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Reamer-Irrigator-Aspirator RIA

Objectives. Identify the purposes/uses of the RIA system.Identify the safety aspects of the RIA system, the good and the bad.How to assemble the RIA system.Look at results obtained by the use of the RIA system.. The Original Purpose for the RIA. Originally, the RIA was designed to be a single

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Reamer-Irrigator-Aspirator RIA

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    1. Reamer-Irrigator-Aspirator (RIA) Michelle Whitlow, CST Indiana University Health Surgical Technology Program Clinical Coordinator

    2. Objectives Identify the purposes/uses of the RIA system. Identify the safety aspects of the RIA system, the good and the bad. How to assemble the RIA system. Look at results obtained by the use of the RIA system.

    3. The Original Purpose for the RIA Originally, the RIA was designed to be a single pass Intramedullary Reamer. By providing irrigation and aspiration during the reaming The RIA decreased OR time spent gradually reaming up the desired diameter.

    4. What the RIA came to be Doctors noticed all of the good bone being wasted by going into the suction canister. They found a new way to get Autogenous Cancellous Bone Graft With much less pain than from the Iliac crest, the Gold Standard for bone grafts. And they could obtain more bone graft with the RIA than from the Iliac crest. They also found the RIA to be an excellent way to debride the canal after removing an infected nail.

    5. Safety Concerns for the better The RIAs irrigation cools as it reams therefore minimizing the chance for thermal necrosis. The RIA creates a negative pressure, decreasing the possibility of a Pulmonary fat embolism.

    6. Safety Concerns to watch for The Reamer tip is extremely sharp! When placing the Guide Rod, the surgeon must be sure that it is in the center of the canal. If it is not, the RIA will follow the Guide rod, not the bone canal. The surgeon needs to make sure they do not choose too large of a reamer tip.

    7. RIA Parts Instrument Tray Tissue Protector Guide wire Opening Drill Bit Measuring Device For width of bone canal For length of bone Reamer Shaft T-Handle chuck

    9. Disposable; Single use items Drive Shaft Seal Tube Assembly (2 sizes) 360mm (Tibia) 520mm (Femur) Reamer Heads (sizes 12-19 by .5 sizes) 2.5 Ball Tipped Guide Rod Gravity fed irrigation Irrigation and Aspiration Tubing With a fine meshed filter to capture the bone graft

    11. How to Assemble the RIA Once the appropriate reamer head is selected, attach it to the tube assembly. The reamer head is very sharp. When attached correctly, the reamer head can spin freely while retained by the tube assembly. Insert the correct sized drive shaft to match the size of tube assembly.

    12. Assembly cont. The hexagonal ends of the RIA drive shaft need to mate with the recess in the reamer head. You can do this by visually watching through the aspiration holes of the tube assembly. The drive shaft is properly engaged in the reamer when the retaining groove is hidden. Push the outer sleeve of the drive shaft forward to engage the body of the tube assembly. The tan/gray plastic coupling shaft should no longer be visible.

    13. Attach the drive shaft seal. Attach drive unit to power. Either quick coupling for DHS/DCS or Jacobs Chuck with key. Connect irrigation Be sure the irrigation is clamped off until you are ready to start reaming. Irrigation port is the smaller of the two ports and is indicated by an I.

    14. Connect aspiration Connect the aspiration tube (non-flared end) to the aspiration port which is the larger of the two and indicated by an A. Connect the graft filter to the aspiration port if doing a bone graft.

    15. Supplied by Weber MD (2008)

    16. GRAFT OBTAINED

    17. RESULTS VOLUMES FEMUR AVE = 70cc RANGE = 50 - 110 TIBIA - 4 CASES AVE = 30 RANGE 25 - 40

    18. Special Thanks to Dr. T. Weber and Steve Voivodas

    19. Resources Weber MD, Timothy, Ortho Indy Trauma The Evolution of the Reamer-Irrigator-Aspirator as a Bone Graft Instrument. MSU Grand Rounds, 2008 Nov; 7 Synthes Product Literature; Reamer/Irrigator/Aspirator: Technique Guide. us.Synthes.com/Products/Trauma http://www.ncbi.nlm.nih.gov/pubmed/20035177 J Orthop Trauma. 2010 Jan; 24 http://journals.lww.com/jorthotrauma/Abstract/2010/01000/Use_of_the_Reamer_Irrigator_Aspirator_for_Bone.8.aspx

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