Biomechanical Analysis of Tibial Strength After Harvesting Unicortical Tibial Grafts of Two Different Lengths

Abstract

Though this study cannot be extrapolated directly to the clinical setting, the longer graft tested in this study may raise concerns regarding the strength of the tibia after graft removal.

Donor site morbidity following the harvesting of cortical bone graft from the tibia in children

“…Cortical graft would be preferred in situations where the graft is required to provide some mechanical support. Tibial cortical graft appears to provide sufficient strength for its use in the spine and other locations where it is subjected to compressive and torsional stresses [3][4][5][16][17][18]. Recent reports of the use of cortical bone graft reamed out by an intra-medullary device suggest that morcellised cortical graft could also be used to fill cavities [19].…”

Special Report: Highlights of the Twenty-first Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society, Boston, Massachusetts, July 15–17, 2005

“…Proximal tibial bone graft: In 10 matched pairs of cadaver tibias, a 1.5 by 4.0 cm cortical bone graft was removed from either the tibial crest (wedge shaped graft with minimal cancellous bone) or from 1 cm posteromedial to the tibial crest (flat, uniform cortex with cancellous bone base). 28 Application of an external rotational torque to the axially loaded tibias showed no difference in average torque to failure between the tibias with different graft donor sites. 28 B. Titanium cage: A titanium alloy cage filled with autogenous iliac crest cancellous bone graft was successfully used in a revision distraction subtalar arthrodesis in a 46-year old-patient.…”