Research progress in reamer-irrigator-aspirator technique in the treatment of bone defects and intramedullary canal infection / 中华创伤杂志

Treatment of large bone defects and nonunion induced by various causes requires bone graft, and autologous iliac bone graft has always been considered as the gold standard for the treatment of bone transplantation. However, there exist problems such as postoperative pain and numbness in the donor area or insufficient bone taking. The application of reamer-irrigator-aspirator（RIA）technique can reduce complications in the donor area and collect a maximum of 90 ml of autologous bone to treat large bone defects. In addition, it can also be used to remove the infected lesion and residual bone cement in the medullary cavity. The authors review the instrument structure, operation process, clinical application and complications of RIA technique, so as to provide a reference in the treatment of bone defects and intramedullary canal infection.

Chemokine Receptors Expression in MSCs: Comparative Analysis in Different Sources and Passages

MSC-based therapy is providing a cure for degenerative diseases with unmet medical need and usually iliac crest bone marrow (ICBM) are being applied in clinics. Alternative sources, including adipose tissue and reamer/irrigator/ aspirator hold great potential for isolating MCSs. Here, we compared original MSCs features of adipose tissue (Ad-MSCs) and bone marrow of long-bone (RIA-MSCs) or iliac crest, and the expression of chemokine receptors (including CXCR4, CX3CR1, CXCR6, CXCR2, CCR1 and CCR7) in these three sources, which are important in the context of homing. We further investigated the role of SDF-1/CXCR4 axis as a key player in motility of different population of MSCs using Transwell migration assay. All cells exhibited typical MSCs characteristics. However, different MSCs sources expressed different levels of chemokine receptors. Generally, the expression of these chemokine receptors was decreased with increasing passage (P) number from 2 to 3. Interestingly, it was observed that the CXCR4 expression and migration capacity in Ad-MSCs is significantly higher than ICBM and RIA-MSCs in P2. Although our data showed that CXCR4 had highest expression in P2 Ad-MSCs, but it dramatically declined following sub-culturing in the P3. Hence, to improve homing of MSCs by means of chemokine/their receptors axis, the source of isolation and passage number should be considered for clinical applications.