More weighted cancellous bone can be harvested from the proximal tibia with less donor site pain than anterior iliac crest corticocancellous bone harvesting: retrospective review

Abstract

Background 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 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. Methods Fifty-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. Results The 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%). Conclusions Harvesting 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.

Knochenaufbau und Knochenersatzmaterialien

“…Die autologe Knochentransplantation gilt als der Goldstandard, ist aber mit einem zusätzlichen Eingriff mit Verlängerung der OP-Zeit und dem Risiko der Entnahmemorbidität sowie mit einem beschränkten verfügbaren Gesamtvolumen verbunden [4].…”

3D-Printing for Critical Sized Bone Defects: Current Concepts and Future Directions

“…The current “gold-standard” bone graft material is autologous autograft, with nearly 500,000 bone grafting procedures performed annually in the United States [ 30 , 31 ]. Autografting involves utilizing bone that is harvested from the host and can be obtained from number of sites including the anterior or posterior iliac crest, intramedullary femoral or tibial canal (reamer irrigator aspirator), distal radius, medial femoral condyle, proximal tibia, or calcaneus [ 32 , 33 , 34 , 35 , 36 ]. Autologous bone has numerous advantages in that it is readily available; has osteoconductive, osteoinductive, and osteogenic properties; and avoids any risk of immunogenicity or disease transmission [ 31 , 37 , 38 , 39 , 40 ].…”

Role of Implantable Drug Delivery Devices with Dual Platform Capabilities in the Prevention and Treatment of Bacterial Osteomyelitis

“…Autologous or allogenic bone grafts are sometimes utilized in the treatment of osteomyelitis, particularly when there is substantial bone loss, whether that is the result of trauma or extensive debridement of compromised bone [ 36 , 50 , 133 , 134 ]. While autologous bone grafts provide excellent osteoinductive, osteogenic, and osteoconductive properties, they require an additional harvest procedure, which is painful and can create donor site morbidity [ 66 , 90 , 135 , 136 , 137 ]. Recently, Kim et al [ 135 ] proposed that the proximal tibia be utilized as a harvest site for cancellous bone, suggesting that this procedure is less painful than the traditional anterior iliac crest harvest site.…”

“…While autologous bone grafts provide excellent osteoinductive, osteogenic, and osteoconductive properties, they require an additional harvest procedure, which is painful and can create donor site morbidity [ 66 , 90 , 135 , 136 , 137 ]. Recently, Kim et al [ 135 ] proposed that the proximal tibia be utilized as a harvest site for cancellous bone, suggesting that this procedure is less painful than the traditional anterior iliac crest harvest site. Owing to challenges in harvest procedures and concerns of patient morbidity when large amounts of bone are required, allogenic bone grafting is sometimes elected instead of autologous grafts [ 66 , 137 , 138 ].…”