Complications Associated With Negative Pressure Reaming for Harvesting Autologous Bone Graft: A Case Series

被引:49
作者
Lowe, Jason A. [1 ]
Della Rocca, Gregory J. [1 ]
Murtha, Yvonne [1 ]
Liporace, Frank A. [2 ]
Stover, Michael D. [3 ]
Nork, Sean E. [4 ]
Crist, Brett D. [1 ]
机构
[1] Univ Missouri, Dept Orthopaed Surg, Columbia, MO 65212 USA
[2] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Orthopaed Surg, Newark, NJ 07103 USA
[3] Loyola Univ, Dept Orthopaed Surg, Chicago, IL 60611 USA
[4] Univ Washington, Harborview Med Ctr, Dept Orthopaed Surg, Seattle, WA 98104 USA
关键词
RIA system; autogenous bone graft; osteopenia; CONTROL ORTHOPEDIC-SURGERY; ILIAC CREST; DAMAGE CONTROL; POLYTRAUMA PATIENTS; SITE MORBIDITY; INTRAMEDULLARY; FRACTURES; FIXATION; FEMUR; SHEEP;
D O I
10.1097/BOT.0b013e31819c0ccb
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm(3)) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.
引用
收藏
页码:46 / 52
页数:7
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