scholarly journals Safety and efficacy of a novel retrograde route for femoral bone graft harvesting by Reamer-Irrigator-Aspirator: a pilot study on 24 patients

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Fernando Bidolegui ◽  
Sebastián Pereira ◽  
Cristina Irigoyen ◽  
Robinson Esteves Pires
Keyword(s):  
Postoperative Pain ◽  
Bone Graft ◽  
Iliac Crest ◽  
Bone Defects ◽  
Femoral Bone ◽  
Femoral Route ◽  
Bone Graft Harvesting ◽  
Post Traumatic ◽  
Graft Volume

Abstract Background The Reamer–Irrigator–Aspirator system was initially developed to reduce fat embolism and thermic necrosis during reamed intramedullary nail fixation of femoral shaft fractures. Currently, this system is used in extended applications including accessing large volume of autologous bone graft, as alternative for iliac crest harvesting. Antegrade femoral bone graft harvesting using the Reamer-Irrigator-Aspirator system is considered the standard technique. The aim of our study is to evaluate the efficacy (bone graft volume) and the complications (blood loss, postoperative pain, and incidence of iatrogenic fractures) of the Reamer–Irrigator–Aspirator system through the retrograde femoral route in a series of patients with post-traumatic bone defects or nonunions. Methods A non-controlled single center retrospective observational cohort study was conducted in a level1 trauma center to evaluate all patients who were treated using the RIA system. Between November 2015 and May 2019, 24 patients (8 women and 16 men; mean age: 41 years [range 27–55 years]) with bone defects or nonunions underwent bone graft harvesting using the Reamer–Irrigator–Aspirator system through retrograde femoral route. Postoperative pain, complications, and bone graft volume were analyzed. Inclusion criteria was patients older than 18 years with a diagnosis of post-traumatic bone defect or associated tibial or femoral nonunion, with minimum 6-months follow, treated using the RIA. We hypothesized that the retrograde route of the RIA system is a safe and efficacious method for bone harvesting. Results The average volume of collected graft was 45 cc (range 30–60 cc). In 83% of the cases, bone grafting was sufficient, while in 17% it was necessary to add iliac crest bone graft to completely fill the bone defect. A mean drop in postoperative hemoglobin of 4.1 g / dL (range 0.5–6.0 g / dL) was evidenced. In 4 cases (33%), a unit of packed red blood cells was required. Regarding postoperative pain, visual analogue scale after 3 months postoperatively was 1.6 in average. After 6 months, the value has decreased to 0.4. There were no perioperative or postoperative complications at 6-month follow-up. Conclusion In this limited case series, large volumes of bone graft were harvested using the retrograde route of the RIA system and there were no intra-/ postoperative complications observed at 6-month follow-up. Therefore this novel technique appears safe and efficacious. However, it’s important to highlight that future prospective controlled studies are necessary to validate the insights from this pilot study.

Postoperative pain following posterior iliac crest bone graft harvesting in spine surgery: a prospective, randomized trial

2018 ◽  
Vol 18 (6) ◽  
pp. 986-992 ◽  
Author(s):  
Evan D. Sheha ◽  
Dennis S. Meredith ◽  
Grant D. Shifflett ◽  
Benjamin T. Bjerke ◽  
Sravisht Iyer ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Bone Graft ◽  
Randomized Trial ◽  
Spine Surgery ◽  
Iliac Crest ◽  
Prospective Randomized Trial ◽  
Iliac Crest Bone Graft ◽  
Posterior Iliac Crest ◽  
Bone Graft Harvesting

scholarly journals Outcomes and complications of the reamer irrigator aspirator versus traditional iliac crest bone graft harvesting: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Oliva ◽  
Filippo Migliorini ◽  
Francesco Cuozzo ◽  
Ernesto Torsiello ◽  
Frank Hildebrand ◽  
...  
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Meta Analysis ◽  
Medullary Canal ◽  
Current Evidence ◽  
Iliac Crest Bone Graft ◽  
Bone Graft Harvesting ◽  
Mean Time ◽  
Lower Site

Abstract Background The reamer irrigator aspirator (RIA) is a relatively recent device that is placed in the medullary canal of long bones to harvest a large volume of bone marrow, which is collected in a filtered canister. This study compares outcomes and complications of the RIA versus a traditional iliac crest bone graft (ICBG) for the treatment of bone defects. Methods This meta-analysis was conducted according to the PRISMA guidelines. The Embase, Google Scholar, PubMed, and Scopus databases were accessed in June 2021. All clinical trials comparing the RIA and ICBG with a minimum of 6 months follow-up were included. Results Data from 4819 patients were collected. The RIA group demonstrated lower site pain (P < 0.0001), fewer infections (P = 0.001), and a lower rate of adverse events (P < 0.0001). The ICBG group demonstrated a greater rate of bone union (P < 0.0001). There was no difference between groups in VAS (P = 0.09) and mean time to union (P = 0.06). Conclusion The current evidence supports the use of the RIA, given its low morbidity and short learning curve.

Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate

2021 ◽  
pp. 105566562110251
Author(s):  
Vijay Kumar ◽  
Vidya Rattan ◽  
Sachin Rai ◽  
Satinder Pal Singh ◽  
Jai Kumar Mahajan
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Volumetric Analysis ◽  
Group I ◽  
Alveolar Bone Grafting ◽  
Group Ii ◽  
Demineralized Bone

Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. Design: Prospective, randomized, parallel groups, double-blind, controlled trial. Setting: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. Participants: Twenty patients with UCLP. Interventions: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. Outcomes Measures: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting. Results: Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I. Conclusions: Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.

scholarly journals Patients’ appreciation of pre-implant augmentation of the severely resorbed maxilla with calvarial or anterior iliac crest bone:a randomized controlled trial

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Dagmar E. Wortmann ◽  
Carina G. Boven ◽  
Jurjen Schortinghuis ◽  
Arjan Vissink ◽  
Gerry M. Raghoebar
Keyword(s):  
Oral Health ◽  
Bone Graft ◽  
Iliac Crest ◽  
Controlled Trial ◽  
Scar Formation ◽  
Physical Mobility ◽  
Post Operative Pain ◽  
Chewing Ability ◽  
Bone Graft Harvesting ◽  
The Impact

Abstract Background Little is known about the impact of bone graft harvesting for pre-implant augmentation of the maxilla from a patient’s perspective. To assess patient-reported outcome measures (PROMs) related to augmentation of the extremely resorbed edentulous maxilla with calvarial or anterior iliac crest bone. Materials and methods For this randomised controlled trial, 20 consecutive edentulous patients needing extensive pre-implant surgery of the maxilla were randomly assigned to either calvarial (n = 10) or anterior iliac crest (n = 10) bone harvesting. Patient reports on procedure-related satisfaction, questionnaires on oral functionality (denture satisfaction, chewing ability) and oral health-related quality of life (OHIP-49NL) and subjective donor site-related outcomes (e.g. of post-operative pain, scar formation, physical mobility) were assessed. Results Irrespective of the harvesting site, patients were generally satisfied (median VAS score 93 (86–99) mm, p = 0.400) with the procedure and its final results. Post-operative pain was mild (median 40 (20–40) mm) and decreased to no pain (4 (0–16) mm) within 14 days. Early post-operative pain was significantly higher following anterior iliac crest harvesting (p < 0.00). Impact on physical mobility, daily functioning and satisfaction with the scar formation were similar in both groups. Conclusions The assessed PROMs confirmed that bone graft harvesting from the calvarium or anterior iliac crest is an appropriate procedure, reflected by high levels of satisfaction, minor long-term sequela and improvement of perceived oral health. For clinical decision-making, decisions can be based on individual features and preferences. Trial registration NTR, NTR3968, registered 1 July 2013.

Reconstruction of the glenoid using autologous bone-graft and the SMR Axioma TT metal-backed prosthesis

2018 ◽  
Vol 100-B (12) ◽  
pp. 1609-1617 ◽  
Author(s):  
A. M. Malhas ◽  
J. Granville-Chapman ◽  
P. M. Robinson ◽  
S. Brookes-Fazakerley ◽  
M. Walton ◽  
...  
Keyword(s):  
Bone Graft ◽  
Reliable Method ◽  
Titanium Surface ◽  
Bone Defects ◽  
Autologous Bone Graft ◽  
Short Term ◽  
Bone Deficiency ◽  
Autologous Bone ◽  
Shoulder Arthroplasties

Aims We present our experience of using a metal-backed prosthesis and autologous bone graft to treat gross glenoid bone deficiency. Patients and Methods A prospective cohort study of the first 45 shoulder arthroplasties using the SMR Axioma Trabecular Titanium (TT) metal-backed glenoid with autologous bone graft. Between May 2013 and December 2014, 45 shoulder arthroplasties were carried out in 44 patients with a mean age of 64 years (35 to 89). The indications were 23 complex primary arthroplasties, 12 to revise a hemiarthroplasty or resurfacing, five for aseptic loosening of the glenoid, and five for infection. Results Of the 45 patients, 16 had anatomical shoulder arthroplasties (ASA) and 29 had reverse shoulder arthroplasties (RSA). Postoperatively, 43/45 patients had a CT scan. In 41 of 43 patients (95%), the glenoid peg achieved > 50% integration. In 40 of 43 cases (93%), the graft was fully or partially integrated. There were seven revisions (16%) but only four (9%) required a change of baseplate. Four (25%) of the 16 ASAs were revised for instability or cuff failure. At two-year radiological follow-up, five of the 41 cases (11%) showed some evidence of lucent lines. Conclusion The use of a metal baseplate with a trabecular titanium surface in conjunction with autologous bone graft is a reliable method of addressing glenoid bone defects in primary and revision RSA setting in the short term. ASAs have a higher rate of complications with this technique.

Anterior Iliac Crest Bone Graft Harvesting Using the Corticocancellous Reamer System

2001 ◽  
Vol 15 (7) ◽  
pp. 500-506 ◽  
Author(s):  
Geoffrey H. Westrich ◽  
David S. Geller ◽  
Martin J. O'Malley ◽  
Jonathan T. Deland ◽  
David L. Helfet
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Iliac Crest Bone Graft ◽  
Bone Graft Harvesting
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