What happens if the cancellous fragments are not rinsed out after reaming?
The bone fragments produced during the reaming process act as autografts when left in the femur From a physiological standpoint we leave in place not just growth factors but also living cells, e.g. defence cells that naturally combat infection. This promotes bone growth and increases new synthesis of bone, generally from the proximal to the distal end. From a bio-mechanical standpoint the bone fragments act as guiding structures for new bone formation, providing mechanical bracing and reducing the risk of bone fragmentation in the proximal femur. The fragments also promote direct contact between implant and bone, again accelerating osseointegration.
