Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty

Ryan M. Porter, Fangjun Liu, Carmencita Pilapil, Oliver B. Betz, Mark S. Vrahas, Mitchel B. Harris, Christopher H Evans

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Intramedullary nailing preceded by canal reaming is the current standard of treatment for long-bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced-pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow-through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71-78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open-pore filter, and the resulting filtrate (230 ± 200 mL) was processed by Ficoll-gradient centrifugation to isolate mononuclear cells (6.2 ± 5.2 × 106 cells/mL). The aqueous supernatant contained FGF-2, IGF-I, and latent TGF-β1, but BMP-2 was below the limit of detection. The cell fraction included culture plastic-adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenehymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost-effective technologies for accelerating the healing of bone and other musculoskeletal tissues.

Original languageEnglish (US)
Pages (from-to)42-49
Number of pages8
JournalJournal of Orthopaedic Research
Volume27
Issue number1
DOIs
StatePublished - Jan 2009
Externally publishedYes

Fingerprint

Arthroplasty
Hip
Hemiarthroplasty
Chondrogenesis
Intramedullary Fracture Fixation
Pressure
Bone and Bones
Ficoll
Temperature
Bone Fractures
Autografts
Suction
Fibroblast Growth Factor 2
Insulin-Like Growth Factor I
Pulmonary Embolism
Centrifugation
Plastics
Limit of Detection
Stem Cells
Cell Culture Techniques

Keywords

  • Bone regeneration
  • Hemiarthroplasty
  • Intramedullary reaming
  • Mesenehymal stem cells
  • Reamer irrigator aspirator

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty. / Porter, Ryan M.; Liu, Fangjun; Pilapil, Carmencita; Betz, Oliver B.; Vrahas, Mark S.; Harris, Mitchel B.; Evans, Christopher H.

In: Journal of Orthopaedic Research, Vol. 27, No. 1, 01.2009, p. 42-49.

Research output: Contribution to journalArticle

Porter, Ryan M. ; Liu, Fangjun ; Pilapil, Carmencita ; Betz, Oliver B. ; Vrahas, Mark S. ; Harris, Mitchel B. ; Evans, Christopher H. / Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty. In: Journal of Orthopaedic Research. 2009 ; Vol. 27, No. 1. pp. 42-49.
@article{12f3397a420f46b78e89e1b416e62fe9,
title = "Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty",
abstract = "Intramedullary nailing preceded by canal reaming is the current standard of treatment for long-bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced-pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow-through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71-78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open-pore filter, and the resulting filtrate (230 ± 200 mL) was processed by Ficoll-gradient centrifugation to isolate mononuclear cells (6.2 ± 5.2 × 106 cells/mL). The aqueous supernatant contained FGF-2, IGF-I, and latent TGF-β1, but BMP-2 was below the limit of detection. The cell fraction included culture plastic-adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenehymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost-effective technologies for accelerating the healing of bone and other musculoskeletal tissues.",
keywords = "Bone regeneration, Hemiarthroplasty, Intramedullary reaming, Mesenehymal stem cells, Reamer irrigator aspirator",
author = "Porter, {Ryan M.} and Fangjun Liu and Carmencita Pilapil and Betz, {Oliver B.} and Vrahas, {Mark S.} and Harris, {Mitchel B.} and Evans, {Christopher H}",
year = "2009",
month = "1",
doi = "10.1002/jor.20715",
language = "English (US)",
volume = "27",
pages = "42--49",
journal = "Journal of Orthopaedic Research",
issn = "0736-0266",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Osteogenic potential of reamer irrigator aspirator (RIA) aspirate collected from patients undergoing hip arthroplasty

AU - Porter, Ryan M.

AU - Liu, Fangjun

AU - Pilapil, Carmencita

AU - Betz, Oliver B.

AU - Vrahas, Mark S.

AU - Harris, Mitchel B.

AU - Evans, Christopher H

PY - 2009/1

Y1 - 2009/1

N2 - Intramedullary nailing preceded by canal reaming is the current standard of treatment for long-bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced-pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow-through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71-78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open-pore filter, and the resulting filtrate (230 ± 200 mL) was processed by Ficoll-gradient centrifugation to isolate mononuclear cells (6.2 ± 5.2 × 106 cells/mL). The aqueous supernatant contained FGF-2, IGF-I, and latent TGF-β1, but BMP-2 was below the limit of detection. The cell fraction included culture plastic-adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenehymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost-effective technologies for accelerating the healing of bone and other musculoskeletal tissues.

AB - Intramedullary nailing preceded by canal reaming is the current standard of treatment for long-bone fractures requiring stabilization. However, conventional reaming methods can elevate intramedullary temperature and pressure, potentially resulting in necrotic bone, systemic embolism, and pulmonary complications. To address this problem, a reamer irrigator aspirator (RIA) has been developed that combines irrigation and suction for reduced-pressure reaming with temperature modulation. Osseous particles aspirated by the RIA can be recovered by filtration for use as an autograft, but the flow-through is typically discarded. The purpose of this study was to assess whether this discarded filtrate has osteogenic properties that could be used to enhance the total repair potential of aspirate. RIA aspirate was collected from five patients (ages 71-78) undergoing hip hemiarthroplasty. Osseous particles were removed using an open-pore filter, and the resulting filtrate (230 ± 200 mL) was processed by Ficoll-gradient centrifugation to isolate mononuclear cells (6.2 ± 5.2 × 106 cells/mL). The aqueous supernatant contained FGF-2, IGF-I, and latent TGF-β1, but BMP-2 was below the limit of detection. The cell fraction included culture plastic-adherent, fibroblastic cells that displayed a surface marker profile indicative of mesenehymal stem cells and that could be induced along the osteogenic, adipogenic, and chondrogenic lineages in vitro. When compared to outgrowth cells from the culture of osseous particles, filtrate cells were more sensitive to seeding density during osteogenic culture but had similar capacity for chondrogenesis. These results suggest using RIA aspirate to develop improved, clinically expeditious, cost-effective technologies for accelerating the healing of bone and other musculoskeletal tissues.

KW - Bone regeneration

KW - Hemiarthroplasty

KW - Intramedullary reaming

KW - Mesenehymal stem cells

KW - Reamer irrigator aspirator

UR - http://www.scopus.com/inward/record.url?scp=58149215820&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149215820&partnerID=8YFLogxK

U2 - 10.1002/jor.20715

DO - 10.1002/jor.20715

M3 - Article

C2 - 18655129

AN - SCOPUS:58149215820

VL - 27

SP - 42

EP - 49

JO - Journal of Orthopaedic Research

JF - Journal of Orthopaedic Research

SN - 0736-0266

IS - 1

ER -