Department of Orthopaedic Surgery, Avicenne Hospital AP-HP, 123, route de Stalingrad, 93009 Bobiny, France.
Orthop Traumatol Surg Res. 2012 Apr;98(2):227-32. doi: 10.1016/j.otsr.2012.01.003. Epub 2012 Mar 7.
The "Reamer-Irrigator-Aspirator" (RIA) is a device that provides continuous irrigation and aspiration during intramedullary reaming of long bones. The RIA system is first used to collect the reaming material from medullary cavities, a thick paste of finely morselized osseous particles containing significantly elevated levels of stem cells and growth factors as reported by quantitative analyses. The volume of bone graft material available from an adult femur corresponds to the amount of cancellous bone graft obtained from both the anterior and posterior iliac crests. The assembly and technicalities of the RIA system require a training period to prevent any femoral fracture, which appears to be the major RIA-related complication. The elective indications for RIA bone grafting are filling of bone defects in the epiphyseal and metaphyseal regions. Diaphyseal defects may also be managed using the RIA system provided the graft is placed in a constrained system (induced membrane) to prevent dispersion of the graft into the surrounding soft tissues and is aerated with a porous material to promote its revascularization. Other RIA indications include debriding intramedullary infections and reaming for intramedullary nailing of long bone fractures to reduce the risk of fat embolization.
“扩髓冲洗吸引器”（RIA）是一种在长骨髓内扩孔时提供持续冲洗和吸引的装置。该系统首先用于从髓腔中收集扩髓材料，这是一种含有大量干细胞和生长因子的精细碎骨颗粒的浓稠糊状物，如定量分析所报告的那样。成人股骨可供使用的骨移植物量相当于从前髂嵴和后髂嵴获得的松质骨移植物量。RIA 系统的组装和技术要求经过一定的培训期，以防止任何股骨骨折，这似乎是 RIA 相关的主要并发症。RIA 植骨的选择性适应证是填充骺和干骺端区域的骨缺损。在使用约束系统（诱导膜）防止移植物分散到周围软组织中并使用多孔材料充气以促进其再血管化的情况下，也可以处理骨干缺损。其他 RIA 适应证包括清创髓内感染和扩髓以进行长骨骨折的髓内钉固定，以降低脂肪栓塞的风险。
