Voskuil Ryan T, Viscomi Brian, Holt Ginger E, Bruce Jeremy
Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Tennessee 975 E. Third Street, Hospital Box 260,Chattanooga, TN 37403, United States.
Department of Orthopaedic Surgery, East Tennessee State University Quillen School of Medicine, 1276 Gilbreath Dr, Johnson City, TN 37614, United States.
J Orthop Case Rep. 2019;9(5):47-50. doi: 10.13107/jocr.2250-0685.1528.
The treatment of chronic intramedullary infection of the long bones relies on microbe-specific antibiotics in conjunction with surgical removal of infected necrotic material. We discuss the use of reamer-irrigator-aspirator(RIA) for debridement of the intramedullary canal instead of conventional reaming techniques. This is the first case report to explore the use of RIA for osteomyelitis.
We discuss the use of the RIA in treatment of a 26-year-old female presenting with chronic osteomyelitis of the left distal femoral shaft. She had normalization of infection laboratories at 6 weeks and complete resolution of symptoms at 3 months and was released at 6 months.
Recent exploration of the RIA system's (Synthes®, Inc. West Chester, Philadelphia) multipurpose applications has indicated use in long bone debridement. While further exploration and high-quality studies are needed to make robust claims of efficacy, we believe that the use of RIA in the context of chronic osteomyelitis is a superior alternative to conventional reaming techniques.
长骨慢性骨髓腔内感染的治疗依赖于针对特定微生物的抗生素，并结合手术清除感染的坏死物质。我们讨论使用扩髓-冲洗-吸引器（RIA）进行髓腔清创，而非传统的扩髓技术。这是首例探讨RIA用于骨髓炎治疗的病例报告。
我们讨论了RIA在治疗一名26岁患有左股骨干远端慢性骨髓炎女性患者中的应用。她在6周时感染实验室指标恢复正常，3个月时症状完全缓解，并于6个月时出院。
近期对RIA系统（辛迪斯公司，宾夕法尼亚州韦斯特切斯特）多功能应用的探索表明其可用于长骨清创。虽然需要进一步探索和高质量研究以有力证明其疗效，但我们认为在慢性骨髓炎的治疗中，使用RIA是优于传统扩髓技术的选择。
