Complications associated with negative pressure reaming for harvesting autologous bone graft: A case series

Jason A. Lowe, Gregory J. Della Rocca, Yvonne Murtha, Frank A. Liporace, Michael D. Stover, Sean E. Nork, Brett D. Crist

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm 3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalJournal of Orthopaedic Trauma
Issue number1
StatePublished - Jan 1 2010


  • Autogenous bone graft
  • Osteopenia
  • RIA system

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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