Abstract
Introduction:
Open bone graft harvesting continues to be recognized as the gold standard of obtaining autograft in patients needing bone graft. Conventional bone graft harvesting using the iliac crest is often cited as having significant donor site morbidity and complications. Intramedullary harvesting, using a reamer irrigation aspiration system (RIA) has recently become available.
Method:
We performed a retrospective case series on 16 patients, where this system was used. A single pass reaming technique to harvest autograft from the femoral canal was performed. Fluoroscopy was used to size the canal and to confirm placement of a guide wire. Bone harvest volumes, complications encountered and donor site satisfaction post operatively was assessed. Patient satisfaction was determined via telephonic interviews at regular intervals with follow-up times up to 2 years.
Results:
The study group consisted of 16 patients with an average age of 31 years. The mean post-operative follow up period was 18.8 months. The average amount of bone harvested was 39.6 cc. Although two technical complications were encountered intra-operatively, there were no systemic effects due to reaming. Most of the patients reported mild to severe pain immediately post operatively with an average pain score of 6.5 (1–10). Only seven patients reported minor pain at the donor site with the last interview bringing the average pain score down to 1.2. All pain scores reduced to zero after 21 months.
Conclusion:
RIA was found to be a safe technique with reliable volumes of autograft obtained. Patients recovered quickly with no wound complications reported and minimal donor site morbidity at early follow-up. This new technique seems to be a viable option as an alternative to conventional bone graft harvesting.
