Abstract
BackgroundThe anterior iliac crest (AIC) and proximal tibia (PT) are common donor sites for autologous bone graft harvesting. We compared pain levels at these harvest sites on 1 day, 5 days, 2 weeks, 4 weeks, and 8 weeks post-harvest.MethodsWe retrospectively reviewed 18 patients undergoing autologous bone grafting surgery at a level I trauma center between June 2013 and October 2014. Ten grafts were harvested from the AIC group and eight from the PT group. A standard visual analog scale (VAS) was used to rate pain at the harvest sites on postoperative day (POD) 1, 5, 14, 28, and 56 and at the recipient site on POD 1.ResultsThere were no statistically significant differences between both groups in age (p = 0.474), gender (p = 1.00), incidence of harvest site morbidity (p = 1.00), and average VAS at the recipient site on POD 1 (p = 0.471). VAS at the harvest site on POD 1, 5, and 14 confirmed statistically that pain was more severe in the AIC group than in the PT group (p < 0.001). However, no significant difference was observed on POD 28 and 56 between both groups. Pain was significantly less on POD 1 in the PT group at the harvest site than at the recipient site (p < 0.001).ConclusionsThe PT is a suitable harvest site, producing statistically less pain for at least two postoperative weeks than the AIC. Besides, patients report less postoperative pain at the PT harvest site than at the recipient site.
Highlights
The anterior iliac crest (AIC) and proximal tibia (PT) are common donor sites for autologous bone graft harvesting
There was no difference between the incidence of harvest site morbidity in the AIC and PT groups (p = 1.00)
Mauffrey et al conducted a prospective in vivo quantification study that indicated no significant difference in the volumetric amount of cancellous bone available for harvest between the PT site and the AIC site [5]
Summary
The anterior iliac crest (AIC) and proximal tibia (PT) are common donor sites for autologous bone graft harvesting. We compared pain levels at these harvest sites on 1 day, 5 days, 2 weeks, 4 weeks, and 8 weeks post-harvest. Orthopedic surgeons use bone grafts to augment bone healing, perform arthrodesis, treat nonunions, lengthen bones, or fill defects. Autogenous bone is considered as the best origin for bone grafts, with inherent osteogenic, osteoconductive, and osteoinductive properties [1]. The iliac crest is a commonly harvested site for its abundant cortical and cancellous bone. Bone grafting at the donor site may result in more severe pain than that from the original surgical procedure [5]. Many alternatives to graft harvest sites have been described, such as the
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