Document Detail

Long-term functional outcome and donor-site morbidity associated with autogenous iliac crest bone grafts utilizing a modified anterior approach.
MedLine Citation:
PMID:  20001937     Owner:  NLM     Status:  MEDLINE    
Prior studies and techniques for harvesting iliac crest bone have shown significant postoperative pain, disability, and poor cosmesis. This retrospective study was conducted to examine bone graft donor-site morbidity by evaluating functional outcomes in patients who have undergone a modified anterior harvesting approach. The medical charts and hospital records of 43 patients were retrospectively reviewed over a 6-year period. Demographic information, operative notes, laboratory results, and the American Society of Anesthesiologists (ASA) classification were recorded. All patients were evaluated retrospectively at a mean 41 months after bone-graft harvesting. Patients available for follow-up were asked to quantify their pain level at the donor-site on a visual analog pain scale (0-10). They also completed SMFA forms, as well as a survey pertaining to sensory deficits, gait disturbances, and cosmetic appearance. Forty-four patients met the inclusion criteria consisting of 25 males and 18 females, mean age 47 years (range, 22 to 80 years). A total of 32 (73%) patients were available for long-term follow-up at a mean of 41.3 months (range, 8 to 83 months). Eight (25%) of these patients reported minimal postoperative pain at time of follow-up. Three of 32 (9%) patients reported minor ambulation difficulty as a result of donor-site pain. Other minor complications included hypertrophic scar formation (7%) and hematoma/seroma (3%). There were no major complications reported, such as deformity at the crest site (0%) or infection (0%). SMFA scores demonstrated a mean dysfunction score of 48.5 (range, 41.8 to 71.1) and a bother index of mean 47.9 (range, 42.6 to 73.9). Utilizing the anterior approach in iliac crest bone harvesting provides an abundant supply of both cortical and cancellous bone, an aesthetically favorable scar, and decreased postoperative donor-site pain. There were very few complications seen in our cohort as compared to previous studies with very good long-term functional outcomes.
Jaspal Ricky Singh; Uzoma Nwosu; Kenneth A Egol
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bulletin of the NYU hospital for joint diseases     Volume:  67     ISSN:  1936-9727     ISO Abbreviation:  Bull NYU Hosp Jt Dis     Publication Date:  2009  
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101300541     Medline TA:  Bull NYU Hosp Jt Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  347-51     Citation Subset:  IM    
Department of Orthopaedic Surgery, The Hospital for Joint Diseases, New York, New York, USA.
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MeSH Terms
Aged, 80 and over
Cicatrix / etiology
Disability Evaluation
Fractures, Ununited / physiopathology,  surgery*
Ilium / transplantation*
Middle Aged
Pain Measurement
Pain, Postoperative / etiology
Patient Satisfaction
Recovery of Function
Retrospective Studies
Time Factors
Tissue and Organ Harvesting / adverse effects*
Transplantation, Autologous
Treatment Outcome
Young Adult

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