title: Bone graft harvesting using the RIA (reaming irrigation aspirator) system - a quantitative assessment.
abstract: BACKGROUND
  Autologous bone graft is still considered to be the gold standard for treating non-unions in trauma and orthopedic surgery. Intramedullary bone graft harvest appears to be an alternative to other bone graft options such as iliac crest bone graft and synthetic bone substitutes. A one-step reamer-irrigator-aspirator (RIA) system has been developed to reduce the intramedullary pressure and, as a consequence, minimize the risk of fat embolization. The purpose of this study was to determine whether the quantity of harvested intramedullary bone graft is comparable to the quantity of graft that was harvested from the iliac crest in other studies. The aim of the present study was to quantify harvested bone marrow and to compare our results to already published data.
  
  
  METHODS
  Eight human cadavers (7 males, 1 female, and 16 limbs) with an average age of 68 years (range, 49-79 years) were obtained for this study. Intramedullary reaming was performed in the tibiae and femora of each cadaver. Two different sizes (12- and 14-mm diameter) of the RIA system were used. After a medial parapatellar incision was made at the knee, antegrade and retrograde reaming were performed in the tibiae and femur to harvest bone graft.
  
  
  RESULTS
  A significantly greater quantity of bone graft was harvested from the femora (27 ± 12 g) than the tibiae (17 ± 9 g) (p = 0.007).
  
  
  CONCLUSIONS
  On the basis of our present results, harvesting intramedullary bone graft with the RIA system appears to be an innovative technique for bone grafting in limb reconstruction. A significantly greater quantity of bone graft was harvested from the femora than the tibiae (p = 0.007). No significant differences among age, sex, body weight, bone length, or BMI were observed. Our results showed that a sufficient quantity in weight of autogenous bone graft could be obtained using the RIA system.
authors.affiliation: Department of Traumatology, General Hospital Vienna, Medical University Vienna, Vienna, Austria.
authors.forename: Florian M
authors.initials: FM
authors.lastname: Kovar
authors.forename: Gerald E
authors.initials: GE
authors.lastname: Wozasek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005269:Femur / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013396:Suction / Q000295:instrumentation*; D007507:Therapeutic Irrigation / Q000295:instrumentation; D013977:Tibia / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000295:instrumentation*