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Reamer–Irrigator–Aspirator bone graft harvesting for treatment of segmental bone loss: analysis of defect volume as independent risk factor for failure

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The management of segmental bone loss poses a significant clinical challenge. The purpose of this study was to conduct a retrospective evaluation of our experience in treating segmental bone loss, using Reamer–Irrigator–Aspirator (RIA)-harvested autologous bone graft.

Materials and methods

Between June 2008 and March 2015, 81 patients were treated with the RIA technique for multiple purposes. Inclusion criteria for this study were skeletal mature patients with segmental bone loss, due to acute trauma or non-union, who were treated with RIA-harvested bone graft. Exclusion criteria were skeletal immaturity, pathological fractures and indications for the RIA system other than bone graft harvesting. The primary outcome parameter was clinical and radiographical bone healing.

Results

During the study period, 72 patients met the inclusion criteria. In total, 39 patients (54.2%) were classified as having clinical and radiographical bone healing. Although univariate analysis could not reveal any significant influence of specific risk factors to predict the outcome, there was a trend towards statistical significance for defect volume. Further analysis indeed revealed that smaller defect volumes (< 8 cm3) had a lower risk of non-union.

Conclusions

In approximately half of our study population, the use of the RIA technique for autologous bone graft harvesting in cases of segmental bone loss resulted in a successful outcome with bone healing. Defect size seems to be a critical issue regarding the outcome. Although our results are less promising than previously published, the RIA technique has its place in the treatment algorithm of segmental bone defects.

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Authors and Affiliations

  1. Department Development and Regeneration, KU Leuven-University of Leuven, B-3000, Louvain, Belgium

    W. J. Metsemakers, H. Hoekstra & S. Nijs

  2. Department of Trauma Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Louvain, Belgium

    W. J. Metsemakers, G. Claes, H. Hoekstra & S. Nijs

  3. Department of Radiology, University Hospitals Leuven, B-3000, Louvain, Belgium

    P. J. Terryn

  4. KU Leuven-University of Leuven, L-BioStat, B-3000, Louvain, Belgium

    A. Belmans

Authors
  1. W. J. Metsemakers
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  2. G. Claes
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  4. A. Belmans
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Correspondence to W. J. Metsemakers.

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Conflict of interest

All authors were involved in the study and contributed substantially to the manuscript. Each of the authors is in agreement with the contents of the manuscript. Prof. dr. Willem-Jan Metsemakers and prof. dr. Stefaan Nijs are consultants for DepuySynthes. Prof. dr. Harm Hoekstra is a member of the lecture bureau of DepuySynthes. The department of Trauma Surgery receives an unrestricted research grant from DepuySynthes and is a training centre for DepuySynthes. All authors hereby disclose any financial and personal relationships with other people or organizations that could inappropriately influence this work.

Ethical standards

Given the retrospective nature of the study, the results described did not contain direct research involving Human Participants, nor did it contain research on Animals. The study protocol was conducted following good clinical practice guidelines. The study was approved by the Ethics Committee of the Catholic University Leuven, Belgium.

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Metsemakers, W.J., Claes, G., Terryn, P.J. et al. Reamer–Irrigator–Aspirator bone graft harvesting for treatment of segmental bone loss: analysis of defect volume as independent risk factor for failure. Eur J Trauma Emerg Surg 45, 21–29 (2019). https://doi.org/10.1007/s00068-017-0821-7

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  • DOI: https://doi.org/10.1007/s00068-017-0821-7

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