Thought i'd pop in and say that i finally gave Highwood saddles a try - i was too tired of my hands getting jabbed when resting my palm on the stock saddles + they had rusted a lot.
I got the 10.50mm string spacing ones and they work just fine on my 2018 American SS. Like someone else said, they don't fit in the grooves like the original saddles (i think because of the height-adjustment screw's size + spacing between them) but after tuning the guitar to pitch and gently pushing them into place, the string spacing looks to be about 99% as good as the original which is great.
They feel so much better against my right hand, so i am very happy with the change. Can't say much about sound, they might sustain slightly worse than the original PRS saddles but that could be my mind playing tricks on me, guitar still sounds great.
Time will tell whether these will collect rust to the same degree as the originals (i have hyper toxic hand sweat, it's a pain) but since it's such an inexpensive replacement it wouldn't even bother me if they do.
Hope this clears some things up for other folks in the same position, it sure took me a while to take the plunge and give them a try :8