Laubach Markus, Bessot Agathe, Saifzadeh Siamak, Simon Craig, Böcker Wolfgang, Bock Nathalie, Hutmacher Dietmar W, McGovern Jacqui
Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, Queensland, Australia.
Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Queensland, Australia.
J Orthop Res. 2025 May;43(5):984-993. doi: 10.1002/jor.26059. Epub 2025 Feb 25.
The management of large osseous defects requires innovative intramedullary bone graft harvesting techniques to optimize healing while minimizing complications. Intramedullary bone graft harvesting is, however, associated with potential cardiopulmonary adverse events due to embolic phenomena and systemic inflammation. This study compares the newly introduced aspirator + reaming-aspiration (ARA) concept with the established second-generation Reamer-Irrigator-Aspirator (RIA 2) system, focusing on cardiopulmonary safety in a non-fracture sheep femur model. Sixteen female Merino sheep underwent intramedullary bone grafting using either the RIA 2 system or the ARA concept. The primary outcomes measured were blood loss, hemodynamic parameters, pulmonary function via the Horovitz index, and systemic inflammatory responses postprocedure. Findings revealed minimal and comparable blood loss between the two groups (p = 0.55). Additionally, no significant differences were found in hemodynamic stability (all p ≥ 0.05), pulmonary function (p = 0.96), or systemic inflammation (all p ≥ 0.10) between the RIA 2 system and ARA concept groups, demonstrating the comparable safety profile of the ARA concept to the RIA 2 system. In conclusion, the ARA concept emerges as a viable and effective alternative to the RIA 2 system for intramedullary bone graft harvesting, with similar safety profiles. These promising results advocate for further clinical trials to validate the utility of the ARA concept in human patients.
大型骨缺损的治疗需要创新的髓内骨移植采集技术，以优化愈合效果并将并发症降至最低。然而，由于栓塞现象和全身炎症，髓内骨移植采集与潜在的心肺不良事件相关。本研究将新引入的抽吸器+扩髓-抽吸（ARA）概念与已确立的第二代扩髓冲洗抽吸器（RIA 2）系统进行比较，重点关注非骨折绵羊股骨模型中的心肺安全性。16只雌性美利奴绵羊使用RIA 2系统或ARA概念进行髓内骨移植。测量的主要结果包括失血量、血流动力学参数、通过霍洛维茨指数评估的肺功能以及术后全身炎症反应。结果显示两组之间的失血量极少且相当（p = 0.55）。此外，RIA 2系统组和ARA概念组在血流动力学稳定性（所有p≥0.05）、肺功能（p = 0.96）或全身炎症（所有p≥0.10）方面均未发现显著差异，表明ARA概念与RIA 2系统具有相当的安全性。总之，ARA概念是一种可行且有效的替代RIA 2系统进行髓内骨移植采集的方法，具有相似的安全性。这些有前景的结果提倡进一步开展临床试验，以验证ARA概念在人类患者中的实用性。
