A technical note: How to extract broken Reamer-Irrigator-Aspirator (RIA) metal intramedullary debris

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Surgical instrumentation

Background:

• The Reamer-Irrigator-Aspirator (RIA-2) system is widely used for harvesting autografts.
• While generally safe, hardware complications like reamer head breakage can occur.
• Intramedullary retention of metal debris presents a unique surgical challenge.

Purpose of the Study:

• To describe a technical solution for reamer head breakage during RIA-2 autograft harvesting.
• To address the complication of intramedullary metal debris retention.
• To provide a bailout technique for this specific hardware failure.

Main Methods:

• A case report detailing the complication and its management.
• Description of a novel retrieval technique for fractured reamer heads.
• Intraoperative fluoroscopy and imaging guidance.

Main Results:

• Successful retrieval of the fractured reamer head and associated metal debris.
• Restoration of the integrity of the intramedullary canal.
• No reported adverse events or long-term complications.

Conclusions:

• Hardware failure of the RIA-2 system, specifically reamer head breakage, is a rare but significant complication.
• The presented technical trick offers an effective bailout strategy for managing intramedullary metal debris.
• This technique ensures patient safety and successful autograft harvesting completion.