Prospective RCT at three Level I trauma centers randomizing 133 patients with nonunions or posttraumatic segmental bone defects to autograft harvested via RIA versus anterior or posterior iliac crest bone graft — asking whether RIA achieves equivalent union rates with less morbidity.
When a nonunion or bone defect requires substantial autograft volume, RIA from the femoral canal matches iliac crest union rates while cutting donor-site pain and harvest time — choose posterior ICBG only when RIA is unavailable or femoral access is contraindicated, and prefer anterior ICBG only when a small graft volume suffices and cost minimization is the priority.
Prospective RCT at three Level I trauma centers randomizing 133 patients with nonunions or posttraumatic segmental bone defects to autograft harvested via RIA versus anterior or posterior iliac crest bone graft — asking whether RIA achieves equivalent union rates with less morbidity.
When a nonunion or bone defect requires substantial autograft volume, RIA from the femoral canal matches iliac crest union rates while cutting donor-site pain and harvest time — choose posterior ICBG only when RIA is unavailable or femoral access is contraindicated, and prefer anterior ICBG only when a small graft volume suffices and cost minimization is the priority.