3D geometry of femoral reaming for bone graft harvesting

Abstract 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-...

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Autores principales:	Dominic Gehweiler, Nina Schmitz, Boyko Gueorguiev, Ivan Zderic, Leonard Grünwald, Geoff Richards, Dirk Wähnert, Michael J. Raschke
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8dfa9319579f4cedb7b1cc033f58d3ce
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spelling	oai:doaj.org-article:8dfa9319579f4cedb7b1cc033f58d3ce2021-12-02T16:34:58Z3D geometry of femoral reaming for bone graft harvesting10.1038/s41598-021-95983-82045-2322https://doaj.org/article/8dfa9319579f4cedb7b1cc033f58d3ce2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95983-8https://doaj.org/toc/2045-2322Abstract 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.Dominic GehweilerNina SchmitzBoyko GueorguievIvan ZdericLeonard GrünwaldGeoff RichardsDirk WähnertMichael J. RaschkeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dominic Gehweiler Nina Schmitz Boyko Gueorguiev Ivan Zderic Leonard Grünwald Geoff Richards Dirk Wähnert Michael J. Raschke 3D geometry of femoral reaming for bone graft harvesting
description	Abstract 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.
format	article
author	Dominic Gehweiler Nina Schmitz Boyko Gueorguiev Ivan Zderic Leonard Grünwald Geoff Richards Dirk Wähnert Michael J. Raschke
author_facet	Dominic Gehweiler Nina Schmitz Boyko Gueorguiev Ivan Zderic Leonard Grünwald Geoff Richards Dirk Wähnert Michael J. Raschke
author_sort	Dominic Gehweiler
title	3D geometry of femoral reaming for bone graft harvesting
title_short	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_sort	3d geometry of femoral reaming for bone graft harvesting
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8dfa9319579f4cedb7b1cc033f58d3ce
work_keys_str_mv	AT dominicgehweiler 3dgeometryoffemoralreamingforbonegraftharvesting AT ninaschmitz 3dgeometryoffemoralreamingforbonegraftharvesting AT boykogueorguiev 3dgeometryoffemoralreamingforbonegraftharvesting AT ivanzderic 3dgeometryoffemoralreamingforbonegraftharvesting AT leonardgrunwald 3dgeometryoffemoralreamingforbonegraftharvesting AT geoffrichards 3dgeometryoffemoralreamingforbonegraftharvesting AT dirkwahnert 3dgeometryoffemoralreamingforbonegraftharvesting AT michaeljraschke 3dgeometryoffemoralreamingforbonegraftharvesting
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3D geometry of femoral reaming for bone graft harvesting

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