invasive sacroiliac joint fusion. There is, however, no knowledge of how triangular titanium implants osseointegrate in humans and whether fusion is induced over the sacroiliac joint. During planned revision surgery due to recurrent pain, six triangular titanium implants were retrieved from six different patients at median 9 months from primary surgery. All six implants were scanned using microcomputed tomography. The presence or absence of bone in-growth, on-growth, and through-growth of the implants was evaluated as an indication of implant osseointegration. Three of six implants showed no or minor signs of osseointegration. Of the three remaining implants, one showed partial osseointegration and two implants showed high degrees of osseointegration. This study showed that triangular titanium implants can osseointegrate into host bone in humans. When osseointegration occurs, triangular titanium implants can give fusion across the sacroiliac joint.
微创性骶髂关节融合术越来越普遍，被描述为可以减轻疼痛和改善功能。在一些患者中，初次手术后数月内疼痛可能会复发。早期植入物骨整合不良可能是疼痛的原因，因此需要进行翻修手术。三角形钛植入物是最有文献记载的微创性骶髂关节融合植入物。然而，我们并不了解三角形钛植入物在人体中是如何进行骨整合的，以及融合是否在骶髂关节上诱导发生。由于疼痛复发，在计划的翻修手术中，从 6 名不同的患者中取出了 6 个初次手术后中位时间为 9 个月的三角形钛植入物。使用微计算机断层扫描对所有 6 个植入物进行了扫描。植入物的骨内生长、骨上生长和骨贯通生长的存在或不存在被评估为植入物骨整合的指示。6 个植入物中有 3 个显示出无或轻微的骨整合迹象。在其余 3 个植入物中，1 个显示部分骨整合，2 个显示高度骨整合。这项研究表明，三角形钛植入物可以在人体中与宿主骨整合。当发生骨整合时，三角形钛植入物可以在骶髂关节上实现融合。
