Abstract
Background
Chronic osteomyelitis with intramedullary sequestrum resulting in persistent infection is a challenging orthopaedic problem that often involves multiple surgical operations and unfortunately has a significant recurrence rate. Reasons for this may include difficulty in eradicating all intramedullary microsequestra making subsequent prolonged antibiotic therapy less effective. Use of the Reamer-Irrigator-Aspirator (RIA) has many advantages for management of intramedullary infections in chronic osteomyelitis. The RIA technique allows irrigation of sterile large quantities of saline with simultaneous bony debridement with very sharp reamers that are specially designed to allow simultaneous fluid aspiration.
Purpose
We will illustrate the pearls and pitfalls associated with the RIA technique, based on our experience so far.
Method
We retrospectively reviewed a number of 6 (six) patients with chronic osteomyelitis of tibia (n=2) and femur (n=4). In an average follow up of 9.6 months post treatment (range 3–18 months) using a protocol including treatment with RIA we noticed immediate control of infection.
Complications
Include pin tract infection, pin site pain and fungal infection (due to prolonged use of antibiotics).
Conclusion
Based on our patient series so far, the encouraging results we have seen with regard to eradication of infection lead us to believe that RIA has a valuable role to play in the treatment of chronic osteomyelitis.
