Harvesting of cancellous bone from the proximal tibia under local anesthesia: donor site morbidity and patient experience

J Oral Maxillofac Surg. 2007 Nov;65(11):2235-41. doi: 10.1016/j.joms.2006.11.038.

Abstract

Purpose: The objective of this retrospective study was to evaluate postoperative morbidity, risk of complications, and patient discomfort after ambulatory tibial bone harvesting procedures under local anesthesia.

Patients and methods: Between 2000 and 2005, bone was harvested from the head of the tibia for internal or external maxillary augmentation in 79 patients. A medial osteoplastic approach to the donor region was used. All patients' records were reviewed. Forty-five of the 79 patients later came in for follow-up examination. A traumatologist examined the donor region both clinically and radiologically. Subjective disorders and experiences of the patients were documented using a standardized questionnaire.

Results: The patient records revealed that 80% did not report significant complaints or gait disturbances after bone harvesting, and only 5% reported postoperative complaints or gait disturbances lasting longer than 2 weeks. In 1 case, a nondisplaced fracture healed without further complications. Clinical and radiologic examinations of 45 patients revealed full regeneration of the donor region in all cases. Some 91% of the patients described the outpatient bone harvesting procedure under local anesthesia as "not distressing" and would undergo such an intervention again if required.

Conclusions: This study demonstrates that both complaints and risk of complications after outpatient bone harvesting from the proximal tibia under local anesthesia can be considered very low, especially as far as outpatient maxillary augmentation (eg, sinus floor elevation) is concerned.

MeSH terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation
  • Ambulatory Surgical Procedures
  • Anesthesia, Local*
  • Attitude to Health
  • Bone Regeneration / physiology
  • Bone Transplantation*
  • Female
  • Follow-Up Studies
  • Gait / physiology
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / etiology
  • Patient Satisfaction
  • Postoperative Complications*
  • Retrospective Studies
  • Tibia / pathology
  • Tibia / surgery*
  • Tibial Fractures / etiology
  • Tissue and Organ Harvesting / adverse effects
  • Tissue and Organ Harvesting / methods*