Clinical experience of the use of reamer irrigator aspirator in Japanese patients: A report of the first 42 cases

Abstract

BackgroundA reamer irrigator aspirator (RIA) can be used to harvest substantial amounts of autologous bone and debride the intramedullary canal. Clinical experience using reamer irrigator aspirators in Japan is very limited. The applicability of the reamer irrigator aspirator head with a minimum diameter of 12 mm for Japanese people is often questioned as the Japanese are smaller than Americans and Europeans. There are no reports of complications in Japanese patients. This study aimed to retrospectively review clinical cases and describe reamer irrigator aspirator use in Japanese patients. MethodsAll patients for whom a reamer irrigator aspirator was used during surgery at our hospital between January 2014 and September 2018 were included. The patients’ clinical and radiographic data were retrospectively reviewed. ResultsData of 40 patients (42 cases) were collected. The reamer irrigator aspirator was used for bone graft harvesting in 32 cases, intramedullary debridement and irrigation in 9 cases, and reaming for exchange nailing in 1 case. The diameter of the reamer irrigator aspirator reamer head was 12 mm in 22 cases (53.7%), 12.5 mm in 4 cases (9.8%), 13 mm in 9 cases (22.0%), 13.5 mm in 1 case (2.4%), 14.0 mm in 1 case (2.4%), 14.5 mm in 1 case (2.4%), and 15 mm in 4 cases (9.8%). Mean intraoperative bleeding volume was 1158.6 mL (range, 100–3800 mL). We experienced no difficulty inserting the reamer irrigator aspirator into the intramedullary canals and no cases of insertion-related intraoperative fracture. Five cortical perforations (11.9%) were observed on postoperative computed tomography scans, although no patient was symptomatic. One case (2.4%) of postoperative femur fracture occurred. ConclusionsReamer irrigator aspirators can be used in Japanese patients. Smaller reamer head sizes were mainly used in our experience. We should manage complications as in previous reports from Western countries.