title: Complications associated with negative pressure reaming for harvesting autologous bone graft: a case series.
abstract: A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri-Columbia, Columbia, MO 65212, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Lowe
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Della Rocca
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Murtha
authors.forename: Frank A
authors.initials: FA
authors.lastname: Liporace
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stover
authors.forename: Sean E
authors.initials: SE
authors.lastname: Nork
authors.forename: Brett D
authors.initials: BD
authors.lastname: Crist
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000009:adverse effects*; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013396:Suction / Q000009:adverse effects*; D007507:Therapeutic Irrigation / Q000009:adverse effects*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*