Lowe Jason A, Della Rocca Gregory J, Murtha Yvonne, Liporace Frank A, Stover Michael D, Nork Sean E, Crist Brett D
Department of Orthopaedic Surgery, University of Missouri-Columbia, Columbia, MO 65212, USA.
J Orthop Trauma. 2010 Jan;24(1):46-52. doi: 10.1097/BOT.0b013e31819c0ccb.
A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.
扩孔钻-冲洗-吸引器（RIA）系统（辛迪斯公司，宾夕法尼亚州波利）的一个技术优势是能够获取大量（40 - 90立方厘米）的自体骨移植材料。对该技术的早期评估报告显示问题较少，所有问题均归因于技术失误。本病例系列回顾了6例与RIA相关的并发症，包括4例骨折及其相关危险因素。病例来自4个独立的骨科中心，所有患者均因下肢长骨损伤接受了RIA取骨术。在这组人群中，2例患者发生了与RIA相关的急性事件，需要额外的手术或改变术后康复方案，而4例患者在术后早期供骨部位发生了骨折。该病例系列表明，外科医生应（1）术前评估长骨取骨部位的皮质直径，（2）术中仔细监测扩孔操作，（3）对于有骨质疏松或骨质减少病史的患者，除非考虑取骨后髓内固定术，否则应避免进行RIA取骨术。
