Medical Devices: Evidence and Research (Sep 2018)
Postmarket surveillance of 3D-printed implants for sacroiliac joint fusion
Abstract
Daniel Cher,1 Kendrick Wroe,2 W Carlton Reckling,3 Scott Yerby4 1Clinical Affairs, SI-BONE, Inc., Santa Clara, CA, USA; 2Quality Assurance, SI-BONE, Inc., Santa Clara, CA, USA; 3Medical Affairs, SI-BONE, Inc., Santa Clara, CA, USA; 4Research and Development, SI-BONE, Inc., Santa Clara, CA, USA Background: Government regulations require postmarket surveillance for cleared/approved medical devices. Trend analysis of newly marketed devices may help to confirm device-related safety or uncover other device or procedure-related problems. Methods: Complaints related to the use of 3D-printed triangular titanium implants for sacroiliac joint (SIJ) fusion were compared with those of the prior machined version of the device manufactured with a titanium plasma spray (TPS) coating. Event rates were calculated either by dividing event counts by numbers of surgeries or, for late events, using Kaplan–Meier survival analysis. Results: Three types of complaints with nontrial frequencies were identified. Issues in instruments occurred at a low and constant rate (1.3%). Using Kaplan–Meier analysis, pain-related complaints occurred at a low and similar rate in both groups (<0.5%). The 1-year cumulative probability of surgical revision was low in both the 3D and machined versions of the device (1.5% for machined and 1% for 3D printed, P=0.0408 for difference). No implant breakages or migrations were identified in either group, and overall rates were similar to a previously published report. Conclusion: The 3D-printed version of triangular titanium implant was associated with complaint and adverse event rates similar to those for the prior machined version of the device. Keywords: permanent implants, quality system, complaint analysis, adverse events, postmarket surveillance, sacroiliac joint fusion
