ArticlePloS one2018
Complications and risk management in the use of the reaming-irrigator-aspirator (RIA) system: RIA is a safe and reliable method in harvesting autologous bone graft.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Complications associated using the reamer-irrigator -aspirator (RIA) system: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Outcomes and complications of the reamer irrigator aspirator versus traditional iliac crest bone graft harvesting: a systematic review and meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2021Pooled it
- The road to the Pearl-String Technique: lessons learned from early IMT modifications using RIA autograft and cancellous allograft granules.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Control Group Selection in Preclinical Rat Bone Defect Models: A Systematic Review.Journal of functional biomaterials · 2026Review
- Novel Technique for Extracting Metallic Debris from a Broken Reamer-Irrigator-Aspirator-2 Head within the Intramedullary Canal.Journal of orthopaedic case reports · 2025Article
- Managing Nonunions and Fracture-Related Infections-A Quarter Century of Knowledge, and Still Curious: A Narrative Review.Journal of clinical medicine · 2025Review
- Complications of Reamer-Irrigator-Aspirator System in Pediatric Orthopedic Surgery-Case Series and Scoping Review.Children (Basel, Switzerland) · 2025Review
- Assessing Cardiopulmonary Safety of Intramedullary Bone Graft Harvesting: A Comparative Study of the RIA 2 System and the ARA Concept.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- Autologous Bone Graft Harvest Technique Using Reamer-Irrigator-Aspirator for 2-Stage Revision Anterior Cruciate Ligament Reconstruction.Arthroscopy techniques · 2025Article
- [Modified Masquelet technique for reconstruction of critical bone defects].Unfallchirurgie (Heidelberg, Germany) · 2024Review
- An in vivo study to investigate an original intramedullary bone graft harvesting technology.European journal of medical research · 2023Article
- Masquelet Technique and Proximal Tibial Autograft Utilizing Avitus® Bone Harvester for Severely Comminuted Open Distal Radius Fracture with Extensive Bone Loss: A Case Report.Journal of orthopaedic case reports · 2022Article
- Safety and efficacy of a novel retrograde route for femoral bone graft harvesting by Reamer-Irrigator-Aspirator: a pilot study on 24 patients.Patient safety in surgery · 2022Article
- Autologous Bone Grafting in Trauma and Orthopaedic Surgery: An Evidence-Based Narrative Review.Journal of clinical medicine · 2021Review
- 3D geometry of femoral reaming for bone graft harvesting.Scientific reports · 2021Article
- Early myocardial damage (EMD) and valvular dysfunction after femur fracture in pigs.Scientific reports · 2021Article
- The Influence of an Occult Infection on the Outcome of Autologous Bone Grafting During Surgical Bone Reconstruction: A Large Single-Center Case-Control Study.Journal of inflammation research · 2021Article
- Additive Manufacturing of β-Tricalcium Phosphate Components via Fused Deposition of Ceramics (FDC).Materials (Basel, Switzerland) · 2020Article
- Treatment options for aseptic tibial diaphyseal nonunion: A review of selected studies.EFORT open reviews · 2020Review
- [Diamond concept for treatment of nonunions and bone defects].Der Unfallchirurg · 2020Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAutologous bone grafting (ABG) remains the gold standard for augmentation of bone defects. The RIA system has become more prevalent, but evidence regarding risk management and complications remain scarce. This study presents the risk management and complications associated with RIA in the largest single-center case series to date.
methodsAll records, operative notes, lab data and radiographs of patients receiving a RIA procedure at Heidelberg´s University Hospital between 01/01/2010 and 31/12/2016 were reviewed. Multivariate logistic regression models adjusting for clinically relevant covariates were used to examine the respective relevance regarding the presence and absence of prolonged postoperative pain (PPP).
resultsA total of 341 RIA procedures on 306 patients were performed at our level-1 trauma center. The femur was the main donor site (98.53%; N = 336) whereas only in 1.47% (N = 5) the tibia was utilized. A total of 11 patients showed a relevant loss of hemoglobin requiring blood transfusion. A total of 22 patients suffered from PPP directly associated with the RIA procedure resulting in prevalence of 6.45%. The 6 major complications in our study were of diverse origin and all intraoperative complications took place in the early phase of the RIA procedure in our center (2010-2013). Our data revealed influence of sex (p = 0.0459) and age (p = 0.0596) on the criterion PPP. The favored model including sex and age resulted in an AUC of 66.2% (CI: 55.5%-76.9%).
conclusionPerioperative blood loss remains a prevalent complication during RIA reaming. In addition, PPP occurs with a prevalence of 6.45%. This study showed a complication rate of 1.76%, emphasizing RIA´s overall safety and furthermore highlighting the need for vigilance in its application and prior extensive hands-on training of surgeons. Level of Evidence: II.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.