Treatment of Large Segmental Bone Defects with Reamer-Irrigator-Aspirator Bone Graft: Technique and Case Series

McCall, Todd A.; Brokaw, D. S.; Jelen, Bradley A.; Scheid, D. Kevin; Scharfenberger, Angela; Maár, D; Green, James M.; Shipps, Melanie R.; Stone, Marcus B.; Musapatika, Dana; Weber, Timothy G.

doi:10.1016/j.ocl.2009.08.002

Cited by 127 publications

(67 citation statements)

References 39 publications

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“…The RIA has been reported as a source of bone graft with supportive experimental [17] and clinical studies [5,[7][8][9] and case reports [6,[20][21][22][23]. Direct grafting of harvested RIA bone fragments, in addition to 'autografting' alone has been shown to improve stiffness (1.21 Nm compared with 0.48 Nm; P=0.029) and strength (14.09 Nm compared with 6.94 Nm; P=0.029) in a sheep model [19].…”

Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 99%

“…Direct grafting of harvested RIA bone fragments, in addition to 'autografting' alone has been shown to improve stiffness (1.21 Nm compared with 0.48 Nm; P=0.029) and strength (14.09 Nm compared with 6.94 Nm; P=0.029) in a sheep model [19]. Large volumes of graft can be obtained, with 40-90 ml harvests being reported [5,[7][8][9]. This graft has been shown to be 'comparable to iliac crest' in terms of osteoinductive growth factors [24], and high union rates have been reported in clinical series (50-90%) [5,[7][8][9].…”

Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 99%

“…Large volumes of graft can be obtained, with 40-90 ml harvests being reported [5,[7][8][9]. This graft has been shown to be 'comparable to iliac crest' in terms of osteoinductive growth factors [24], and high union rates have been reported in clinical series (50-90%) [5,[7][8][9]. It is noted that union rates reported by Belthur et al using RIA derived graft (37 of 41 cases) compared well with an iliac crest bone graft (ICBG) control group (32 of 40 cases) [7].…”

Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 99%

“…When combining all 87 patients from initial studies [5,[7][8][9], only three complications are reported: (1) femoral neck fracture, (2) perforation of the anterior cortex of the femur, and (3) hypertrophic scar. All complications were successfully managed, with the femoral neck fracture being fixed and the other two managed non-operatively [5,7].…”

Section: Safety Of the Ria Reamermentioning

confidence: 99%

“…Reported indications for the RIA have expanded since its inception to include treating postoperative osteomyelitis [4], using the aspirated bone-fragments as bone graft to treat non-unions [5][6][7][8][9][10] and harvesting mesenchymal-stemcells (MSCs) [11]. A systematic review of this device is necessary to inform the wider orthopaedic community of the RIAs indications, efficacy and safety.…”

Section: Introductionmentioning

confidence: 99%

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Reamer-irrigator-aspirator indications and clinical results: a systematic review

Cox

Jones

McGonagle

et al. 2011

International Orthopaedics (SICOT)

126

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Background The 'reamer-irrigator-aspirator' (RIA) is an innovation developed to reduce fat embolism (FE) and thermal necrosis (TN) that can occur during reaming/ nailing of long-bone fractures. Since its inception its indications have expanded to include the treatment of long-bone osteomyelitis and as a harvester of bone graft/ mesenchymal stem cells (MSCs). Methods This study involved a systematic review, via Pubmed® and Google Scholar®, of English language sources (nine non-clinical studies, seven clinical studies and seven case reports) using the keywords: 'reamer', 'irrigator', 'aspirator' (1st May 2010). Sources were reviewed with reference to the RIAs efficacy in (1) preventing FE/TN, (2) treating long-bone osteomyelitis, (3) harvesting bone graft/MSCs, and (4) operating safely. Experimental data supports the use of the RIA in preventing FE and TN, however, there is a paucity of clinical data. Conclusions The RIA is a reliable method in achieving high volumes of bone graft/MSCs, and high union rates are reported when using RIA bone-fragments to treat nonunions. Evidence suggests possible effectiveness in treating long-bone osteomyelitis. The RIA appears relatively safe, with a low rate of morbidity provided a meticulous technique is used. When complications occur they respond well to conventional techniques. The RIA demands further investigation especially with respect to the optimal application of MSCs for bone repair strategies.

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Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 99%

Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 99%

Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 99%

Section: Safety Of the Ria Reamermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reamer-irrigator-aspirator indications and clinical results: a systematic review

Cox

Jones

McGonagle

et al. 2011

International Orthopaedics (SICOT)

126

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Bone tissue engineering and regenerative medicine: Targeting pathological fractures

Nguyen

Burg

2014

J. Biomed. Mater. Res.

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Patients with bone diseases have the highest risk of sustaining fractures and of suffering from nonunion bone healing due to tissue degeneration. Current fracture management strategies are limited in design and functionality and do not effectively promote bone healing within a diseased bone environment. Fracture management approaches include pharmaceutical therapy, surgical intervention, and tissue regeneration for fracture prevention, fracture stabilization, and fracture site regeneration, respectively. However, these strategies fail to accommodate the pathological nature of fragility fractures, leading to unwanted side effects, implant failures, and nonunions. To target fragility fractures, fracture management strategies should include bioactive bone substitutes designed for the pathological environment. However, the clinical outcome of these materials must be predictable within various disease environments. Initial development of a targeted treatment strategy should focus on simulating the physiological in vitro bone environment to predict clinical effectiveness of the engineered bone. An in vitro test system can facilitate reduction of implant failures and non-unions in fragility fractures.

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Autologous Bone Graft Harvesting with the Use of RIA (Reamer Irrigator Aspirator System: RIA)

Giannoudis

Kanakaris

2011

Practical Procedures in Orthopedic Surgery

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Treatment of Large Segmental Bone Defects with Reamer-Irrigator-Aspirator Bone Graft: Technique and Case Series

Cited by 127 publications

References 39 publications

Reamer-irrigator-aspirator indications and clinical results: a systematic review

Reamer-irrigator-aspirator indications and clinical results: a systematic review

Bone tissue engineering and regenerative medicine: Targeting pathological fractures

Autologous Bone Graft Harvesting with the Use of RIA (Reamer Irrigator Aspirator System: RIA)

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