title: Reaming Irrigator Aspirator system: early experience of its multipurpose use.
abstract: The evolution of contemporary intramedullary reaming systems has recently generated the Reamer Irrigator Aspirator system (RIA-Synthes®), which has progressively gained in popularity as well as in indications. The preliminary results of its use over the initial period of 18 months ata single tertiary referral centre were prospectively collected and are presented. The wide spectrum of RIA's indications have been exploited, including 7 patients with polytrauma that underwent acute femoral nailing, 8 with femoral intramedullary osteomyelitis, 9 with pathological lesions of the femoral shaft, as well as 18 patients where the RIA system has been used to harvest morselised autologous bone graft in the presence of recalcitrant atrophie non-unions and bone defects. Overall its use was proven safe and efficient, achieving aggressive medullary canal debridement, collection of adequate samples for further analysis in the infected and oncology cases, as well as impressive volumes of the osteoinductive and osteogenic reaming debris for grafting purposes. No pulmonary complications or evidence of the second hit sequelae were recorded in the polytrauma patient subgroup despite the presence of a high ISS Further controlled clinical studies should follow focused in all different applications of this reliable, user-friendly and impressively versatile system, to validate these preliminary results.
authors.affiliation: Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, School of Medicine, University of Leeds, Leeds, West Yorkshire, UK.
authors.forename: Nikolaos K
authors.initials: NK
authors.lastname: Kanakaris
authors.forename: Dan
authors.initials: D
authors.lastname: Morell
authors.forename: Suribabu
authors.initials: S
authors.lastname: Gudipati
authors.forename: Simon
authors.initials: S
authors.lastname: Britten
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D016025:Bone Transplantation; D003646:Debridement / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D005598:Fractures, Spontaneous / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery; D010019:Osteomyelitis / Q000601:surgery; D011446:Prospective Studies; D013396:Suction / Q000295:instrumentation*; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D020858:Tissue and Organ Harvesting / Q000295:instrumentation; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult