Anterior Iliac Crest, Posterior Iliac Crest, and Proximal Tibia Donor Sites: A Comparison of Cancellous Bone Volumes in Fresh Cadavers

Reported sites for retrieval of cancellous bone for grafts include the iliac crest, greater trochanter, proximal tibia, and distal tibia. A new lateral technique for retrieval of cancellous bone from the calcaneus is evaluated through anatomic review, quantitative analysis, and retrospective clinical assessment. Of 22 patients managed with this technique over a 2-year period, 17 returned for an evaluation by questionnaire, physical examination, and radiographic follow-up at an average of 7 months after surgery (range, 4–16 months). Complaints/complications were minor: three had minor incisional symptoms, five had medial heel pain (3 caused by plantar fasciitis), and one had unchanged preoperative heel pain secondary to clubfoot deformity. Compared with more extensive bone-grafting procedures, this procedure offers the advantages of bone harvested under local anesthesia using a readily accessible ipsilateral extremity and producing minor complications.

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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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02364-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Hanju Kim ◽

Ajit Kumar Kar ◽

Aditya Kaja ◽

Eic Ju Lim ◽

Wonseok Choi ◽

...

Keyword(s):

Bone Graft ◽

Cancellous Bone ◽

Iliac Crest ◽

Proximal Tibia ◽

Donor Site ◽

Autogenous Bone ◽

Vas Score ◽

Donor Site Pain ◽

The Mean ◽

Site Pain

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.

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