Reamer Irrigator Aspirator bone graft harvesting: Complications and outcomes in an Asian population

Han, Fucai; Peter, Luke; Lau, Eugene Tze-Chun; Thambiah, Joseph; Murphy, Diarmuid; Kagda, Fareed

doi:10.1016/j.injury.2015.07.027

Cited by 30 publications

(30 citation statements)

References 23 publications

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“…Hence, infected bone defects remain a clinical challenge. 2 To treat these defects, ideally, a scaffold needs to be implanted to fill the defect to promote new bone formation and at the same time should be able to kill clinically present bacteria. Hence, there is a pressing need for the development of an osteogenesis-inducing and clinical bacteria-killing scaffold.…”

Section: Introductionmentioning

confidence: 99%

Multifunctional Copper-Containing Carboxymethyl Chitosan/Alginate Scaffolds for Eradicating Clinical Bacterial Infection and Promoting Bone Formation

Li²,

Zhu

et al. 2017

ACS Appl. Mater. Interfaces

161

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Repairing infected bone defects relies on a scaffold that can not only fill the defects to promote bone formation but also kill clinically present bacterial pathogens such as Staphylococcus aureus (S. aureus). To meet this demand, here, we develop a new copper (Cu) containing natural polymeric scaffold with a full potential for repairing infected bone defects. Instead of directly adding antibacterial Cu2+ ions to the polymer mixtures, which caused uncontrolled polymer cross-linking, we added Cu nanoparticles to the mixture of anionic carboxymethyl chitosan (CMC) and alginate (Alg). Then, the Cu2+ ions released from the Cu nanoparticles gradually cross-linked the polymer mixtures, which was further turned into a scaffold (CMC/Alg/Cu) with an interconnected porous structure by freeze-drying. We found that the CMC/Alg/Cu scaffolds showed significantly improved capabilities of osteogenesis and killing clinical bacteria compared to CMC/Alg scaffolds fabricated by the same procedure but without adding Cu nanoparticles. Specifically, in vitro studies showed that the CMC/Alg/Cu scaffolds with excellent biocompatibility could enhance preosteoblastic cell adhesion by upregulating the expression level of adhesion-related genes (focal adhesion kinase (FAK), paxillin (PXN), and vinculin (VCL)), promoting osteogenic differentiation and mineralization by upregulating the osteogenesis-related gene expression and extracellular calcium deposition. In vivo studies further demonstrated that CMC/Alg/Cu scaffolds could induce the formation of vascularized new bone tissue in 4 weeks while avoiding clinical bacterial infection even when the implantation sites were challenged with the clinically collected S. aureus bacteria. This work represents a facile and innovative approach to the fabrication of Cu containing polymer scaffolds that can potentially be used to repair infected bone defects.

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Section: Introductionmentioning

confidence: 99%

Multifunctional Copper-Containing Carboxymethyl Chitosan/Alginate Scaffolds for Eradicating Clinical Bacterial Infection and Promoting Bone Formation

Li²,

Zhu

et al. 2017

ACS Appl. Mater. Interfaces

161

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“…Numerous studies have shown that RIA can provide good quality and quantity of autologous bone graft with relatively little post-operative pain [6][7][8] Table 1 [4,5,9,[10][11][12][13][14][15][16][17]. Most reported complications were seen when the intact femur was used as source of harvesting autologous bone graft.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic-Induced Cardiovascular Complications During Reamer–Irrigator–Aspirator-Assisted Femoral Nonunion Treatment

Donders

Baumann²,

Stevens

et al. 2016

Journal of Orthopaedic Trauma

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“…Reamer–irrigator–aspirator is a modality that is gaining popularity amongst orthopaedic surgeons. Nevertheless, it should be emphasised that certain well-described complications [ 20 , 38 ] and a steep learning curve are associated with its use. Major associated complications include but are not limited to significant intraoperative blood loss and intraoperative femoral shaft fracture due to thinning of the cortex from the head reamer.…”

Section: Open Questionsmentioning

confidence: 99%

“…Due to its versatility, its use has lately been expanded to the management of long bone infections as well as to harvesting of autologous bone graft from the femoral canal [ 16 – 19 ]. Recent evidence is available in relation to the pathophysiology associated with the reaming–irrigation–aspiration process and clinical studies suggest that it is a safe and effective device [ 20 – 22 ]. In the herein study, all original and review articles in English language, retrieved from PUBMED and SCOPUS, containing the terms “RIA’’ and/or “reamer–irrigator–aspirator’’ in their title/abstract and published within the last 10 years were reviewed.…”

Section: Introductionmentioning

confidence: 99%

The use of Reamer–irrigator–aspirator in the management of long bone osteomyelitis: an update

Tosounidis

Calori

Giannoudis

2016

Eur J Trauma Emerg Surg

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PurposeReamer–irrigator–aspirator (RIA) is an innovative device that its indications have recently been expanded to the management of long bone infections.MethodsIn this narrative review, we summarise the most important studies in the field and we present the current open questions pertaining to the use of RIA in the management of osteomyelitis of long bones.ResultsThe relevant literature is sparse and low quality. Nevertheless, the use of RIA for infected cases has yielded promising outcomes in specialised centres. Technical aspects that merit special attention in osteomyelitis of long bones are its inapplicability in small diameter long bones, the inadequate debridement of wide metaphyseal areas and the potential bleeding sequelae. The use of RIA in open fracture management to reduce infection risk has not gained acceptance. The antibiotic impregnated nails and rods constitute a complimentary strategy for the management of infections.ConclusionsThe use of RIA for the management of long bone infections is an innovative and promising strategy. High quality studies are needed to shed light in its efficacy compared to conventional methods of management of osteomyelitis of long bones.

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Reamer Irrigator Aspirator bone graft harvesting: Complications and outcomes in an Asian population

Cited by 30 publications

References 23 publications

Multifunctional Copper-Containing Carboxymethyl Chitosan/Alginate Scaffolds for Eradicating Clinical Bacterial Infection and Promoting Bone Formation

Multifunctional Copper-Containing Carboxymethyl Chitosan/Alginate Scaffolds for Eradicating Clinical Bacterial Infection and Promoting Bone Formation

Hemorrhagic-Induced Cardiovascular Complications During Reamer–Irrigator–Aspirator-Assisted Femoral Nonunion Treatment

The use of Reamer–irrigator–aspirator in the management of long bone osteomyelitis: an update

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