Incidence of donor site morbidity following harvesting from iliac crest or RIA graft

G M Calori; M Colombo; E L Mazza; S Mazzola; E Malagoli; G V Mineo

doi:10.1016/j.injury.2014.10.034

Incidence of donor site morbidity following harvesting from iliac crest or RIA graft

Injury. 2014 Dec:45 Suppl 6:S116-20. doi: 10.1016/j.injury.2014.10.034. Epub 2014 Oct 27.

Authors

G M Calori¹, M Colombo², E L Mazza², S Mazzola², E Malagoli², G V Mineo³

Affiliations

¹ Reparative Orthopaedic Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy. Electronic address: gmc@studiocalori.it.
² Reparative Orthopaedic Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
³ University Department of Orthopaedic, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.

PMID: 25457330
DOI: 10.1016/j.injury.2014.10.034

Abstract

Introduction: Clinical management of non-union of long bone fractures and segmental bone defect is a challenge for orthopaedic surgeons. The use of autologous bone graft (ABG) is always considered the gold standard treatment. Traditional techniques for harvesting ABG from iliac crest usually involve several complications, particularly at the donor site. The Reamer-Irrigator-Aspirator (RIA) is an intramedullary reaming system that generates a large volume of cancellous bone material in a single-step reaming process; this bone material can be collected and potentially used as an ABG source. Our interest is to compare the complications associated with the standard technique of harvesting from iliac crest with those of the innovative RIA harvesting device.

Materials and methods: A database of 70 patients with long bone non-unions was studied. The patients were divided into two groups according to the surgical harvesting technique used: RIA system ABG (35 patients) and iliac crest ABG (35 patients).

Results: At the 12-month follow-up, pain at the donor site was reported in no patients in the RIA system ABG group and five of 35 patients (14.28%) in the iliac crest ABG group. Local infections at the donor site were found in no patients in the RIA system ABG group compared with five patients (14.28%) in the iliac crest ABG group. There were no fractures in the RIA system ABG group and one case (2.85%) of anterior superior iliac spine (ASIS) dislocation in the iliac crest ABG group. No systemic infections were detected in either group.

Discussion: We analysed the scientific literature on the use of RIA technique to collect ABG for use in patients with anthropic-oligotrophic non-unions, with a focus on the complications associated with this technique.

Conclusion: RIA bone graft for the treatment of non-unions and segmental bone defect of long bones seems to be a safe and efficient procedure with low donor site morbidity.

Keywords: Bone defect; Bone graft; Diamond concept; Iliac crest; Non-union; Polytherapy; RIA; Reamer irrigator aspirator; Segmental defect.

Publication types

Review

MeSH terms

Bone Transplantation / adverse effects
Bone Transplantation / methods*
Equipment Design
Femoral Fractures / diagnostic imaging
Femoral Fractures / surgery*
Follow-Up Studies
Fracture Healing*
Fractures, Ununited / diagnostic imaging
Fractures, Ununited / surgery*
Graft Survival
Humans
Ilium / pathology
Ilium / transplantation*
Incidence
Radiography
Retrospective Studies
Suction / instrumentation
Therapeutic Irrigation
Tissue and Organ Harvesting / adverse effects
Tissue and Organ Harvesting / instrumentation*
Transplant Donor Site / pathology*
Transplantation, Autologous
Treatment Outcome