Niikura Takahiro, Oe Keisuke, Fukui Tomoaki, Hayashi Shinya, Matsumoto Tomoyuki, Matsushita Takehiko, Kuroda Ryosuke
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
J Orthop Sci. 2021 May;26(3):459-465. doi: 10.1016/j.jos.2020.04.004. Epub 2020 May 31.
A reamer irrigator aspirator (RIA) can be used to harvest substantial amounts of autologous bone and debride the intramedullary canal. Clinical experience using reamer irrigator aspirators in Japan is very limited. The applicability of the reamer irrigator aspirator head with a minimum diameter of 12 mm for Japanese people is often questioned as the Japanese are smaller than Americans and Europeans. There are no reports of complications in Japanese patients. This study aimed to retrospectively review clinical cases and describe reamer irrigator aspirator use in Japanese patients.
All patients for whom a reamer irrigator aspirator was used during surgery at our hospital between January 2014 and September 2018 were included. The patients' clinical and radiographic data were retrospectively reviewed.
Data of 40 patients (42 cases) were collected. The reamer irrigator aspirator was used for bone graft harvesting in 32 cases, intramedullary debridement and irrigation in 9 cases, and reaming for exchange nailing in 1 case. The diameter of the reamer irrigator aspirator reamer head was 12 mm in 22 cases (53.7%), 12.5 mm in 4 cases (9.8%), 13 mm in 9 cases (22.0%), 13.5 mm in 1 case (2.4%), 14.0 mm in 1 case (2.4%), 14.5 mm in 1 case (2.4%), and 15 mm in 4 cases (9.8%). Mean intraoperative bleeding volume was 1158.6 mL (range, 100-3800 mL). We experienced no difficulty inserting the reamer irrigator aspirator into the intramedullary canals and no cases of insertion-related intraoperative fracture. Five cortical perforations (11.9%) were observed on postoperative computed tomography scans, although no patient was symptomatic. One case (2.4%) of postoperative femur fracture occurred.
Reamer irrigator aspirators can be used in Japanese patients. Smaller reamer head sizes were mainly used in our experience. We should manage complications as in previous reports from Western countries.
扩髓-冲洗-吸引器（RIA）可用于获取大量自体骨并清理髓腔。在日本，使用扩髓-冲洗-吸引器的临床经验非常有限。由于日本人身材比美国人和欧洲人小，最小直径为12毫米的扩髓-冲洗-吸引器头部对日本人的适用性常受到质疑。目前尚无关于日本患者并发症的报道。本研究旨在回顾临床病例，描述扩髓-冲洗-吸引器在日本患者中的使用情况。
纳入2014年1月至2018年9月期间在我院手术中使用扩髓-冲洗-吸引器的所有患者。对患者的临床和影像学资料进行回顾性分析。
收集了40例患者（42例次）的数据。扩髓-冲洗-吸引器用于骨移植取材32例次，髓腔清理和冲洗9例次，扩髓用于更换髓内钉1例次。扩髓-冲洗-吸引器扩髓头部直径为12毫米的有22例次（53.7%），12.5毫米的4例次（9.8%），13毫米的9例次（22.0%），13.5毫米的1例次（2.4%），14.0毫米的1例次（2.4%），14.5毫米的1例次（2.4%），15毫米的4例次（9.8%）。术中平均出血量为1158.6毫升（范围100 - 3800毫升）。我们在将扩髓-冲洗-吸引器插入髓腔时未遇到困难，也没有发生与插入相关的术中骨折。术后计算机断层扫描发现5例皮质穿孔（11.9%），但无患者出现症状。发生1例（2.4%）术后股骨骨折。
扩髓-冲洗-吸引器可用于日本患者。根据我们的经验，主要使用较小尺寸的扩髓头部。我们应如西方国家先前报道那样处理并发症。
