Proximal Tibia Fracture after Proximal Tibia Autograft Harvest

Kim, Jin-Kak; Song, Jong-Hyeop; Lee, Kyung-Bum; Cho, Jae-Woo; Moon, Ki-Ho; Yeo, Do-Hyun; Kim, Beomsoo; Oh, Jong‐Keon

doi:10.20408/jti.2017.30.4.247

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Although proximal tibial fracture has been reported in the literature, this is a rare complication, occurring in less than 1% of patients. 11,12,15 In 2 of these cases, the metaphyseal void was not filled after the harvest procedure. 11,12 The necessity of backfilling the harvest site has not been conclusively demonstrated in the literature and has been most thoroughly studied for iliac crest harvest for spine surgery.…”

Section: Discussionmentioning

confidence: 98%

Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis

Lukasiewicz

Bagi

et al. 2021

Foot & Ankle Orthopaedics

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Background: Autogenous cancellous bone graft and bone marrow aspirate are commonly used in lower extremity fusion procedures to enhance fusion potential, and frequently in revision situations where bone loss and osteolysis may be a feature. The tibial metaphysis is a common donor site for bone graft, with the procedure typically performed using a curette or trephine to harvest the cancellous bone. Some limitations of this technique include suboptimal harvest of the marrow portion in particular, incomplete graft harvest, and loss of graft material during the harvest process. We describe a novel vacuum-assisted bone harvesting device to acquire cancellous bone and marrow from the proximal tibia. Methods: This is a retrospective study of a single surgeon’s consecutive patients who underwent foot and ankle arthrodesis procedures using proximal tibia autograft obtained using a vacuum-assisted bone harvesting device. Descriptive statistics were used to summarize patient and operative characteristics and outcomes. We identified 9 patients with a mean age of 51 years, 4 of whom were female. Results: On average, the skin incision was slightly more than 2 cm, and 27 mL of solid graft and 16 mL of liquid phase aspirate were collected. At 6 weeks after the procedure, there was minimal to no pain at the donor site, and we did not observe any fractures or other complications. Conclusions: We report the use of a novel vacuum-assisted curette device to harvest bone graft from the proximal tibial metaphysis for use in foot and ankle fusions. This device has been reliable and efficient in clinical practice. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 98%

Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis

Lukasiewicz

Bagi

et al. 2021

Foot & Ankle Orthopaedics

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“…Fractures at the donor site have been reported as a very rare but serious complication, 10 patients in total, mostly by craniomaxillofacial surgeons and after activities, such as playing tennis, one to six weeks and even three months after the procedure, or a fall from staircase two weeks after the operation [30][31][32]. However, it has been reported without trauma [33]. Fractures of the tibial plateau have been reported twice [33,34], both in the postoperative follow-up and without specific trauma.…”

Section: Bodymentioning

confidence: 99%

“…However, it has been reported without trauma [33]. Fractures of the tibial plateau have been reported twice [33,34], both in the postoperative follow-up and without specific trauma. Also, a plateau fracture has been reported as an intraoperative complication [35].…”

Section: Bodymentioning

confidence: 99%

“…Although protection for six to twelve months has been suggested to prevent fractures of the tibia after graft removal [37], this seems to be about cases, in which large cortical grafts have been harvested from the shaft and this is usually performed only in children. In most cases, immediate weight-bearing after surgery is allowed, but still, some other authors preferred four to six weeks of non-weight-bearing after this procedure as a routine [25,30,31,33]. If the window crosses the midline, protected weight-bearing for six to twelve weeks has been advocated, and as a general, recommendation sharp angels in the window should be avoided to prevent a stress riser [25].…”

Section: Bodymentioning

confidence: 99%

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Bone Grafting Surgery, Proximal Tibia as Donor Site

Khani

Mehrabi

Saied

2021

J. Res. Orthop. Sci.

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Proximal tibia is the second most common site for cancellous bone harvest after iliac crest. It is an excellent bone graft donor site especially when the same limb is undergoing the primary operation. The amount of graft and the quality probably are comparable to that taken from iliac crest and complications are by far less common and less serious. It seems that proximal tibia is a suitable donor site for bone graft harvest and orthopedic surgeons must keep this site in mind when this surgery is necessary.

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“…Temporary paresthesia and/or pain, seromas, and cosmetic defects are minor resolving complications with a rate of 10 to 40%. [1,2]Although complications are generally less common and less morbid with proximal tibia autogenous bone graft harvest, up to 30 cm 3 may be obtained, similar to the iliac crest. [3][4] The proximal tibia has the potential to form new cancellous bone after harvesting up to full consolidation in more than 90% of the cases.…”

Section: Stre Ngths a Nd L I Mi Ta Ti Ons Of Thi S Study Stre Ngths Amentioning

confidence: 99%

Protocol:A Scoping Review of the Biomechanics of the Autogenous Bone Graft Harvest from Proximal Tibia v1

provided¹,

provided²,

Mauck³

et al. 2020

Preprint

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Background: The maxillofacial as well as orthopedic community have known proximal tibia bone as an abundant, reliable, and safe autogenous bone donor for reconstructive purposes. There have been reports of uncommon complications, mostly resolving seromas and hematomas, and rarely bone fractures following such procedures. Objectives: The authors aim to locate, review, and summarize the evidence concerning the biomechanics of the proximal tibial donor site following graft harvestation. Methods and analysis: Our study will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. With the help of a librarian, we will design a search strategy using Boolean features through PubMed, Embase, and Google Scholar using terms like tibia, graft, mechanical, shear, etc, restricted to English language. We will upload the results in EndNote, eliminate the duplicates, and scan the titles for potential inclusion. We will export the chosen titles into Rayyan QCRI website for abstract review and selection of articles for full text review. A summary and a critical appraisal of the extracted evidence will follow. Thestudy protocol is registered in Open Science Framework, https://osf.io/mequ6. Article summary: this study maps and summarizes the available evidence on the biomechanics of donor site following proximal tibial autogenous bone graft harvest. Strengths and limitations of this study The strength of this study relies on its systematic review of the evidence based on gold standard methods and protocol registrations. This study suggests there is need for further investigation into the biomechanics of proximal tibia autogenous bone harvest. This study is a scoping review and harbors the inherent limitations of such studies.

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Proximal Tibia Fracture after Proximal Tibia Autograft Harvest

Abstract: Bone-grafting procedures are common in orthopedic trauma surgeries. There are only few reports on the morbidity after proximal tibia harvesting. Here, we report an experience of complication after proximal tibia harvesting while treating subtrochanteric femoral osteomyelitis.

Cited by 5 publications

References 13 publications

Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis

Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis

Bone Grafting Surgery, Proximal Tibia as Donor Site

Protocol:A Scoping Review of the Biomechanics of the Autogenous Bone Graft Harvest from Proximal Tibia v1

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