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Bone Graft Harvest Using a New Intramedullary System

  • Symposium: Advances in Limb Lengthening and Reconstruction
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Obtaining autogenous bone graft from the iliac crest can entail substantial morbidity. Alternatively, bone graft can be harvested from long bones using an intramedullary (IM) harvesting system. We measured bone graft volume obtained from the IM canals of the femur and tibia and documented the complications of the harvesting technique. Donor site pain and the union rate were compared between the IM and the traditional iliac crest bone graft (ICBG) harvest. Forty-one patients (23 male, 18 female) with an average age of 44.9 years (range, 15–78 years) had graft harvested from long bones using an IM harvest system (femoral donor site, 37 patients; tibial donor site, four patients). Forty patients (23 male, 17 female; average age, 46.4 years; range, 15–77 years) underwent anterior ICBG harvest. We administered patient surveys to both groups to determine pain intensity and frequency. IM group reported lower pain scores than the ICBG group during all postoperative periods. Mean graft volume for the IM harvest group was 40.3 mL (range, 25–75 mL) (graft volume was not obtained for the ICBG group). Using an intramedullary system to harvest autogenous bone graft from the long bones is safe provided a meticulous technique is used.

Level of Evidence: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dror Paley, MD, for the contribution of his cases to this study. We also thank Stacy C. Specht, MPA, for her assistance with statistical analysis, Joy Marlowe, MA, for her graphic expertise, Alvien Lee for his photography and graphic expertise, and Amanda E. Chase, MA, for her editing expertise.

Author information

Authors and Affiliations

  1. SPARSH Hospital, Bangalore, India

    Mohan V. Belthur MD

  2. Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD, 21215, USA

    Janet D. Conway MD & John E. Herzenberg MD

  3. Children’s Healthcare of Atlanta at Scottish Rite, Atlanta, GA, USA

    Gaurav Jindal MD

  4. Shriners Hospitals for Children, Philadelphia, PA, USA

    Ashish Ranade MD

Authors
  1. Mohan V. Belthur MD
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  2. Janet D. Conway MD
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  3. Gaurav Jindal MD
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  4. Ashish Ranade MD
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  5. John E. Herzenberg MD
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Corresponding author

Correspondence to Janet D. Conway MD.

Additional information

One of the authors (JDC) has or will receive funding from Synthes for research relevant to the RIA reamer.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Appendix

Appendix

Appendix 1 RIA/iliac crest questionnaire
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Belthur, M.V., Conway, J.D., Jindal, G. et al. Bone Graft Harvest Using a New Intramedullary System. Clin Orthop Relat Res 466, 2973–2980 (2008). https://doi.org/10.1007/s11999-008-0538-3

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  • DOI: https://doi.org/10.1007/s11999-008-0538-3

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