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3D geometry of femoral reaming for bone graft harvesting

The reamer-irrigator-aspirator (RIA) technique allows to collect large bone graft amounts without the drawbacks of iliac crest harvesting. Nevertheless, clinical cases with occurrence of femur fractures have been reported. Therefore, this study aimed to systematically investigate the three-dimension...

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Autores principales: Gehweiler, Dominic, Schmitz, Nina, Gueorguiev, Boyko, Zderic, Ivan, Grünwald, Leonard, Richards, Geoff, Wähnert, Dirk, Raschke, Michael J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387500/
https://www.ncbi.nlm.nih.gov/pubmed/34433855
http://dx.doi.org/10.1038/s41598-021-95983-8
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author Gehweiler, Dominic
Schmitz, Nina
Gueorguiev, Boyko
Zderic, Ivan
Grünwald, Leonard
Richards, Geoff
Wähnert, Dirk
Raschke, Michael J.
author_facet Gehweiler, Dominic
Schmitz, Nina
Gueorguiev, Boyko
Zderic, Ivan
Grünwald, Leonard
Richards, Geoff
Wähnert, Dirk
Raschke, Michael J.
author_sort Gehweiler, Dominic
collection PubMed
description The reamer-irrigator-aspirator (RIA) technique allows to collect large bone graft amounts without the drawbacks of iliac crest harvesting. Nevertheless, clinical cases with occurrence of femur fractures have been reported. Therefore, this study aimed to systematically investigate the three-dimensional geometry of the reamed bone as a function of the reaming diameter and its influence on the associated potential fracture pattern. Forty-five intact fresh-frozen human cadaveric femora underwent computed tomography (CT). They were randomized to three groups (n = 15) for reaming at a diameter of either 1.5 mm (Group 1), 2.5 mm (Group 2) or 4.0 mm (Group 3) larger than their isthmus using RIA. Reaming was followed by a second CT scan, biomechanical testing until failure and a third CT scan. All CT scans of each femur were aligned via rigid registration, and fracture lines were visualized. Subsequently, a decrease in wall thickness, cross-sectional area, and harvested bone volume have been evaluated. The total volume of the bone graft was significantly higher for Group 3 (7.8 ± 2.9 ml) compared to Group 1 (2.9 ± 1.1 ml) and Group 2 (3.0 ± 1.1 ml). The maximal relative decrease of the wall thickness was located medially (72.7%) in the third (61.4%), fourth (18.2%) and second (9.1%) eighth for all groups. As the diameter of the reaming increased, an overlap of the fracture line with the maximal relative decrease in wall thickness and a maximal average relative decrease of the cross-sectional area became more frequent. This suggests that a reaming-associated fracture is most likely to occur in this region.
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spelling pubmed-83875002021-09-01 3D geometry of femoral reaming for bone graft harvesting Gehweiler, Dominic Schmitz, Nina Gueorguiev, Boyko Zderic, Ivan Grünwald, Leonard Richards, Geoff Wähnert, Dirk Raschke, Michael J. Sci Rep Article The reamer-irrigator-aspirator (RIA) technique allows to collect large bone graft amounts without the drawbacks of iliac crest harvesting. Nevertheless, clinical cases with occurrence of femur fractures have been reported. Therefore, this study aimed to systematically investigate the three-dimensional geometry of the reamed bone as a function of the reaming diameter and its influence on the associated potential fracture pattern. Forty-five intact fresh-frozen human cadaveric femora underwent computed tomography (CT). They were randomized to three groups (n = 15) for reaming at a diameter of either 1.5 mm (Group 1), 2.5 mm (Group 2) or 4.0 mm (Group 3) larger than their isthmus using RIA. Reaming was followed by a second CT scan, biomechanical testing until failure and a third CT scan. All CT scans of each femur were aligned via rigid registration, and fracture lines were visualized. Subsequently, a decrease in wall thickness, cross-sectional area, and harvested bone volume have been evaluated. The total volume of the bone graft was significantly higher for Group 3 (7.8 ± 2.9 ml) compared to Group 1 (2.9 ± 1.1 ml) and Group 2 (3.0 ± 1.1 ml). The maximal relative decrease of the wall thickness was located medially (72.7%) in the third (61.4%), fourth (18.2%) and second (9.1%) eighth for all groups. As the diameter of the reaming increased, an overlap of the fracture line with the maximal relative decrease in wall thickness and a maximal average relative decrease of the cross-sectional area became more frequent. This suggests that a reaming-associated fracture is most likely to occur in this region. Nature Publishing Group UK 2021-08-25 /pmc/articles/PMC8387500/ /pubmed/34433855 http://dx.doi.org/10.1038/s41598-021-95983-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Gehweiler, Dominic
Schmitz, Nina
Gueorguiev, Boyko
Zderic, Ivan
Grünwald, Leonard
Richards, Geoff
Wähnert, Dirk
Raschke, Michael J.
3D geometry of femoral reaming for bone graft harvesting
title 3D geometry of femoral reaming for bone graft harvesting
title_full 3D geometry of femoral reaming for bone graft harvesting
title_fullStr 3D geometry of femoral reaming for bone graft harvesting
title_full_unstemmed 3D geometry of femoral reaming for bone graft harvesting
title_short 3D geometry of femoral reaming for bone graft harvesting
title_sort 3d geometry of femoral reaming for bone graft harvesting
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387500/
https://www.ncbi.nlm.nih.gov/pubmed/34433855
http://dx.doi.org/10.1038/s41598-021-95983-8
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