Journal of Orthopedics and Joint Surgery

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VOLUME 7 , ISSUE 1 ( January-June, 2025 ) > List of Articles

Surgical Technique

Autologous Proximal Tibia Cancellous Bone Graft Harvesting through a Modified Minimally Invasive Transtendinous Approach

Ganesh R Shetty, Priyan T Pandiyan, Muthusarvanakumar Meignanaguru, Raj G Veeramani

Keywords : Bone grafting, Cancellous bone graft, Proximal tibia

Citation Information : Shetty GR, Pandiyan PT, Meignanaguru M, Veeramani RG. Autologous Proximal Tibia Cancellous Bone Graft Harvesting through a Modified Minimally Invasive Transtendinous Approach. J Orth Joint Surg 2025; 7 (1):49-53.

DOI: 10.5005/jojs-10079-1197

License: CC BY-NC 4.0

Published Online: 15-01-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Aims and background: Conventionally, bone grafting (BG) is done from the iliac crest (IC). It has its complications, such as hematoma formation, persistent pain, and nerve injury. Another site for harvesting bone grafts is the proximal tibia (PT). This site is not widely preferred because of the uncertainty involved in the amount of graft that can be obtained and the associated complications. Anteromedial and anterolateral approaches are classically described in the literature. We present a modified technique of using the infrapatellar approach, splitting the patellar tendon minimally, approaching the PT, and harvesting the bone graft. Materials and methods: We present a case series of 30 cases who underwent PT bone graft harvesting using this technique. The volume of bone graft harvested was measured by packing it in a syringe. Pain was assessed with the visual analog scale in the immediate postoperative period. Long-term pain, paresthesia, infection, incidence of fracture, and other complications were assessed. Results: Thirty patients were followed up for a period of 1 year retrospectively. At the 1-year follow-up, 26 patients were asymptomatic, with a mean visual analog scale score of 1. Two patients had mild pain, and two patients had numbness around the scar at the 1-year follow-up. Conclusion: The volume of bone graft harvested is equivalent to the graft harvested from the anterior IC, both in terms of quality and quantity. Minimal pain was noted on the visual analog scale in the postoperative period. Complications, such as fractures of the PT, which are reported in the anteromedial and anterolateral approaches, were not seen in this approach. Full weight-bearing can be allowed in the immediate postoperative period. To our knowledge, this is the first paper to describe this modified technique, which is simple, easily reproducible, and associated with negligible complications.


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