# Complications of Reamer–Irrigator–Aspirator System in Pediatric Orthopedic Surgery–Case Series and Scoping Review

## TL;DR

This paper examines complications from using a Reamer–Irrigator–Aspirator system in pediatric orthopedic surgeries and finds most issues are minor and temporary.

## Contribution

The study is one of the few to report on RIA complications specifically in pediatric populations.

## Key findings

- All four pediatric cases experienced intraoperative complications, including retained hardware and cortical disruption.
- Complications were classified as stage I and had no long-term effects.
- Literature on pediatric RIA complications is extremely limited.

## Abstract

Background: Reamer–irrigator–aspirators (RIAs) are newer orthopedic devices intended to harvest bone while minimizing complications associated with traditional harvesting techniques. Its high success rate has resulted in relatively few studies on its intraoperative and postoperative complications, especially in pediatric populations. This study provides a scoping review of complications associated with the RIA and presents an institutional case series of RIA complications. Materials and Methods: The scoping review was conducted via modified Joanna Briggs Institute (JBI) guidelines. Cases at a single institution were selected on an individual basis as they occurred during or after RIA-associated surgeries. Results: Our case series consists of three males and one female, ranging from 8 to 14 years old, with varying comorbid orthopedic conditions. All complications occurred intraoperatively, with three instances of retained hardware and one instance of cortical disruption. Each complication was classified as stage I according to the modified Clavien–Dindo–Sink classification system. There were no long-term sequelae despite limited management. A scoping review of the literature revealed extremely limited data on pediatric complications, but several mechanical and clinical complications have been described. Conclusions: Complications associated with RIA use in children appear to be inconsequential, but data are very sparse, and further studies are required.