What do we know about the biomechanics of the sacroiliac joint and of sacropelvic fixation? A literature review. (February 2020)

• Record Type: Journal Article
• Authors: Casaroli, Gloria; Bassani, Tito; Brayda-Bruno, Marco; Luca, Andrea; Galbusera, Fabio
• Is Part Of: Medical engineering & physics. Volume 76(2020)
• Page Start: 1
• Page End: 12
• Publication Date: 2020-02
• Subjects: Experimental studies -- Finite element analysis -- Long-posterior fixation -- Sacralpelvic fixation; SIJ sacroiliac joint -- FE finite elements -- ROM range of motion -- IS iliac–sacral -- S2AI S2 alar – iliac; Biomedical engineering -- Periodicals; Biomedical Engineering -- Periodicals; Physics -- Periodicals; Génie biomédical -- Périodiques; Biomedical engineering; Electronic journals; Periodicals; 610.28
• DOI: 10.1016/j.medengphy.2019.10.009
• Languages: English
• ISSNs: 1350-4533

Abstract

Highlights: The sacroiliac joint ligamentous network and complex geometry constrain its movement. Reported insignificant movements seem incorrect in light of contemporary evidence. Motion between sacrum and pelvis is multi-dimensional and variable among individuals. There is a large variability of bone size, shape and contours among individuals. High variability makes the in silico simulations hard to validate and compare. Abstract: The purpose of this review is to summarize the general knowledge about the biomechanics of the sacroiliac joint and sacropelvic fixation techniques. Additionally, this study aims to support biomechanical investigations in defining experimental protocols as well as numerical modeling of the sacropelvic structures. The sacroiliac joint is characterized by a large variability of shape and ranges of motion among individuals. Although the ligament network and the anatomical features strongly limit the joint movements, sacroiliac displacements and rotations are not negligible. Currently available treatments for sacroiliac joint dysfunction include physical therapy, steroid injections, Radio-frequency ablation of specific neural structures, and open or minimally invasive SIJ fusion. In long posterior construct, the most common solutions are the iliac screws and the S2 alar - iliac screws, whereas for the joint fixation alone, mini – invasive alternative system can be used. Several studies reported the clinical outcomes of the different techniques and investigated the biomechanical stability of the relative construct, but the effect of sacropelvic fixation techniques on the joint flexibility and on the stress generated into the bone is still unknown. In our opinion, more biomechanical analyses on the behavior of the sacroiliac joint may be performed in order to better predict the risk of failure or instability of the joint.