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Gewinnung großvolumiger Spongiosamengen zur autologen Knochentransplantation aus dem femoralen Markraum

Eine besondere Applikation der „Reamer-Irrigator-Aspirator-“ (RIA-)Technik

Voluminous bone graft harvesting of the femoral marrow cavity for autologous transplantation

An indication for the“Reamer-Irrigator-Aspirator-” (RIA-)technique

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Zusammenfassung

Autologe Knochentransplantate haben aufgrund ihrer hervorragenden osteoinduktiven, osteogenetischen sowie osteokonduktiven Eigenschaften biomechanische Vorteile gegenüber künstlichen Knochenpräparaten. Auch im Vergleich zu Kadavertransplantaten oder Xenotransplantaten sind diese aufgrund fehlender immunologischer Abstoßung oder Übertragung infektiöser Erkrankungen vorteilhaft. Die limitierte Verfügbarkeit der autologen Knochenspongiosa bedingt es jedoch, bei großen Knochendefekten auf oben genannte Knochenersatzstoffe zurückzugreifen.

Seit kurzem ist eine neue Technik verfügbar, welche die Gewinnung größerer Volumina an autologer Knochenspongiosa erlaubt. Wir berichten über die Verwendung der „Reamer-Irrigator-Aspirator-“ (RIA-)Technik zur Gewinnung von Knochenspongiosa bei einem Patienten mit Pseudarthrose bei großer Defektzone des proximalen Femurs. Hierzu wurde das kontralaterale Femur in gesamter Länge aufgebohrt und die gewonnene Knochenspongiosa im Bereich der Pseudarthrose angelagert. Klinisch und radiologisch zeigte sich im Verlauf eine Ausheilung der Pseudarthrose ohne Entnahmemorbidität.

Abstract

Due to their excellent osteoinductive, osteogenetic, and osteoconductive properties, autologous bone grafts possess biomechanical advantages over synthetic bone substitutes. Furthermore, unlike cadaveric allografts and xenografts, they carry no risk of immunogenic response or transmission of infectious diseases. However, the limited availability of autologous bone grafts requires the use of the above-mentioned bone substitutes for management of large bone defects.

The“Reamer-Irrigator-Aspirator-” (RIA-)technique may present an alternative method for harvesting a larger volume of autologous bone graft as compared with conventional harvesting procedures. We report on intramedullary reaming by the RIA technique to obtain autologous bone graft for a nonunion of the proximal femur. The contralateral femur was reamed and the bone graft was applied to the nonunion. The patient showed clinical and radiological healing of the nonunion without donor site complications.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kaufmann Medical Building, University of Pittsburgh, 3471 Fifth Avenue, Suite 1010, Pittsburgh, PA 15213, USA

    P. Kobbe, I.S. Tarkin & H.C. Pape

  2. Center for Surgical Research, University of Alabama, Birmingham, USA

    M. Frink

Authors
  1. P. Kobbe
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  2. I.S. Tarkin
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  3. M. Frink
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  4. H.C. Pape
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Correspondence to P. Kobbe.

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Kobbe, P., Tarkin, I., Frink, M. et al. Gewinnung großvolumiger Spongiosamengen zur autologen Knochentransplantation aus dem femoralen Markraum. Unfallchirurg 111, 469–472 (2008). https://doi.org/10.1007/s00113-007-1359-7

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  • DOI: https://doi.org/10.1007/s00113-007-1359-7

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