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.

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Chronic Donor Site Pain Complicating Bone Graft Harvesting From the Posterior Iliac Crest for Spinal Fusion

Spine ◽

10.1097/00007632-199212000-00006 ◽

1992 ◽

Vol 17 (12) ◽

pp. 1474-1480 ◽

Cited By ~ 336

Author(s):

Jeffrey C. Fernyhough ◽

Jeffrey J. Schimandle ◽

Margaret C. Weigel ◽

Charles C. Edwards ◽

Alan M. Levine

Keyword(s):

Bone Graft ◽

Spinal Fusion ◽

Iliac Crest ◽

Donor Site ◽

Posterior Iliac Crest ◽

Donor Site Pain ◽

Bone Graft Harvesting ◽

Site Pain

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Iliac Crest Bone Graft Donor Site Pain After Anterior Lumbar Interbody Fusion

Journal of Spinal Disorders & Techniques ◽

10.1097/01.bsd.0000112045.36255.83 ◽

2005 ◽

Vol 18 (Supplement 1) ◽

pp. S77-S81 ◽

Cited By ~ 268

Author(s):

Rick C Sasso ◽

Jean Charles LeHuec ◽

Christopher Shaffrey

Keyword(s):

Bone Graft ◽

Interbody Fusion ◽

Iliac Crest ◽

Donor Site ◽

Anterior Lumbar Interbody Fusion ◽

Iliac Crest Bone Graft ◽

Lumbar Interbody Fusion ◽

Donor Site Pain ◽

Graft Donor ◽

Site Pain

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SPINE SURGERY;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.02.642 ◽

2013 ◽

Vol 20 (02) ◽

pp. 266-271

Author(s):

ABDUL SATAR ◽

MUHAMMAD INAM ◽

MOHAMMAD ARIF ◽

Mohammad Saeed, ◽

Imran Khan Wazir,

Keyword(s):

Bone Graft ◽

Spine Surgery ◽

Iliac Crest ◽

Donor Site ◽

Deep Infection ◽

Autogenous Bone ◽

Superficial Infection ◽

Graft Harvest ◽

Donor Site Pain ◽

Minimum Age

Objectives: The objective of this study is to find out the complication directly related to iliac bone graft harvest in spinesurgery. Design: Observational prospective study. Setting: Department of Orthopedic and Spine surgery, Hayatabad Medical ComplexPeshawar. Period: January 2007 to April 2012 on 139 patients. Material and method: Only those cases were included in whom bonegrafting was done for fusion as part of their spine surgery and were successfully followed for at least 6 months. Results: Out of 139patients 59(42.4%) were female patients while 80(57.6%) were male. Minimum age of the patients was 4 years while maximum was 70years. In 119(85.6%) patients cortico-cancellous bone graft was taken. While in 20(14.4%) patients, tri-cortical graft was taken. Inmajority 106(76.3%) cases graft was obtained from the posterior iliac crest while in 33(23.7%) it was obtained from the anterior iliaccrest. 45(32.4%) had some pain at the bone graft site. 8(5.8%) had early deep infection while 6(4.3%) had early superficial infection. Nine(6.4%) of our patients had nerve injury evident by parasthesia in the zone of distribution. Conclusions: Iliac crest is an excellent sourceand best available material for autogenous bone grafting. However it is not free of complications. The most common complications arepersistent chronic donor site pain, infection and heamatoma.

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The Incidence of Donor Site Pain After Bone Graft Harvesting From the Posterior Iliac Crest May Be Overestimated

Spine ◽

10.1097/brs.0b013e318107674e ◽

2007 ◽

Vol 32 (17) ◽

pp. 1865-1868 ◽

Cited By ~ 66

Author(s):

Diyar Delawi ◽

Wouter J. A. Dhert ◽

René M. Castelein ◽

Abraham J. Verbout ◽

F Cumhur Oner

Keyword(s):

Bone Graft ◽

Iliac Crest ◽

Donor Site ◽

Posterior Iliac Crest ◽

Donor Site Pain ◽

Bone Graft Harvesting ◽

Site Pain

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Novel, vacuum-assisted method for harvesting autogenous cancellous bone graft and bone marrow from the proximal tibial metaphysis

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00149 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0014

Author(s):

Paul Bagi ◽

Raymond Walls

Keyword(s):

Bone Marrow ◽

Bone Graft ◽

Cancellous Bone ◽

Proximal Tibia ◽

Donor Site ◽

Donor Site Morbidity ◽

Cancellous Bone Graft ◽

Incision Length ◽

Donor Site Pain

Category: Other Introduction/Purpose: Autogenous cancellous bone graft and bone marrow aspirate are commonly used in lower extremity fusion procedures. Autologous graft is considered the gold standard as it is osteogenic, osteoinductive, and osteoconductive, and is without the potential risks of graft-associated infection and immunologic reaction. Disadvantages include graft harvest time and donor site morbidity due to the surgical incision, approach and bone corticotomy. This study evaluated the safety and efficacy of a novel vacuum-assisted bone graft harvesting device which was able to obtain both cancellous bone and bone marrow for insertion into the arthrodesis sites of patients undergoing complex primary and revision lower extremity fusion procedures. Methods: Between March and November 2017, 9 patients had a foot and/or ankle complex primary or revision arthrodesis performed, with autogenous cancellous graft and bone marrow harvested from the ipsilateral proximal tibia. All patients were 18 years or older with no prior history of knee pain, injury, or surgery at the proximal tibia. Following a circular corticotomy, cancellous bone was harvested using a novel suction-powered, hand-driven bone curettage system (Avitus Orthopaedics, Farmington, CT). The donor site was backfilled with bone graft substitute. Incision length was recorded as well as surgical time from donor site incision to completion of graft acquisition. The volume of cancellous graft and bone marrow were separately recorded. All patients were non-weight bearing on the involved extremity for a minimum of 6 weeks post-operatively and all were evaluated at 2 and 6 weeks post-operatively for donor site pain and associated complications. Results: There were five male and four female patients with an average age of 51 years and 8 months. Procedures included six complex primary fusions and three revision subtalar or tibio-talar-calcaneal fusions for nonunion. Mean incision length was 2 cm (range 1.80-2.75 cm). Mean volume of obtained graft material included 25 cm3 of cancellous bone (range 9-30 cm3) and 21 cm3 bone marrow aspirate (range 10-40 cm3). Mean procedure time was 5 mins (range 4-8 mins), and average blood loss was less than 1 mL. Two patients had mild pain at 2 week follow-up; however, no patients reported donor site pain at 6 week follow-up. There were no major or minor complications including fracture, infection, hematoma formation, sensory changes, or wound healing issues. Conclusion: The use of an innovative, vacuum-assisted bone harvesting device allows large volumes of autogenous cancellous bone graft and marrow to be rapidly and readily obtained from the ipsilateral proximal tibia with minimal donor site morbidity.

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