Sacroiliac joint fixation with screws leads to more revision than fusion with SI-Bone Ifuse

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SI-Bone Ifuse implants

A single-centre retrospective study of patients who had undergone sacroiliac joint fusion has compared revision rates between those who received fusion via titanium triangular implants (Si-Bone Ifuse) or fixation via cannulated screws (7.2mm stainless steel screws, Synthes).

The study was published in the International Journal of Spine Surgery and involved the review of medical records and tailored patient follow-up contact for patients who underwent sacroiliac joint fusion or fixation between 2003 and 2015 at the site.

Four-year cumulative revision rates, calculated using Kaplan-Meier survival analysis, showed a 5.7% revision rate for the 263 patients who underwent sacroiliac joint fusion with Ifuse vs a 30.8% revision rate for the 36 patients who underwent sacroiliac joint screw fixation. At the longest follow-up time point, the cumulative probability of revision in the screw group was 79.8%. Subgroup analysis showed no predictors of revision other than device used.

“In our practice, we switched from screws to Ifuse in early 2012 because we noticed that with iFuse, a much smaller proportion of patients returned to clinic with complaints of continued SI joint pain,” said Timothy Holt of the Montgomery Spine Center in Montgomery, USA, and senior study author. “Surgical revision was required in a large proportion of patients who underwent screw-based fixation. In contrast, the surgical revision rate with Ifuse was low, similar to that reported in the literature.”

The Ifuse implant is designed for sacroiliac joint fusion. Its triangular shape should prevent rotational motion and its porous surface is designed to promote bony ongrowth.