Abstract
BackgroundIliac crest is the most preferred autogenous bone graft harvesting donor site while it has sorts of complications like prolonged pain, hematoma, and fracture. Harvesting cancellous bone from proximal tibia is also increasingly being used because of lower complications and less donor site pain. However, there are lack of studies to compare these two donor sites in detail. Thus, we proposed to investigate the available amount of autogenous bone graft from the proximal tibia.MethodsFifty-one patients who underwent simultaneous bone graft harvest from the PT and the AIC to fill up the given critical sized bone defects were enrolled in this study. We prospectively collected data including the weight of the harvested bone, donor site pain using the visual analog scale (VAS) score, and complications between the two sites.ResultsThe mean weight of cancellous bone harvested from the PT was greater than AIC (33.2g vs. 27.4g, p = 0.001). The mean VAS score was significantly lesser in the PT up to 60 days after harvesting (p < 0.001). There was persistent pain up to 90 days in four PT patients and in seven AIC patients. The major complication was reported only in AIC patients (11.8%).ConclusionsHarvesting cancellous bone from the PT is an acceptable alternative to the AIC for autogenous bone grafting owing to availability of more weighted graft bone and less donor site pain.
Highlights
Bone grafting has played a vital role in orthopedic surgery owing to its use in treating atrophic nonunion, reconstruction of large bone defect nonunion, and in musculoskeletal infection, trauma, and tumor [1, 2]
The abovementioned options are all widely accepted in orthopedic surgery, autogenous bone grafts remain the gold standard as they exhibit the desirable qualities of osteoinduction, osteoconduction, and osteogenesis with minimal adverse reactions [5, 6]
Autogenous bone can be harvested from various donor sites such as the iliac crest (IC), proximal tibia (PT), distal tibia, distal radius, and the olecranon process [5]
Summary
Bone grafting has played a vital role in orthopedic surgery owing to its use in treating atrophic nonunion, reconstruction of large bone defect nonunion, and in musculoskeletal infection, trauma, and tumor [1, 2]. Autogenous bone can be harvested from various donor sites such as the iliac crest (IC), proximal tibia (PT), distal tibia, distal radius, and the olecranon process [5]. Among these sites, the IC has been regarded as the first priority source and is mostly used in the clinical setting, as it provides easy access to good quality and quantity cancellous autograft [2]. Iliac crest is the most preferred autogenous bone graft harvesting donor site while it has sorts of complications like prolonged pain, hematoma, and fracture. Harvesting cancellous bone from proximal tibia is increasingly being used because of lower complications and less donor site pain. We proposed to investigate the available amount of autogenous bone graft from the proximal tibia
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