title: Donor site morbidity with reamer-irrigator-aspirator (RIA) use for autogenous bone graft harvesting in a single centre 204 case series.
abstract: Donor site morbidity and complication rate using the reamer-irrigator-aspirator (RIA) system for intramedullary, non-structural autogenous bone graft harvesting were investigated in a retrospective chart and radiographic review at a University affiliated Level-1 Trauma Centre. 204 RIA procedures in 184 patients were performed between 1/1/2007 and 12/31/2010. RIA-indication was bone graft harvesting in 201 (98.5%), and intramedullary irrigation and debridement in 3 (1.5%) cases. Donor sites were: femur - antegrade 175, retrograde 4, tibia - antegrade 7, retrograde 18. Sixteen patients had undergone two RIA procedures, two had undergone three procedures, all using different donor sites. In 4 cases, same bone harvesting was done twice. Mean volume of bone graft harvested was 47 ± 22ml (20-85 ml). The complication rate was 1.96% (N=4). Operative revisions included 2 retrograde femoral nails for supracondylar femur fractures 6 and 41 days postoperatively (antegrade femoral RIA), 1 trochanteric entry femoral nail (subtrochanteric fracture) 17 days postoperatively (retrograde femoral RIA) and 1 prophylactic stabilization with a trochanteric entry femoral nail for intraoperative posterior femoral cortex penetration without fracture. In our centre, the RIA technique has a low donor site morbidity and has been successfully implemented for harvesting large volumes of nonstructural autogenous bone graft.
authors.affiliation: Department of Orthopaedic Surgery, University at Buffalo, School of Medicine and Biomedical Sciences, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, United States.
authors.forename: Lars M
authors.initials: LM
authors.lastname: Qvick
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Ritter
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Mutty
authors.forename: Bernhard J
authors.initials: BJ
authors.lastname: Rohrbacher
authors.forename: Cathy M
authors.initials: CM
authors.lastname: Buyea
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Anders
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005269:Femur / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D013977:Tibia / Q000637:transplantation; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000295:instrumentation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Bone graft harvesting; Reamer-irrigator-aspirator