Can the Reamer/Irrigator/Aspirator System replace anterior iliac crest grafting when treating long bone nonunion?

Autor: Richard Volpi, Marie Le Baron, Pascal Maman, Xavier Flecher, Jean-Philippe Vivona
Rok vydání: 2019
Předmět:
Male
Time Factors
medicine.medical_treatment
Long bone
Bone grafting
Iliac crest
Postoperative Complications
0302 clinical medicine
Orthopedics and Sports Medicine
Femur
Prospective Studies
Fracture Healing
030222 orthopedics
Bone Transplantation
Orthopedic Equipment
Middle Aged
musculoskeletal system
surgical procedures
operative
medicine.anatomical_structure
Tissue and Organ Harvesting
Female
Femoral Fractures
Adult
musculoskeletal diseases
medicine.medical_specialty
Operative Time
Nonunion
Bone healing
Transplantation
Autologous
Ilium
Young Adult
03 medical and health sciences
medicine
Humans
Tibia
Therapeutic Irrigation
Retrospective Studies
Femur fracture
business.industry
030229 sport sciences
Length of Stay
medicine.disease
Surgery
Tibial Fractures
Fractures
Ununited
Diaphyses
business
Zdroj: Orthopaedics & Traumatology: Surgery & Research. 105:529-533
ISSN: 1877-0568
DOI: 10.1016/j.otsr.2018.12.011
Popis: INTRODUCTION Autologous bone graft is the gold standard for filling bone defects associated with diaphyseal nonunions. It is typically harvested from the anterior iliac crest (AIC) despite the high complication rate. The Reamer/Irrigator/Aspirator System (RIA) was developed to recover the reaming aspirate and use it as autograft. Initially described for harvesting bone from the femur, the bone volume available is similar to the AIC site; however, its use directly at nonunion sites has been studied very little. HYPOTHESES Compared to AIC harvesting, RIA at a non-union site will result in (1) sufficient bone volume, (2) similar time to union and union rate, (3) lower morbidity. RESULTS Two groups of patients received an autograft for aseptic nonunion of the tibia or femur for a bone defect up to 2cm: the RIA group (n=30) was followed prospectively and received an autograft by RIA while the AIC group (n=29) was reviewed retrospectively and received an autograft by AIC. We compared the time to union and union rate, operative time, intake of analgesics, duration of hospital stay and complication rate between groups. The RIA provided sufficient bone, 60cm3 on average in a reliable manner. The union rate was similar between groups: 90% (RIA) and 89.7% (CIA) (p=0.965), while the time to union was shorter in the RIA group (8.63±1.47months vs. 10.08±1.7 months) (p=0.006). The operative time (p
Databáze: OpenAIRE
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