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Recently, a new harvesting concept was introduced in which a novel aspirator is used first for bone marrow (BM) aspiration and then for subsequent aspiration of morselized endosteal bone during sequential reaming (A\u2009+\u2009R\u2009+\u2009A). In contrast to the established Reamer-Irrigator-Aspirator (RIA) 2 system, the new A\u2009+\u2009R\u2009+\u2009A concept allows for the evacuation of fatty BM prior to reaming. In this study, we hypothesized that the risk of FE, associated coagulopathic reactions and pulmonary FE would be comparable between the RIA 2 system and the A\u2009+\u2009R\u2009+\u2009A concept.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Intramedullary bone graft was harvested from intact femora of 16 Merino sheep (age: 1\u20132\u00a0years) with either the RIA\u00a02 system (n\u2009=\u20098) or the A\u2009+\u2009R\u2009+\u2009A concept (n\u2009=\u20098). Fat intravasation was monitored with the Gurd test, coagulopathic response with D-dimer blood level concentration and pulmonary FE with histological evaluation of the lungs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The total number and average size of intravasated fat particles was similar between groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.13 and <jats:italic>p<\/jats:italic>\u2009=\u20090.98, respectively). D-dimer concentration did not significantly increase within 4\u00a0h after completion of surgery (RIA 2: <jats:italic>p<\/jats:italic>\u2009=\u20090.82; A\u2009+\u2009R\u2009+\u2009A: <jats:italic>p<\/jats:italic>\u2009=\u20090.23), with an interaction effect similar between groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.65). The average lung area covered with fat globules was similar between groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.17).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The use of the RIA 2 system and the novel A\u2009+\u2009R\u2009+\u2009A harvesting concept which consists of BM evacuation followed by sequential IM reaming and aspiration of endosteal bone, resulted in only minor fat intravasation, coagulopathic reactions and pulmonary FE, with no significant differences between the groups. Our results, therefore, suggest that both the RIA 2 system and the new A\u2009+\u2009R\u2009+\u2009A concept are comparable technologies in terms of FE-related complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-024-05220-w","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T16:02:27Z","timestamp":1708185747000},"page":"1535-1546","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["In vivo study to assess fat embolism resulting from the Reamer-Irrigator-Aspirator 2 system compared to a novel aspirator-based concept for intramedullary bone graft harvesting"],"prefix":"10.1007","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3451-1445","authenticated-orcid":false,"given":"Markus","family":"Laubach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agathe","family":"Bessot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siamak","family":"Saifzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia Medeiros","family":"Savi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Bock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar W.","family":"Hutmacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqui","family":"McGovern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"key":"5220_CR1","first-page":"73","volume":"34","author":"M Laubach","year":"2022","unstructured":"Laubach M, Suresh S, Herath B et al (2022) Clinical translation of a patient-specific scaffold-guided bone regeneration concept in four cases with large long bone defects. 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