J Korean Orthop Assoc.  2013 Oct;48(5):391-396. 10.4055/jkoa.2013.48.5.391.

Autogenous Cancellous Bone Graft Harvested from Proximal Tibia in Foot and Ankle Surgery

• Jung HG
• Lee JG
• Park JT
• Lee SH
• Shin MH

• KMID: 1494152
• DOI: http://doi.org/10.4055/jkoa.2013.48.5.391

Abstract

PURPOSE
The aim of this study was to evaluate clinical availability and advantage of autogenous cancellous bone graft from proximal tibia metaphysis.
MATERIALS AND METHODS
A retrospective review was conducted of 58 cases of foot and ankle surgeries using bone graft from the ipsilateral proximal tibia from August 2008 to March 2012 in Konkuk University Medical Center (Seoul, Korea). The group included patients with isolated reconstructions as well as trauma in the foot and ankle area.
RESULTS
The mean volume of cancellous bone harvested from the proximal tibia was 14 ml (range, 5 to 28 ml) and allograft was added to the autogenous bone graft in order to fill the large bone defect for six cases. The bone graft was performed for 41 arthrodesises, seven supramalleolar tibial osteotomies, eight open reduction and internal fixation procedures, and two curettage and bone grafts of bone tumor. At final follow-up, one case (1.7%) showed mild pain on the donor site and the mean visual analogue scale score for pain was 0.1 (range, 0 to 2). There was no occurrence of major post-operative complication at the donor site. Solid union at final follow-up was observed in 97% of cases.
CONCLUSION
Proximal tibial bone graft was found to be a viable alternative to the iliac crest bone graft in the aspect of cancellous bone graft with relatively sufficient quantity and minimal donor site morbidity.

Keyword

autogenous cancellous bone graft; proximal tibia; foot and ankle surgeries

MeSH Terms

Academic Medical Centers
Ankle*
Arthrodesis
Curettage
Follow-Up Studies
Foot*
Humans
Osteotomy
Retrospective Studies
Tibia*
Tissue Donors
Transplantation, Homologous
Transplants*

Figure

• 

  Figure 1 Photograph shows bone graft harvest from the medial aspect of the proximal tibia. (A) A skin incision was made 3 to 4 cm longitudinally at the medial aspect of the proximal tibia. (B) A rectangular cortical window measuring 3×2 cm in size was made using a micro-sagittal saw. (C) Volume of cancellous bone graft harvested from the proximal tibia was measured in a graded bowl. (D) After gelform implantation at the site of bone harvest, the cortical window was replaced.

• 

  Figure 2 Antero-posterior and lateral radiographs of proximal tibia show bony consolidation of the cortical window. (A) Antero-posterior and lateral radiographs at one month postoperatively. (B) Antero-posterior and lateral radiographs at three months postoperatively.

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