Kevin M. Kuhn, Brian T. Barlow and David Dromsky
The Reamer-Irrigator-Aspirator (RIA) is an innovative technology created to address physiologic consequences of intramedullary reaming in femur fractures. While multiple physiolgic benefits have been demonstrated in animal studies, currently, no high quality data to demonstrate improved clinical outcomes in trauma patients or support its routine use in the treatment of acute femur fractures. Auto graft obtained from the use of RIA demonstrates osteogenic potential at least equal to iliac crest auto graft with potentially less donor site morbidity. The RIA also demonstrates theoretical benefits in the treatment of conditions which require intramedullary debridement; however, at this time no high level comparative trials exist to support its routine use. Although new complications unique to the RIA device have been reported, most can be avoided with careful preoperative planning and meticulous attention to technique. The RIA has many promising characteristics, but further research is necessary to continue to clarify its clinical role in modern orthopaedics.