SA Orthopaedic Journal
Print version ISSN 1681-150X
SPRONG, Francois; SNYCKERS, Christian Hugo and BIRKHOLTZ, Franz Friedrich. Autologous intramedullary bone graft harvesting as an alternative to conventional harvesting methods. SA orthop. j. [online]. 2011, vol.10, n.4, pp. 53-58. ISSN 1681-150X.
Conventional bone graft harvesting using the iliac crest is often cited as having significant donor site morbidity and complications. A technique has become available in the form of intramedullary harvesting, using a reamerirrigationaspiration (RIA) system. It is hailed as a safe alternative, with minimal donor site morbidity and pain. This study presents a retrospective case series of 16 patients where the RIA system was used as a harvesting technique from June 2008 to January 2010. This technique involves harvesting autograft from the femoral canal (anterograde or retrograde) by reaming the intramedullary cavity only once. A single surgeon performed the operations over a 24month period. Fluoroscopy was used to size and measure the width of the canal and to confirm guide wire placement. Outcomes evaluated were postoperative pain perception and patient satisfaction. Bone harvest volumes, intraand postoperative complications and bony union were noted. Telephonic interviews were conducted in all 16 cases. The average age of the patients was 31 years (15-55 years). The femoral canal was used as the donor site in all the patients. The mean postoperative followup period was 18.8 months (8-27 months). The average amount of bone harvested was 39.6 cc (20-70 cc). Two technical complications were encountered intraoperatively and there were no systemic complications due to reaming. Although The RIA system was found to be a safe technique, with reliable volumes of autograft obtained. Patients recovered quickly without wound complications and minimal donorsite morbidity. This technique seems to be a viable option as an alternative to conventional bone graft harvesting. Ethical clearance was obtained from The Research Ethics Committee, Faculty of Health Sciences, University of Pretoria.
Keywords : Reamerirrigationaspiration; bone graft harvesting; intramedullary harvesting; RIA; donor site morbidity; donor site complications.