Intramedullary Bone Graft Harvest Using Reamer-Irrigator-Aspirator System: A Case Series.

Area of Science:

• Orthopedic Surgery
• Bone Grafting Techniques
• Regenerative Medicine

Background:

• Autogenous iliac crest bone grafting is the traditional gold standard for bone reconstruction.
• Intramedullary bone graft harvesting using the reamer-irrigator-aspirator (RIA) system is emerging as a viable alternative.

Purpose of the Study:

• To evaluate the efficacy and complication rates of bone graft harvesting using the RIA system in patients with nonunions.
• To compare RIA bone grafting outcomes with traditional methods.

Main Methods:

• A retrospective review of 24 RIA bone graft harvesting procedures in 23 consecutive patients with nonunions.
• Assessment of perioperative complications, secondary surgical procedures, and union rates at a mean follow-up of 10.1 months.
• Analysis of reamer size and bone graft volume obtained.

Main Results:

• Eighteen patients (78%) achieved radiographic union.
• Three donor site complications (12.5%) occurred, including two fractures (8.3%).
• A mean graft volume of 39.4 mL was harvested using a mean reamer size of 13.7 mm.

Conclusions:

• RIA bone grafting demonstrates predictable high union rates for nonunions.
• Patients should be thoroughly counseled regarding the potential risk of fractures associated with RIA harvesting.
• Tibial application of RIA may be less suitable as a primary bone graft source.