Morbidity Associated With Anterior Iliac Crest Bone Grafting in Foot and Ankle Surgery

2005 ◽  
Vol 26 (2) ◽  
pp. 147-151 ◽  
Author(s):  
James K. DeOrio ◽  
Daniel C. Farber
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Iliac Crest Bone Graft ◽  
Graft Material ◽  
Foot And Ankle ◽  
Postoperative Hematoma ◽  
Graft Harvest ◽  
Ankle Surgery ◽  
Hospital Days

Background: Substitutes for bone graft have been advocated to avoid the potential morbidity associated with harvest of autogenous iliac crest graft. However, no current commercially available graft equals autogenous bone's osteoinductive and osteoconductive qualities. We reviewed our patients' morbidity after harvest of anterior iliac crest bone grafts for procedures involving the foot and ankle. Methods: A computerized analysis of patient records was undertaken to identify all patients who had a harvest of unicortical iliac crest bone graft during a 12-year period. Patients were contacted either by telephone or by mailed questionnaire, inquiring about the postoperative morbidity of the procedure. Medical records were reviewed for any related complications. Results: Of the 169 patients identified, 134 could be contacted. Follow-up ranged from 1 to 13 years. Not all patients answered every question. At latest follow up, 120 (90%)-patients reported no pain at the bone graft site. Eleven patients complained of persistent residual numbness lateral to the harvest site on the pelvis. Of these 120 patients, 32 (27%) reported that pain at the graft site was greater than the pain at the operative site during the initial postoperative period. No patients had extra hospital days as a result of the bone graft harvest. No deep infections occurred, although 12 (6.7%) of 180 patients had a postoperative hematoma or seroma. Overall, 116 (90%) of 129 patients were satisfied or very satisfied with their bone graft harvest. Conclusions: Harvesting of autogenous iliac crest bone graft provides the optimal bone graft material, yields minimal morbidity, and is an acceptable choice in supplementing surgical procedures on the foot and ankle.

scholarly journals Pain and Complications following Bone Marrow Aspirate Concentrate (BMAC) Harvested from the Iliac Crest in Foot and Ankle Surgery

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0014
Author(s):  
Christy M. Christophersen ◽  
Osama Elattar ◽  
Daniel Farber
Keyword(s):  
Bone Marrow ◽  
Patient Satisfaction ◽  
Bone Graft ◽  
Iliac Crest ◽  
Bone Marrow Aspirate ◽  
Foot And Ankle ◽  
Ankle Surgery ◽  
Harvest Site ◽  
Telephone Questionnaire

Category: bone graft in foot and ankle surgery Introduction/Purpose: Autologous bone is recognized as the gold standard for bone grafting in orthopedics with the iliac crest being the common harvest site. In an attempt to minimize morbidity associated with structural bone graft harvest from the iliac crest and still maintain the proposed benefit of collecting and transplanting live cells and growth factors, Bone Marrow Aspirate Concentrate (BMAC) obtained from the iliac crest has become increasingly popular. However, any harvest procedure can potentially induce pain and introduce complications. The purpose of this study was to evaluate the safety and complications of BMAC from the anterior iliac crest for use in various foot and ankle fusion procedures. Methods: A retrospective chart review was performed on all patients that underwent BMAC harvest from the iliac crest at the time of their foot or ankle surgical procedure by one of four fellowship trained surgeons between 2014 and 2017 with a minimum of six-month follow-up. Patients were evaluated for complications, pain, and functional limitation secondary to the BMAC harvest. The final outcome follow-up for the cohort was conducted using a specifically designed telephone questionnaire to assess patient satisfaction. A total of 55 patients were included, with a median age of 58 years (range 31 to 81 years) and 69% were female. Results: Out of the 55 patients, 52 patients (94.5%) reported reported good to excellent results and were satisfied with the procedure at the time the questionnaire was conducted. Only 3 patients reported persistent complications and some element of dissatisfaction with the procedure after 6 months (the minimum follow up), 1 patient reported persistent numbness at the harvest site, and 2 reported some persistent pain at the harvest site lasting up to 6 months. Some patients reported transient complications that eventually resolved with no implication on their satisfaction of the procedure at the time of the telephone questionnaire. Four patients reported hematoma that was treated conservatively and eventually resolved spontaneously. Four patients reported transient numbness at the harvest site with eventual resolution. Immediately post-operatively, 50% of patients reported some element of post-operative pain. However, at the time of the final follow-up (at least 6 months), only 2 patients reported persistent pain at the harvest site lasting up to 6 months, but it was not considered activity-limiting pain. Conclusion: BMAC harvest is a safe procedure with a high rate of patient satisfaction and minimal morbidity with mostly self- limiting complications. This is the first study to evaluate the safety of BMAC as a part of foot and ankle surgical procedures.

Trochanteric Bone Grafts in Foot and Ankle Surgery

1996 ◽  
Vol 17 (7) ◽  
pp. 402-405 ◽  
Author(s):  
W. Richard Hayes ◽  
Ronald W. Smith
Keyword(s):  
Bone Graft ◽  
Delayed Union ◽  
Iliac Bone ◽  
Patient Questionnaire ◽  
Foot And Ankle ◽  
Greater Trochanter ◽  
Graft Harvest ◽  
Iliac Bone Graft ◽  
Ankle Surgery

Eighty-five patients who underwent trochanteric bone graft harvest in association with foot and ankle surgery were studied retrospectively by patient questionnaire. The average follow-up was 49 months (range, 14–101 months). Ninety-five percent of the patients expressed satisfaction with the procedure, in that they would choose to accept the trochanteric bone graft again if required to make the choice. However, 31 % of the patients acknowledged some degree of hip discomfort and 4% reported some daily pain. Nineteen of 85 patients (22%) were treated for trochanteric pain. Most patients responded to strengthening/stretching and heat/ice. Four patients (5%) had failed or delayed union of the arthrodesis in which trochanteric bone graft was utilized. The greater trochanter may be considered as an alternative for major bone graft when the iliac bone is not available and when weightbearing is restricted for at least 6 weeks after surgery. As with the use of iliac bone graft, patients should be alerted to the possibility of postoperative discomfort. Surgical details should be followed to minimize the risk of peritrochanteric fracture.

Local Bone Graft Harvested From the Distal Tibia or Calcaneus for Surgery of the Foot and Ankle

2005 ◽  
Vol 26 (6) ◽  
pp. 449-453 ◽  
Author(s):  
Steven M. Raikin ◽  
Kenneth Brislin
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Distal Tibia ◽  
Autologous Bone Graft ◽  
Operative Procedures ◽  
Iliac Crest Bone Graft ◽  
Foot And Ankle ◽  
Graft Harvest ◽  
Local Bone ◽  
Autologous Bone

Background: Numerous operative procedures around the foot and ankle use bone graft to augment healing. Autologous bone graft remains the preferred type for these procedures. This can be harvested from the iliac crest, but complications are frequent. The purpose of our study was to investigate the option of harvesting the bone graft from the ipsilateral distal tibia or calcaneus. Method: Bone graft was harvested in 114 patients from the distal tibia (70 patients) or calcaneus (44 patients). The patients were followed postoperatively for an average of 16 (range 5 to 28) months and were evaluated for complications (minor and major), satisfaction, and healing rates. Results: There were no major complications. Ten patients (8.7%) had minor complications including initial incisional sensitivity or local numbness, none of which affected function or required additional treatment. Satisfaction rate for the procedure was 100%. Conclusion: Use of autologous bone graft harvested from the ipsilateral distal tibia or calcaneus is a safe and reliable alternative to iliac crest bone graft harvest for operative procedures of the foot and ankle.

Results of an Alternative Autogenous Iliac Crest Bone Graft Harvest Method

Orthopedics ◽  
2006 ◽  
Vol 29 (4) ◽  
pp. 342-346 ◽  
Author(s):  
Stephen C. Brawley ◽  
R. Bruce Simpson
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Iliac Crest Bone Graft ◽  
Graft Harvest ◽  
Harvest Method

A Comparison of Shepard's Osteotome versus Trapdoor Flap Technique to Harvest Iliac Crest Bone for Secondary Alveolar Bone Grafting

2008 ◽  
Vol 45 (4) ◽  
pp. 347-352 ◽  
Author(s):  
J. Constantinides ◽  
P. Chhabra ◽  
P. J. Turner ◽  
B. Richard
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Alveolar Bone ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Iliac Crest Bone Graft ◽  
Open Technique ◽  
Flap Technique ◽  
Graft Harvest ◽  
Alveolar Bone Grafting

Objective: To compare the postoperative donor site morbidity and alveolar bone graft results following two different techniques for iliac crest bone graft harvest: a closed (Shepard's osteotome) and an open (trapdoor flap) technique. Design: A retrospective review of two cohorts of alveolar bone grafts performed from 1998 to 2004 in Birmingham Children's Hospital by two surgeons using different harvest techniques. Medical and nursing anesthetic notes and medication charts were reviewed. Alveolar bone graft results were assessed using preoperative and postoperative radiographic studies. Patients: A total of 137 patients underwent an operation. Of these, 109 patients were compatible with the inclusion criteria (data available, first operation, no multiple comorbidities). Sixty-four patients had iliac bone harvested using the open trapdoor technique, while 45 had the same procedure using the closed osteotomy technique. Results: Maximum bone graft volumes harvested were similar with both techniques. The mean length of hospital stay was 50.9 hours for the osteotome and 75.5 hours for the open technique group (p < .0001). The postoperative analgesia requirement was higher and the postoperative mobilization was delayed and more difficult for the open technique patients (p < .0005). Kindelan scores performed by two independent orthodontists were similar for both techniques. Conclusion: The findings demonstrate that harvesting bone from the iliac crest using an osteotome technique reduces time in hospital, analgesia requirements, and postoperative donor site morbidity with no detrimental outcome.

Trephine Technique for Iliac Crest Bone Graft Harvest

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Robert F. McLain ◽  
Fernando Techy
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Iliac Crest Bone Graft ◽  
Graft Harvest

scholarly journals Structural Bicortical Autologous Iliac Crest Bone Graft Combined with the Tunnel Bone Tamping Method for the Depressed Tibial Plateau Fractures

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhongzheng Wang ◽  
Yanbin Zhu ◽  
Xiangtian Deng ◽  
Xin Xing ◽  
Siyu Tian ◽  
...  
Keyword(s):  
Bone Graft ◽  
Tibial Plateau ◽  
Iliac Crest ◽  
Short Form ◽  
Tibial Plateau Fractures ◽  
Absolute Difference ◽  
Iliac Crest Bone Graft ◽  
Special Surgery ◽  
The Mean

Background. Clinically, autologous iliac crest bone grafts (ICBG) and bone tamping methods are often applied to manage depressed tibial plateau fractures (DTPFs). The purpose of this study was to describe and evaluate the technique of using structural bicortical autologous ICBG combined with the tunnel bone tamping method (TBTM) for treating DTPFs. Methods. All patients with DTPFs who underwent structural bicortical autologous ICBG combined with TBTM from January 2016 to February 2018 were prospectively analysed. Demographics, injury, surgery, postoperative complications, and clinical outcomes were recorded. All patients were followed up for more than 30 months. Postoperative radiography and CT were employed to assess fracture healing and the reduction quality. Results. Forty-three of the included patients completed the follow-up. No malreduction was observed. Based on the immediate postoperative imaging, the intra-articular step-off was significantly reduced (8.19 mm preoperatively vs. 1.30 mm immediate postoperatively, P < 0.001 ). From the immediate operation to the latest follow-up, the reduction was maintained significantly well, with a nonnegligible absolute difference (0.18 mm, P = 0.108 ). A remarkable secondary loss of reduction (intra-articular step   off > 3   mm ) was found in two elderly patients (2/43, 4.65%). The incidence of complications related to the bone-graft donor and bone-graft site was 2.33% and 4.65%, respectively. At the final follow-up, the mean Hospital for Special Surgery (HSS) score of the knee was 98.19 ± 2.89 , and the mean 36-Item Short-Form Health Survey (SF-36) score was 95.65 ± 4.59 . Conclusion. Structural bicortical autologous ICBG combined with TBTM is radiologically effective and stable in terms of complications for the DTPFs.

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