Reaming Irrigator Aspirator system: Early experience of its multipurpose use

The evolution of contemporary intramedullary reaming systems has recently generated the Reamer Irrigator Aspirator system (RIA - Synthes (R)), which has progressively gained in popularity as well as in indications. The preliminary results of its use over the initial period of 18 months at a single tertiary referral centre were prospectively collected and are presented. The wide spectrum of RIA's indications have been exploited, including 7 patients with polytrauma that underwent acute femoral nailing, 8 with femoral intramedullary osteomyelitis, 9 with pathological lesions of the femoral shaft, as well as 18 patients where the RIA system has been used to harvest morselised autologous bone graft in the presence of recalcitrant atrophic non-unions and bone defects. Overall its use was proven safe and efficient, achieving aggressive medullary canal debridement, collection of adequate samples for further analysis in the infected and oncology cases, as well as impressive volumes of the osteoinductive and osteogenic reaming debris for grafting purposes. No pulmonary complications or evidence of the second hit sequelae were recorded in the polytrauma patient subgroup despite the presence of a high ISS Further controlled clinical studies should follow focused in all different applications of this reliable, userfriendly and impressively versatile system, to validate these preliminary results. (C) 2011 Elsevier Ltd. All rights reserved.